The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
The structure, reliability and validity of pain expression: Evidence from patients with shoulder pain
Abstract
The present study examined psychometric properties of facial expressions of pain. A diverse sample of 129 people suffering from shoulder pain underwent a battery of active and passive range-of-motion tests to their affected and unaffected limbs. The same tests were repeated on a second occasion. Participants rated the maximum pain induced by each test on three self-report scales. Facial actions were measured with the Facial Action Coding System. Several facial actions discriminated painful from non-painful movements; however, brow-lowering, orbit tightening, levator contraction and eye closing appeared to constitute a distinct, unitary action. An index of pain expression based on these actions demonstrated test-retest reliability and concurrent validity with self-reports of pain. The findings support the concept of a core pain expression with desirable psychometric properties. They are also consistent with the suggestion of individual differences in pain expressiveness. Reasons for varying reports of relations between pain expression and self-reports in previous studies are discussed.
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Williams, A. C. D. C. (1995) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)90016-0 · Cited by 1,472
Lewis, M. D., Haviland-Jones, J. M., & Barrett, L. F. (2000) · Cited by 1,304
Keefe, F. J., Lefebvre, J. C., Egert, J. R., Affleck, G., Sullivan, M. J., & Caldwell, D. S. (2000) · Pain · doi:10.1016/s0304-3959(00)00296-7 · Cited by 735
Facial expression of pain: An evolutionary account
Williams, A. C. D. C. (2002) · Behavioral and Brain Sciences · doi:10.1017/s0140525x02000080 · Cited by 612
Keltner, D. J., Ekman, P., Gonzaga, G. C., & Beer, J. S. (2002) · doi:10.1093/oso/9780195126013.003.0022 · Cited by 555
The consistency of facial expressions of pain: a comparison across modalities
Prkachin, K. M. (1992) · Pain · doi:10.1016/0304-3959(92)90213-u · Cited by 553
Self-citationThe facial expression of pain in patients with dementia
Miriam Kunz, A., Scharmann, S., Hemmeter, U., Schepelmann, K., & Lautenbacher, S. (2007) · Pain · doi:10.1016/j.pain.2007.09.007 · Cited by 290
Gender Differences in Pain and Pain Behavior: The Role of Catastrophizing
Sullivan, M. J. L., Tripp, D. A., & Santor, D. (2000) · Cognitive Therapy and Research · doi:10.1023/a:1005459110063 · Cited by 285
Handbook of pain assessment, 2nd ed.
Turk, D. C., & Melzack, R. (2001) · Cited by 259
The facial expression of pain.
Craig, K. D., Prkachin, K. M., & GRUNAU, R. E. (2001) · Cited by 259
Self-citationExpressing pain: The communication and interpretation of facial pain signals
Prkachin, K. M., & Craig, K. D. (1995) · Journal of Nonverbal Behavior · doi:10.1007/bf02173080 · Cited by 208
Self-citationGenuine, suppressed and faked facial behavior during exacerbation of chronic low back pain
Craig, K. D., Hyde, S. A., & Patrick, C. J. (1991) · Pain · doi:10.1016/0304-3959(91)90071-5 · Cited by 192
Facial expression during induced pain.
Craig, K. D., & Patrick, C. J. (1985) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.48.4.1089 · Cited by 161
Brain responses to dynamic facial expressions of pain
Simón, D., Craig, K. D., Miltner, W. H. R., & Rainville, P. (2006) · Pain · doi:10.1016/j.pain.2006.08.033 · Cited by 155
Measuring Movement-Exacerbated Pain in Cognitively Impaired Frail Elders
Hadjistavropoulos, T., LaChapelle, D. L., MacLeod, F. K., Snider, B. S., & Craig, K. D. (2000) · Clinical Journal of Pain · doi:10.1097/00002508-200003000-00009 · Cited by 153
Prkachin, K. M., & Mercer, S. R. (1989) · Pain · doi:10.1016/0304-3959(89)90038-9 · Cited by 131
Self-citationHadjistavropoulos, T., & Craig, K. D. (2004) · Psychology Press eBooks · doi:10.4324/9781410609861 · Cited by 130
Prkachin, K. M., Solomon, P. E., & Ross, J. M. (2007) · PubMed · Cited by 127
Self-citationEncoding and decoding of pain expressions: a judgement study
Prkachin, K. M., Berzins, S. A., & Mercer, S. R. (1994) · Pain · doi:10.1016/0304-3959(94)90206-2 · Cited by 127
Self-citationA validation model for verbal descriptor scaling of human clinical pain
Heft, M. W., Gracely, R. H., Dubner, R. A., & McGrath, P. A. (1980) · Pain · doi:10.1016/0304-3959(80)90050-0 · Cited by 127
On the relationship between self-report and facial expression of pain
Miriam Kunz, A., Mylius, V., Schepelmann, K., & Lautenbacher, S. (2004) · Journal of Pain · doi:10.1016/j.jpain.2004.06.002 · Cited by 111
Observer judgments of acute pain: Facial action determinants.
