People are inaccurate in identifying pain from facial animations when lacking contextual information

Though much research demonstrates lack of universality in human emotion expressions, less is known about variability in pain recognition (Williams, 2003). There is also need for increased understanding regarding cultural and perceptual biases that might impact pain perception, which is of huge importance for medical education and treatment. In this study, participants watched video animations of White, Asian and Black female and male faces expressing highly intensive pain. No contextual information was provided. The results indicate that being South Asian as well as Black increased the odds, whereas low state anxiety and positive deactive affect (excited, enthusiastic, happy) decreased the odds of correctly identifying pain from Black female faces. Also, higher generalized anxiety, lower negative deactive affect (sad, disappointed, bored), lower conscientiousness and lower emotional instability (Big-5) increased the odds of correctly identifying pain from Black male faces. Bayesian Belief Networks indicated that participants had generally higher probability of identifying anger and disgust rather than pain on White female and male animations, with the probability highest to identify disgust instead of pain on Asian female and male animations. Overall, our findings suggest the importance of considering cultural and contextual factors that interfere with pain recognition, which would be particularly poignant for training medical students and educators.