• Caroline Blais, Daniel Fiset, Hana Furumoto-Deshaies, Miriam Kunz, Dominik Seuss, and Stéphanie Cormier.
• Department of Psychoeducation and Psychology, University of Québec in Outaouais, Canada. Electronic address: caroline.blais@uqo.ca.
• J Pain. 2019 Jun 1; 20 (6): 728-738.

AbstractPrevious research has revealed that the face is a finely tuned medium for pain communication. Studies assessing the decoding of facial expressions of pain have revealed an interesting discrepancy, namely that, despite eyes narrowing being the most frequent facial expression accompanying pain, individuals mostly rely on brow lowering and nose wrinkling/upper lip raising to evaluate pain. The present study verifies if this discrepancy may reflect an interaction between the features coding pain expressions and the features used by observers and stored in their mental representations. Experiment 1 shows that more weight is allocated to the brow lowering and nose wrinkling/upper lip raising, supporting the idea that these features are allocated more importance when mental representations of pain expressions are stored in memory. These 2 features have been associated with negative valence and with the affective dimension of pain, whereas the eyes narrowing feature has been associated more closely with the sensory dimension of pain. However, experiment 2 shows that these 2 features remain more salient than eyes narrowing, even when attention is specifically directed toward the sensory dimension of pain. Together, these results suggest that the features most saliently coded in the mental representation of facial expressions of pain may reflect a bias toward allocating more weight to the affective information encoded in the face. PERSPECTIVE: This work reveals the relative importance of 3 facial features representing the core of pain expressions during pain decoding. The results show that 2 features are over-represented; this finding may potentially be linked with the estimation biases occurring when clinicians and lay persons evaluate pain based on facial appearance.Copyright © 2019 the American Pain Society. Published by Elsevier Inc. All rights reserved.

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