• Xianwei Che, Robin Cash, Sungwook Chung, Paul B Fitzgerald, and Bernadette M Fitzgibbon.
• Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred and Central Clinical School, Monash University, Melbourne, Australia. Electronic address: xianwei.che@monash.edu.
• Neurosci Biobehav Rev. 2018 Sep 1; 92: 437-452.

AbstractSocial support is demonstrated to have mixed effects on both pain and related physiological arousal. In this study, a meta-analysis was conducted to characterise these effects. A total of 2416 studies were identified in a systematic search, among which 21 were eligible for the quantitative review. The mere presence of another person was not sufficient to modulate pain perception. However, the presence of a stranger was identified to decrease pain-related arousal (SMD = -0.31), and the presence of a significant other increased facial expression of pain (SMD = 0.21). We further found verbal support to decrease pain (SMD = -0.69) and arousal (SMD = -0.99), and we demonstrated moderate to large analgesic effects of intimate relationships through touching (SMD = -0.95) and viewing (SMD = -0.60) of a romantic partner. Finally, we presented evidence of publication bias for pain-related arousal but not for behavioural pain outcomes. Together, our findings suggest that the impact of social support on pain is context-dependent with the verbal communication of support and intimate relationships being of particular importance.Copyright © 2018 Elsevier Ltd. All rights reserved.

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