J Pain. 2023 Nov 18:S1526-5900(23)00623-5. doi: 10.1016/j.jpain.2023.11.011. Online ahead of print.

ABSTRACT

Pain invalidation involves the dismissal or lack of understanding of another’s pain, undermining their subjective experience. Frequent exposure to invalidation negatively impacts mental and physical health as well as pain-related behaviors, potentially leading people to conceal their pain from others in the future and/or withdrawing from potential sources of support. It is therefore possible that experiencing pain invalidation may also impact pain-reporting behavior in clinical settings. Across two separate samples of emerging adults, we examined whether exposure to invalidation of one’s pain was associated with cognizant modulation of one’s subjective acute pain ratings within routine medical and dental settings. Drawing upon social psychological theories of impression management and self-presentation, we hypothesized that exposure to pain invalidation would be associated with under-rating of one’s pain. In Study 1, previous experiences of invalidation were associated with under-rating of one’s pain when visiting the doctor and the dentist. Study 2 found that invalidation from family and medical professionals – but not from friends – was associated with under-rating pain in both settings. Findings provide further evidence for the harmful effects of pain invalidation, particularly for emerging adults, as dismissal of one’s subjective experience may sow self-doubt while reinforcing cultural stigmas against pain, leading to alterations is pain communication that ultimately create barriers to efficacious clinical treatment and care and increase pain-related suffering. PERSPECTIVE: Pain invalidation imparts harm to those who already suffer from pain, be it mentally, physically, and/or behaviorally. We show that people who have encountered invalidation are more likely to under-rate their pain when seeking care, impeding assessment and treatment, and further highlighting the importance of clinical validation of pain experiences.

PMID:37984509 | DOI:10.1016/j.jpain.2023.11.011