Individual- and situation-dependent variations in facial expressions of pain and their impact on decoding processes

• Applicant: Professorin Dr. Miriam Kunz
• Subject Area: General, Cognitive and Mathematical Psychology
• Term: from 2009 to 2015
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 139879491

The goals of the first funding period have all been successfully achieved. One of the central finding of the first study was that we could show that there is no uniform set of facial actions but instead there are at least four different facial activity patterns occurring during pain that are composed of different configurations of facial actions and that stably occur across situations as well as across different samples. In the second study we could demonstrate that training observers to recognize these different faces of pain clearly improved the detection of pain. Those being trained to recognize the different facial expression patterns showed a significantly better decoding performance compared to those being trained to recognize the so called prototypical expression of pain. These findings clearly suggest that the assumption of one prototypical facial expression of pain is unjustifiable and that raising awareness in observers about these distinct facial activity patterns through a brief training procedure can improve recognition accuracy for pain substantially.Given these very promising findings, the next step will be to test the clinical relevance of our developed training procedure. The accurate recognition of facial pain displays is especially crucial when caring for patients with dementia because these patients are often no longer able to express their pain verbally and thus, their facial expression might often be the only indicator of whether they are suffering from pain. However, the ability of health care professionals to accurately recognize facial expressions of pain has been shown to be quite erroneous, leading to under-recognition and under-treatment of pain in dementia. The aim of the proposed study is to test whether our brief training procedure (on the distinct facial activity patterns of pain) will prove to be of clinical relevance by helping health care professionals (caring for patients with dementia) to better detect pain in patients with dementia? To do this, nurses working with demented patients will be trained to recognize the different facial activity patterns of pain with the developed training procedure of the first funding period. Besides video recordings of facial expressions of healthy individuals in response to experimental pain (these were used in the first funding period), we will now also include video recordings of facial expressions of patients with dementia in response to clinical pain; to ensure that our developed training procedure also leads to better decoding performance for the targeted patient group. Furthermore, we want to test whether the training leads to long-lasting improvement in decoding accuracy of facial pain displays and thus, we will include a one-month follow up testing session.

• DFG Programme: Research Grants