Kenneth M Prkachin

University of Northern British Columbia · Department of Psychology

Despite growing evidence that psychopathy entails reduced emotional processing, the relationship between psychopathic traits and third-person pain perception is poorly understood. This study directly examined perception of others' pain in a sample of male and female students (N = 105) who completed the Self-Report Psychopathy scale (SRP-III) and th...

[This corrects the article DOI: 10.3389/fpain.2021.788606.].

Pain is often characterized as a fundamentally subjective phenomenon; however, all pain assessment reduces the experience to observables, with strengths and limitations. Most evidence about pain derives from observations of pain-related behavior. There has been considerable progress in articulating the properties of behavioral indices of pain; espe...

Although pain is frequent in old age, older adults are often undertreated for pain. This is especially the case for long-term care residents with moderate to severe dementia who cannot report their pain because of cognitive impairments that accompany dementia. Nursing staff acknowledge the challenges of effectively recognizing and managing pain in...

Although pain is frequent in old age, older adults are often undertreated for pain. This is especially the case for long-term care residents with moderate to severe dementia who cannot report their pain because of cognitive impairments that accompany dementia. Nursing staff acknowledge the challenges of effectively recognizing and managing pain in...

Background Facial activity during pain is composed of varying combinations of a few elementary facial responses (so‐called Action Units). A previous study of experimental pain showed that these varying combinations can be clustered into distinct facial activity patterns of pain. In the present study, we examined whether comparable facial activity p...

Introduction Technological advances have allowed for the estimation of physiological indicators from video data. FaceReader™ is an automated facial analysis software that has been used widely in studies of facial expressions of emotion and was recently updated to allow for the estimation of heart rate (HR) using remote photoplethysmography (rPPG)....

Facial expressions of pain are important in assessing individuals with dementia and severe communicative limitations. Though frontal views of the face are assumed to allow for the most valid and reliable observational assessments, the impact of viewing angle is unknown. We video-recorded older adults with and without dementia using cameras capturin...

Accurate facial expression analysis is an essential step in various clinical applications that involve physical and mental health assessments of older adults (e.g. diagnosis of pain or depression). Although remarkable progress has been achieved toward developing robust facial landmark detection methods, state-of-the-art methods still face many chal...

The need for automated facial expression analysis arises in various clinical settings involving mental and physical health assessment of older adults. However, the effect of age (young vs. old) and ability (healthy vs. physical or cognitive impairment) on the performance of available methods has not yet been investigated. In this work, we demonstra...

Background This article presents the results of a parallel‐group, non‐randomized, controlled study that evaluated the feasibility of an online training program for improving observer detection of facial pain expression. Method Fifty‐four undergraduate students attended two laboratory sessions interspersed by an intervention period where they were...

This groundbreaking analysis moves our knowledge of pain and its effects from the biomedical model to one accounting for its complex psychosocial dimensions. Starting with its facial and physical display, pain is shown in its manifold social contexts—in the lifespan, in a family unit, expressed by a member of a gender and/or race—and as observed by...

The goal of this volume has been to bring together “state-of-the-science” narrative reviews of major directions in the study of social and interpersonal dimensions of pain. This final chapter takes a broad overview of the feld, placing the individual contributions in context. It begins with a historical overview, situating the !eld of social/interp...

The extent to which affective empathy is impaired in Autism Spectrum Disorder (ASD) remains unclear, as some ‐but not all ‐ previous neuroimaging studies investigating empathy for pain in ASD have shown similar levels to those of neurotypicals individuals. These inconsistent results could be due to the use of different empathy‐eliciting stimuli. Wh...

Third-person pain refers to the components and processes engaged when an observer is confronted by another person in pain. The literature that has arisen around this topic has approached it from diverse perspectives, including behavioral theory, social perception, affective science, psychophysiology, social neuroscience, evolutionary psychology, an...

Background: Fine-grained observational approaches to pain assessment (e.g. the Facial Action Coding System; FACS) are used to evaluate pain in individuals with and without dementia. These approaches are difficult to utilize in clinical settings as they require specialized training and equipment. Easy-to-use observational approaches (e.g. the Pain...

Difficulties in emotion perception are commonly observed in autism spectrum disorder. However, it is unclear whether these difficulties can be attributed to a general problem of relating to emotional states, or whether they specifically concern the perception of others' expressions. This study addressed this question in the context of pain, a senso...

Aim: To determine if differences exist between pediatric intensive care nurses and allied health professionals in empathy, secondary trauma, burnout, pain exposure and pain ratings of self and others. Early and late career differences were also examined. Background: Nurses are routinely exposed to patient pain expression. This work context may m...

