• A D Green, D A Tripp, M J L Sullivan, and M Davidson.
• Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada. amanda.green@dal.ca
• Pain Med. 2009 Mar 1;10(2):381-92.

ObjectiveRecent research suggests that higher scores on measures of empathy correlate with a stronger response to observed pain, as well as higher estimates of pain intensity. Little work to date has examined the impact of empathy on evaluations of different levels of expressed pain, or how empathy may alter the accuracy of interpreting these painful facial expressions. This study examines the role of empathy in rating the intensity of facial expressions of pain, and the accuracy of these ratings relative to self-reported pain. The potential mediating role of available pain cues or the moderating role of gender on this relationship are also examined.MethodsUndergraduate participants (observers, N = 130) were shown video clips of facial expressions of individuals from a cold presser pain task (senders), and then asked to estimate that pain experience. This estimate was compared with the video sender's actual pain ratings.ResultsHigher empathy was associated with an overall increase in estimates of senders' pain, which was not mediated by video subject or participant gender or the duration of painful facial expressions. Further analyses revealed that high empathy was associated with greater accuracy in inferring pain on only one of three inferential accuracy indices.ConclusionsWhile observers with greater empathy may infer greater pain in senders, resulting in a smaller underestimation bias overall, they are not necessarily more accurate in estimating pain on any given stimuli. The importance of these potential differences in perceived pain for clinical assessment and interpersonal relationships are discussed.

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