Patrick, C. J., Craig, K. D., & Prkachin, K. M. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.50.6.1291 · Cited by 89
Self-citationFacial expression in pain: A study of candid photographs
LeResche, L. (1982) · Journal of Nonverbal Behavior · doi:10.1007/bf01001777 · Cited by 87
Sex Differences in Facial Encoding of Pain
Miriam Kunz, A., Gruber, A., & Lautenbacher, S. (2006) · Journal of Pain · doi:10.1016/j.jpain.2006.04.012 · Cited by 80
Using facial expressions to assess musculoskeletal pain in older persons
Hadjistavropoulos, T., LaChapelle, D. L., Hadjistavropoulos, H. D., Green, S., & Asmundson, G. J. G. (2002) · European Journal of Pain · doi:10.1053/eujp.2001.0327 · Cited by 78
Observer judgments of acute pain: Facial action determinants.
Patrick, C. J., Craig, K. D., & Prkachin, K. M. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.50.6.1291 · Cited by 73
Self-citationPrkachin, K. M., Schultz, I. Z., Berkowitz, J., Hughes, E., & Hunt, D. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00075-4 · Cited by 68
Self-citationReal-time assessment of pain behavior during clinical assessment of low back pain patients
Prkachin, K. M., Hughes, E., Schultz, I. Z., Joy, P. W., & Hunt, D. G. (2002) · Pain · doi:10.1016/s0304-3959(01)00369-4 · Cited by 60
Self-citationHale, C., & Hadjistavropoulos, T. (1997) · Pain Research and Management · doi:10.1155/1997/283582 · Cited by 60
Social Influences and the Communication of Pain
Hadjistavropoulos, T., Craig, K. D., & Fuchs-Lacelle, S. (2004) · doi:10.4324/9781410609861-12 · Cited by 50
Cognitive Functioning and Pain Reactions in Hospitalized Elders
Hadjistvropoulos, T., LaChapelle, D. L., MacLeod, F. K., Hale, C., O’Rourke, N., & Craig, K. D. (1998) · Pain Research and Management · doi:10.1155/1998/621580 · Cited by 49
(1993)
Research works printed but not linked: 2
- Hadjistavropoulos, 1997, Toward a research outcome measure of pain in frail elderly in chronic care., Pain Clinic, 10, 71
- Prkachin, 2007, The underestimation of pain among health-care providers., Can J Nurs Res, 39, 88
Cited by
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Painful data: The UNBC-McMaster shoulder pain expression archive database
Lucey, P., Cohn, J. F., Prkachin, K. M., Solomon, P. E., & Matthews, I. (2011) · International Conference on Automatic Face and Gesture Recognition · doi:10.1109/fg.2011.5771462 · Cited by 634
Self-citationCorneanu, C. A., Simon, M. O., Cohn, J. F., & Guerrero, S. E. (2016) · IEEE Transactions on Pattern Analysis and Machine Intelligence · doi:10.1109/tpami.2016.2515606 · Cited by 527
The painful face – Pain expression recognition using active appearance models
Ashraf, A. B., Lucey, S., Cohn, J. F., Chen, T., Ambadar, Z., Prkachin, K. M., & Solomon, P. E. (2009) · Image and Vision Computing · doi:10.1016/j.imavis.2009.05.007 · Cited by 355
Self-citationPain assessment in elderly adults with dementia
Hadjistavropoulos, T., Herr, K., Prkachin, K. M., Craig, K. D., Gibson, S. J., Lukas, A., & Smith, J. H. (2014) · The Lancet Neurology · doi:10.1016/s1474-4422(14)70103-6 · Cited by 344
Self-citationGender Biases in Estimation of Others’ Pain
Zhang, L., Losin, E. A. R., Ashar, Y. K., Koban, L., & Wager, T. D. (2021) · Journal of Pain · doi:10.1016/j.jpain.2021.03.001 · Cited by 315
Metadata
- Authors
- Prkachin, K. M., & Solomon, P. E.
- Affiliations
- University of Northern British Columbia (CA)
- McMaster University (CA)
- Corresponding author
- Prkachin, Kenneth M.
- ORCID
- Solomon, Patricia E.
- Venue
- Pain
- Published
- 2008-10-15
- Volume
- 139
- Issue
- 2
- Pages
- 267-274
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2106043670
- Cited by
- 472
- References
- 31
- Citations by year
- 2026: 29 · 2025: 27 · 2024: 39 · 2023: 27 · 2022: 29 · 2021: 44 · 2020: 40 · 2019: 37 · 2018: 41 · 2017: 21 · 2016: 33 · 2015: 32 · 2014: 24 · 2013: 16 · 2012: 7
- FWCI
- 4.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Keywords
- pain expression, facial expressions of pain, shoulder pain, facial action units, facial action coding system, test-retest reliability, concurrent validity, self-reported pain, range of motion
- MeSH terms
- Facial Expression, Female, Humans, Male, Middle Aged, Pain Measurement, Psychometrics, Sensitivity and Specificity, Reproducibility of Results, Expressed Emotion, Evidence-Based Medicine, Shoulder Pain
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