Aims: To determine if there are brain activity differences between pediatric intensive care nurses and allied health professionals during pain intensity rating tasks and test whether these differences are related to the population observed (infant or adult) and professional experience. Background: The underestimation of patients' pain by healthc...

Repeated exposure to others in pain has been shown to bias vicarious pain perception, but the neural correlates of this effect are currently not known. The current study therefore aimed at measuring electrocortical responses to facial expressions of pain following exposure to expressions of pain. To this end, a between-subject design was adopted. P...

Estimates of patients' pain, and judgments of their pain expression, are affected by characteristics of the observer and of the patient. In this study, we investigated the impact of high or low trustworthiness, a rapid and automatic decision made about another, and of gender and depression history on judgments made by pain clinicians and by medical...

Background: Pain perception in others can be influenced by different contextual factors. In clinical settings, the repeated exposure to others' pain has been proposed as a factor that could explain underestimation of patients' pain by health care providers. Previous research supported this idea by showing that repeated exposure to persons in pain...

Estimates of patients' pain, and judgments of their pain expression, are affected by characteristics of the observer and of the patient. In this study, we investigated the impact of high or low trustworthiness, a rapid and automatic decision made about another, and of gender and depression history on judgments made by pain clinicians and by medical...

First-person pain (the subjective sensory and affective experiences that we associate with tissue damage) motivates changes in the sufferer’s behavior that communicate the experience to others. The ability to infer features of another person’s pain by observing a sufferer’s behavior can be characterized as third-person pain. This chapter reviews re...

Functional neuroimaging investigations of pain have discovered a reliable pattern of activation within limbic regions of a putative "pain matrix" that has been theorized to reflect the affective dimension of pain. To test this theory, we evaluated the experience of pain in a rare neurological patient with extensive bilateral lesions encompassing co...

Chronic pain is highly prevalent in the ageing population. Individuals with neurological disorders such as dementia are susceptible patient groups in which pain is frequently under-recognised, underestimated, and undertreated. Results from neurophysiological and neuroimaging studies showing that elderly adults are particularly susceptible to the ne...

Nonverbal communication, such as facial expression, is an important component of the communication of pain to an observer. One factor that influences pain perception by an observer is characteristics specific to the observer themselves (ie, ‘top-down’ characteristics). The authors of this article aimed to assess how anxiety in the observer affects...

Studies of nonverbal behavior indicate that substantial information about personal characteristics can be found in “thin slices” – very limited samples of the behavioral stream. This concept can also be applied to samples of verbal behavior. We examined the influence of psychopathy and alexithymia characteristics in thin slices of emotional verbal...

Perceiving others in pain generally leads to empathic concern, consisting of both emotional and cognitive processes. Empathy deficits have been considered as an element contributing to social difficulties in individuals with autism spectrum disorders (ASD). Here, we used functional magnetic resonance imaging and short video clips of facial expressi...

Schizophrenia patients display impaired recognition of their own emotions and those of others and deficits in several domains of empathy. The first-person experience of pain and observing others in pain normally trigger strong emotional mechanisms. We therefore hypothesized that schizophrenia patients would display impaired recognition and categori...

Low back pain (LBP), a leading cause of disability, has been linked with profound economic, personal, and social costs (Hills 2006; World Health Organization 2003). This significant effect propels research in identifying modifiable risk factors that protract LBP; these factors can be targeted in early intervention (EI) (Pransky, Journal of Occupati...

Exploratory behaviors of rats with lesions of the visual cortex or superior colliculus (SC) were examined using a traditional open field and a smaller closed field. Animals with large bilateral lesions of the SC or lesions restricted to the deep laminae of the SC exhibited excessive locomotor activity in both experimental situations. The degree of...

The present study investigated the role of observer pain catastrophizing and personal pain experience as possible moderators of attention to varying levels of facial pain expression in others. Eye movements were recorded as a direct and continuous index of attention allocation in a sample of 35 undergraduate students while viewing slides presenting...

Studies of facial responses during experimental and clinical pain have revealed a surprising phenomenon, namely, that a considerable number of individuals respond with a smile. So far, it is not known why smiling occurs during pain. It is possible that the "smile of pain" is socially motivated (e.g., reinforcing social bonds while undergoing an unp...

Background: The induction of one particular emotion - sadness - has shown two different profiles of autonomic nervous system (ANS) response that are characterized by activation, or withdrawal in cardiac parasympathetic activation. We tested whether individual differences in emotion expression predict cardiac vagal reactivity from baseline to autob...

Unlabelled: The present studies investigated the impact of medical and psychosocial information on the observer's estimations of pain, emotional responses, and behavioral tendencies toward another person in pain. Participants were recruited from the community (study 1: N = 39 women, 10 men; study 2: N = 41 women, 12 men) and viewed videos of 4 pat...

