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The consequences of pain: The social and physical pain overlap on psychological responses

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Current theories suggest that social and physical pain overlap in their neurological and physiological outcomes. We investigated how social and physical pain overlap in their psychological responses by testing the hypothesis that both social and physical pain would thwart satisfaction on four human needs, worsen mood, and increase desire to aggress. In Experiment 1, recalling an experience of social or physical pain produced overlapping effects in the form of thwarted self-esteem and control needs and increased negative affect and desire to aggress. In Experiment 2, we induced social (Cyberball ostracism) or physical pain (cold pressor) within the laboratory session, and found that both pain types produced feelings of being ignored and excluded, and thwarted belonging, self-esteem, control, and meaningful existence. Our results provide further support to pain overlap theories and indicate that social and physical pain cause common psychological consequences, resulting in new ways to understand and manage pain. Copyright © 2011 John Wiley & Sons, Ltd.
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The consequences of pain: The social and physical pain overlap on
psychological responses
Department of Psychology, University of Milano-Bicocca, Italy;
Department of Psychology, University of
North Florida, USA;
Department of Psychological Sciences, Purdue University, USA
Current theories suggest that social and physical pain overlap in their neurological and physiological outcomes. We investigated
how social and physical pain overlap in their psychological responses by testing the hypothesis that both social and physical
pain would thwart satisfaction on four human needs, worsen mood, and increase desire to aggress. In Experiment 1, recalling
an experience of social or physical pain produced overlapping effects in the form of thwarted self-esteem and control needs and
increased negative affect and desire to aggress. In Experiment 2, we induced social (Cyberball ostracism) or physical pain (cold
pressor) within the laboratory session, and found that both pain types produced feelings of being ignored and excluded, and
thwarted belonging, self-esteem, control, and meaningful existence. Our results provide further support to pain overlap theories
and indicate that social and physical pain cause common psychological consequences, resulting in new ways to understand and
manage pain. Copyright © 2011 John Wiley & Sons, Ltd.
There is growing evidence in the literature showing that phys-
ical pain, the pain caused by a physical injury, and social pain,
the pain caused by the threat or actual loss of a social connec-
tion (MacDonald & Leary, 2005), share a common neural sys-
tem. Yet, it is still unclear whether the physiological overlap
between the pain types also implies an overlap in their psycho-
logical responses. The present paper aims to ll this gap. We
examined whether the social/physical pain overlap results in
common psychological responses as well.
The physiological overlap underlying physical and social
pain was initially proposed by Panksepp (1998). Panksepp
found that, besides reducing the experience of pain, the admin-
istration of an opiate also reduced crying behavior in animals
that were socially isolated (Panksepp, Herman, Conner,
Bishop, & Scott, 1978). Following Panksepp and colleagues
early suggestion, several authors investigated whether similar
neural brain circuitries are delegated to detect, process, and reg-
ulate both social and physical pain in social animals and humans
(DeWall et al., 2010; Eisenberger, Lieberman, & Williams,
Eisenberger et al. (2003) found those ostracized during a
ball-toss game (Cyberball) experienced activation of the dorsal
anterior cingulated cortex (dACC) and right ventral pre-frontal
cortexbrain regions known for their role in processing the
unpleasantness of physical pain (Rainville, Duncan, Price,
Carrier, & Bushnell, 1997). This pattern of results, which has
been replicated in numerous subsequent studies (e.g., Eisenberger,
Gable, & Lieberman, 2007; Krill & Platek, 2009; Onoda et al.,
2010), represents the rst empirical evidence that social threats
may be detected and processed similarly to physical pain in
Following the study by Eisenberger et al. (2003), several
authors added a variety of evidence to the hypothesis that
physical and social pain rely on shared neurological substrates.
