Patients Are Socially Excluded When Their Pain Has No Medical Explanation


      • Observers were less willing to interact with patients with unexplained pain.
      • Observers less often selected patients with unexplained pain to play a game with.
      • Observers attributed less pain to patients with unexplained pain.


      This study investigated whether observers socially exclude patients who experience pain that is not medically explained by means of an experimental design. Fifty-nine participants (individuals from the general population) viewed videos of 4 patients, each accompanied by a vignette describing the presence or absence of a medical explanation for their pain. Participants estimated patient's pain, and rated the sympathy felt for and the inclination to help the patient. To measure social exclusion, participants indicated their willingness to interact with the patients in several situations (Social Distance Scale). Furthermore, the participants were invited to select 2 of the 4 patients as confederates to play a game against another duo. When no medical explanation for the pain was provided, participants attributed less pain, reported feeling less sympathy, and were less inclined to help the patients with daily activities. Of particular importance to this study, participants were less willing to interact with patients with medically unexplained pain and selected less often patients with ‘medically unexplained’ pain than patients with ‘medically explained’ pain as confederates in the social game. These results are indicative of social exclusion of patients with pain for which there is no clear medical explanation.


      Observers socially exclude patients with pain for which there is no clear medical explanation. These findings have important clinical implications. In particular, social exclusion might have detrimental effects on the mental and physical well-being of patients with pain.

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