The journal of pain : official journal of the American Pain Society
-
Recent studies comparing behavior to different sets of facial stimuli have highlighted a need to employ more naturalistic, genuine facial expressions in cognitive research. To address this need, we identified and selected a large set of highly expressive face stimuli from the public domain, and used these stimuli to test whether participants can recognise when others are experiencing pain from their facial behaviour. After identifying 315 expressive faces to represent the kinds of facial behaviours often seen in three distinct contexts (i.e., injury-related, loss-related and victory-related), we ran six behavioural ratings tasks to characterise these faces along six dimensions; level of arousal, emotional valence, level of physical pain, attractiveness, familiarity, and perceived gender. ⋯ PERSPECTIVE: Here we created and validated a large set of visual stimuli, which have been made available to the scientific community. Our results demonstrate that among high-arousal states, expressions related to feelings of intense pain and injury are visually distinct from expressions related to loss or triumph. Thus, the Wild Faces Database - High Arousal States (WFD-HAS) extension provides an important tool for understanding how we recognise injury-related facial expressions in the real world.
-
The National Institutes of Health, U. S. Department of Defense, and U. ⋯ Notably, trialists adopted a narrow definition of diversity that did not take into consideration multiple intersecting identities of trial participants. Based on experiences of the PMC, we provide 14 recommendations on ways to diversify patient samples in clinical pain research. PERSPECTIVE: This article describes challenges posed, and opportunities provided, with pain pragmatic clinical trial designs, emphasizing approaches that optimize the inclusion of social identity groups that have historically been under-represented in pain research.
-
Kratom (Mitragyna speciosa) is increasingly used in the US for self-management of pain, despite limited research on its efficacy and safety. To better understand how and why people use kratom for pain self-management, we analyzed baseline survey data (N = 395) and 15-day ecological momentary assessment (EMA) data (N = 357) from kratom consumers across the US. Although we recruited participants based on their kratom use, not on whether they used it for pain management, nearly half (49.1 %) met criteria for chronic pain, with many reporting substantial pain relief and high effectiveness of kratom in managing pain. ⋯ These findings underscore the urgent need for systematic, rigorous research on long-term implications, efficacy, and safety of kratom in pain management to guide informed clinical practices and regulatory policies. PERSPECTIVE: This study reveals that chronic pain is common among kratom consumers, who frequently use it for pain self-management and report significant relief, as shown by ecological momentary assessment. There is an urgent need for research into kratom's safety, efficacy, and mechanisms to guide clinical practice and inform policies.