For instance, Way, Taylor, and Eisenberger (2009) found that
sensitivity to social and physical pain is linked by a common
gene (OPRM-1). DeWall et al. (2010) found a common phys-
ical pain suppressant (i.e., acetaminophen) lowered hurt feel-
ing and reduced dACC activation in response to social
exclusion. Based on the evidence for a neurological overlap,
Eisenberger and Lieberman theorized the Pain Overlap Theory
(2004; see also MacDonald & Leary, 2005). The authors sug-
gested that social pain piggybacked onto the existent pain cir-
cuitry developed to signal a bodily threat or harm; sending a
warning to keep close to ones kin.
Do Social and Physical Pain Overlap on Psychological
Despite the considerable amount of research that suggests a
physiological overlap between social and physical pain, to
date little research has investigated whether or how social
and physical pain overlap at the psychological level. As a
matter of fact, a neural overlap does not necessary imply that
social and physical pain would lead to overlapping psycholog-
ical responses as well (Amodio, 2010; Cacioppo et al., 2003;
*Correspondence to: Paolo Riva, Department of Psychology, University of Milano-Bicocca, Piazza Ateneo Nuovo, 1, 20126 Milano (Italy).
European Journal of Social Psychology,Eur. J. Soc. Psychol. 41, 681687 (2011)
Published online 28 July 2011 in Wiley Online Library ( DOI: 10.1002/ejsp.837
Copyright © 2011 John Wiley & Sons, Ltd. Received 7 March 2011, Accepted 21 June 2011
Poldrack, 2006). Therefore, an investigation over the psycho-
logical overlap between social and physical pain would pro-
vide strong convergent validity to the idea of a shared social
and physical pain alarm system.
Preliminary evidence supports the idea that common psy-
chological responses could result from experiencing both
types of threats. Eisenberger, Inagaki, Mashal, and Irwin
(2010) found that exposure to proinammatory cytokines in-
creased feelings of social disconnection and depressed mood.
Furthermore, moving from the notion that extreme physical
pain can lead to temporally analgesia of further physical pain
(Gear, Aley, & Levine, 1999), DeWall and Baumeister
(2006) found that pre-living an extreme social pain condition
(i.e., a life alone) resulted in emotional numbness (a form of
analgesia). Thus, it is possible that physical pain may affect
the psychological equilibrium in a way that mirrors reactions
to social exclusion.
At this regard, given its high degree of aversiveness, the
psychological responses of ostracism (being ignored and ex-
cluded)a form of social painhave been extensively inves-
tigated. Williams (2001) found that ostracism causes a rapid
decrease in the satisfaction of belonging, self-esteem, control,
and meaningful existence. Although ostracism might represent
a particularly severe threat of basic needs (Williams, 2009), re-
search on rejection, social exclusion, and loneliness found
similar outcomes (Gerber & Wheeler, 2009). In addition to
the threat to basic needs, past research showed that experienc-
ing instances of social pain, like ostracism (Williams, 2009),
rejection (Gerber & Wheeler, 2009), or loneliness (Cacioppo
& Hawkley, 2003) often result in increased negative affect.
Finally, past research found aggression as a common response
for those who experience the pain of ostracism and rejection
(Twenge, Baumeister, DeWall, Ciarocco, & Bartels, 2007;
Wesselmann, Butler, Williams, & Pickett, 2010).
Overall, past research highlights a specic set of core psycho-
logical responses to social pain (i.e., ostracism) in the form of
reduced satisfaction of four basic needs, increased negative af-
fect, and greater desire to aggress. Considering the physiolog-
ical evidence for common brain responses to physical and
social pain (Eisenberger & Lieberman, 2004), the present
study investigated whether these two forms of pain induce
common psychological responses. Specically, we hypothe-
size social pain and physical pain will both lead to thwarted
basic need satisfaction, worsened mood, and increased desire
to aggress compared with feeling no pain.
One-hundred and fteen students (42 women; M=19.49 years
SD=1.54; 64% Caucasian) at Purdue University participated
in exchange for course credit.
Procedure and Design
Similar to the procedure of Chen, Williams, Fitness, and Newton
(2008), participants were randomly assigned to recall either a
past socially painful experience or a past physical painful ex-
perience that occurred within the last 5 years of their lives.