<⁄span> Evidence of inadequate pain treatment as a result of patient race has been extensively documented, yet remains poorly understood. Previous research has indicated that nonwhite patients are significantly more likely to be undertreated for pain. <⁄span> To determine whether previous findings of racial biases in pain treatment recommendations...

In intensive care units in hospitals, it has been recently shown that enormous improvements in patient outcomes can be gained from the medical staff periodically monitoring patient pain levels. However, due to the burden/stress that the staff are already under, this type of monitoring has been difficult to sustain so an automatic solution could be...

Background: Theory and research have shown that gratitude interventions have positive outcomes on measures of well-being. Gratitude listing, behavioral expressions, and grateful contemplation are methods of inducing gratitude. While research has examined gratitude listing and behavioral expressions, no study has tested the long-term effects of a gr...

Despite a general decline, early-age motherhood continues to manifest disproportionately among young women living in rural/remote Canada. Although public health interventions exist to ameliorate the negative impacts, key determinants of young mothers’ well-being exist in sectors outside of health. Moreover, there is no clear understanding of how so...

This study examined the influence of patients' likability on pain estimations made by observers. Patients' likability was manipulated by means of an evaluative conditioning procedure: pictures of patients were combined with either positive, neutral, or negative personal traits. Next, videos of the patients were presented to 40 observers who rated t...

SUMMARY People in pain communicate their experience via facial expressions. There has been considerable research into the properties of pain expressions. This article reviews basic findings on the encoding and decoding of pain expression. The facial expression of pain is characterized and recent findings on its assessment and psychometric propertie...

Epidemiological evidence indicates that African Americans receive lower quality pain treatment than European Americans. However, the factors causing these disparities remain unidentified, and solutions to this problem remain elusive. Across three laboratory experiments, we examined the hypotheses that empathy is not only causing pain treatment disp...

A major factor hindering the deployment of a fully functional automatic facial expression detection system is the lack of representative data. A solution to this is to narrow the context of the target application, so enough data is available to build robust models so high performance can be gained. Automatic pain detection from a patient's face rep...

In a clinical setting, pain is reported either through patient self-report or via an observer. Such measures are problematic as they are: 1) subjective, and 2) give no specific timing information. Coding pain as a series of facial action units (AUs) can avoid these issues as it can be used to gain an objective measure of pain on a frame-by-frame ba...

Drawing on data from an ethnographic study examining the experiences of early-age mothers living in a remote city in northern British Columbia, Canada, we examine the perspectives of two study participants – one young mother and one service provider – who proposed that young mothers should visit high school classrooms to provide experiential narrat...

Unlabelled: The present study evaluated the effects of exposure to facial expression of pain, on observers' perceptions of pain expression. Participants were undergraduates shown brief video clips of the facial expressions of shoulder-pain patients displaying no pain or moderate pain. Participants were randomly allocated to either a high preexposu...

Pain is generally measured by patient self-report, normally via verbal communication. However, if the patient is a child or has limited ability to communicate (i.e. the mute, mentally impaired, or patients having assisted breathing) self-report may not be a viable measurement. In addition, these self-report measures only relate to the maximum pain...

Pain is typically assessed by patient self-report. Self-reported pain, however, is difficult to interpret and may be impaired or in some circumstances (i.e., young children and the severely ill) not even possible. To circumvent these problems behavioral scientists have identified reliable and valid facial indicators of pain. Hitherto, these methods...

Recent psychological research suggests that facial movements are a reliable measure of pain. Automatic detection of facial movements associated with pain would contribute to patient care but is technically challenging. Facial movements may be subtle and accompanied by abrupt changes in head orientation. Active appearance models (AAM) have proven ro...

The goal was to provide a clear test of deficits in perception of emotion in alexithymia by investigating the ability to detect and rate the intensity of facial expressions of emotion. Alexithymia was assessed by the 20-item Toronto alexithymia scale (TAS 20). In the first study, using signal detection methods, alexithymia was found to be associate...

Remote and rural regions in Canada are faced with unique challenges in the delivery of primary health services. The purpose of this study was to understand how patients and healthcare professionals in northern British Columbia might make use of the Internet to manage cardiovascular diseases. The study used a qualitative methodology. Eighteen health...

The experience of pain is often represented by changes in facial expression. Evidence of pain that is available from facial expression has been the subject of considerable scientific investigation. The present paper reviews the history of pain assessment via facial expression in the context of a model of pain expression as a nexus connecting intern...

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 t...

The paper is based on an ethnographic study conducted in a rural community in British Columbia, Canada. The study examined the impact of community culture on youth's development as sexual beings. We describe how social and geographical forces intersect to affect youth's lives and trace the ways in which deprivation of various forms of capital as we...

Pain is typically assessed by patient self-report. Self-reported pain, however, is difficult to interpret and may be impaired or not even possible, as in young children or the severely ill. Behavioral scientists have identified reliable and valid facial indicators of pain. Until now they required manual measurement by highly skilled observers. We d...

The purpose of this study was to refine the Dimensions of Tobacco Dependence Scale (DTDS) - a measure of tobacco dependence for adolescents - by removing poorly discriminating items, testing the measurement structure of the remaining items and examining the predictive utility of the resulting scale in terms of its ability to explain the average num...

Health professionals are routinely exposed to evidence of pain in others. It is important that the processes by which they evaluate pain be understood. The purposes of this article are to review and synthesize recent research on how health professionals judge the pain of others and to present a conceptual model of this process. Methodological and c...

Health professionals are routinely exposed to evidence of pain in others. It is important that the processes by which they evaluate pain be understood. The purposes of this article are to review and synthesize recent research on how health professionals judge the pain of others and to present a conceptual model of this process. Methodological and c...

Minor illnesses and major diseases are affected by individual, environmental, and social factors. We sought to determine if children's temperament and pain reactivity (individual response styles) measured in kindergarten are related to future health behavior. Seven-year follow-up measures of health behavior were gathered in 42 children (mean age M...

In this paper, we present a robust approach for pain expression recognition from video sequences. An automatic face detector is employed which uses skin color modeling to detect human face in the video sequence. The pain affected portions of the face are obtained by using a mask image. The obtained face images are then projected onto a feature spac...

To examine prospectively the association between the 4 categories of objectively assessed pain behavior and various disability outcomes. In the present study, relationships among the 4 categories of pain behavior and various disability-related outcomes were examined. One hundred forty-eight workers were identified within 6 weeks of a first episode...

Empathy is a complex form of psychological inference that enables us to understand the personal experience of another person through cognitive/evaluative and affective processes. Recent findings suggest that empathy for pain may involve a 'mirror-matching' simulation of the affective and sensory features of others' pain. Despite such evidence for a...

Two important influences on pain underestimation by health care professionals were investigated by varying specific cues with reference to underestimation of patients' pain: when observers are not allowed to talk to patients and when observers expect social cheating. One hundred and twenty health care professionals watched videotaped facial express...

Two important influences on pain underestimation by health care professionals were investigated by varying specific cues with reference to underestimation of patients' pain: when observers are not allowed to talk to patients and when observers expect social cheating. One hundred and twenty health care professionals watched videotaped facial express...

Supplementary Tables 1–3 On Reliability, Validity and Responsiveness of SPADI reported in previous studies (word file with tables).

The Shoulder Pain and Disability Index (SPADI) is a self-report measure developed to evaluate patients with shoulder pathology. While some validation has been conducted, broader analyses are indicated. This study determined aspects of cross-sectional and longitudinal validity of the SPADI. Community volunteers (n = 129) who self-identified as havin...

Alexithymia, a characteristic involving a limited affective vocabulary appears to involve three components: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. There is evidence that alexithymic characteristics are associated with differences in emotion information-processing. We examined the role of t...

The 'facial feedback hypothesis' suggests that inhibiting or exaggerating pain displays produces parallel effects on subjective experience. Research on the regulation of emotional expressions suggests that the act of self-regulation may be detectable in the properties of facial behavior. Both issues were examined in this study. Healthy young volunt...

Recent neuroimaging and neuropsychological work has begun to shed light on how the brain responds to the viewing of facial expressions of emotion. However, one important category of facial expression that has not been studied on this level is the facial expression of pain. We investigated the neural response to pain expressions by performing functi...

The objective of this research was to develop a multidimensional measure of tobacco dependence, sensitive to signs of incipient dependence and relevant to adolescents. A cross-sectional survey was conducted of students attending randomly selected high schools in two regions of British Columbia, Canada. Of the 3280 adolescents who completed the surv...

The present study evaluated the effects of exposure to facial expression of pain, on observers' perceptions of pain expression. Thirty-one male and 49 female observers judged 1-s video excerpts in a signal detection paradigm. The excerpts showed facial expressions of shoulder-pain patients displaying no pain or moderate pain. Participants were rand...

The ability to perceive pain in others is an important human capacity. Its development has not been studied. The present study examined the development of sensitivity to evidence of pain from childhood to early adulthood. One hundred and thirty-four males and females from four age groups (5-6, 8-9, 11-12 years and young adult) took part. They judge...