We included the no pain control condition of reliving a typical
Wednesday afternoon. The participants were asked to recall
the experience by writing in detail what had happened and
how they felt. Following recalling one of these experiences,
the participants reported their physical pain, their satisfaction
of basic needs, their affect, and desire to aggress based on
how they felt during the event they recalled.
Dependent Variables
The participants completed the Numerical Rating Scale (NRS-
11; Hartrick, Kovan, & Shapiro, 2003) that assessed pain in-
tensity (How much pain did you feel?) and pain unpleasant-
ness (How unpleasant was the pain you felt?). Similarly, the
Short-Form McGill Pain Questionnaire (SF-MPQ-2; Dworkin
et al., 2009) measured physical pain discomfort (e.g., sharp
pain,shooting pain).
Next, the participants lled out the Need-Threat Scale
(Williams, Cheung, & Choi, 2000) that assessed the partici-
pantsfeelings of belongingness (e.g., I felt rejected), self-
esteem (e.g., I felt liked), control (e.g., I felt I had control),
and meaningful existence (e.g., I felt invisible). In addition,
we assessed how negative the participants felt (e.g., sad; anger;
happy (reverse scored positive items)). Responses to all these
measures were recorded on a 1 (Not at all)to5(Extremely)
scale and were averaged together to create overall indexes.
Finally, to assess the desire to aggress, the participants
completed a measure evaluating their aggressive behavior
inclinations (Buckley, Winkel, & Leary, 2004) indicating
how tempted they would be to do aggressive behaviors (e.g.,
Humiliate the person,”“Slapping the other person)towards
a person they might interact with after completing the task.
Responses to this measure were recorded on a 1 (Not at all
tempted)to9(Very tempted) scale and averaged to create
overall index.
Following the completion of these measures, the partici-
pants provided demographic information, were debriefed,
and thanked for their participation.
Multivariate analysis of variance (MANOVA) revealed a sig-
nicant multivariate effect for experimental manipulation
(F(16,210)=17.09, p<.001, Wilksl=.18;
=.560) on the
set of dependent measures. There was a signicant effect of
the experimental manipulation on NRS-11 (F(2,112) = 47.85,
=.46), SF-MPQ-2 (F(2,112)=14.36, p<.001,
=.20), belonging (F(2,112)= 52.68, p<.001,
self-esteem (F(2,112)=59.93, p<.001,
=.51), control (F
(2,112)=36.74, p<.001,
=.39), meaningful existence (F
(2,112)=23.80, p<.001,
=.29), negative affect (F(2,112)=
63.42, p<.001,
=.53), and desire to aggress (F(2,112)=
32.04, p<.001,
682 Paolo Riva et al.
Copyright © 2011 John Wiley & Sons, Ltd. Eur. J. Soc. Psychol. 41, 681687 (2011)
Post-hoc analyses (Bonferroni, correcting for multiple
comparisons) demonstrated the participants recalling social
or physical painful events reported a higher level of pain
response (NRS-11 and SF-MPQ-2) than did those in the
control condition (ps<.001; see Table 1 for descriptives and
univariate ANOVAs). Examining the basic needs combined,
those recalling either social or physical pain experienced less
basic need satisfaction than recalling a typical Wednesday
afternoon (ps<.001). This pattern was true for the individual
needs of control (ps<.001) and self-esteem (ps<.001).
However, for belongingness and meaningful existence, there
were signicant differences between the control and social
pain conditions (ps<.001), but not between the control condi-
tion and physical pain (ps>.53). Negative affect was higher
for those who recalled a social and physical pain episode
compared with those who recalled a daily routine (ps<.001).
Finally, the participants who recalled a painful episodeeither
social or physicalreported having greater desire to aggress
than those in the control condition (ps<.001).
Experiment 1 provided preliminary evidence of the common
psychological responses of social and physical pain, show-
ing that both types of pain can thwart self-esteem and con-
trol needs and increase negative affect and desire to
aggress. The fact that physical pain failed to signicantly
thwart belonging and meaningful existence needs might be
linked to the specic task we adopted (i.e., recalling an ear-
lier painful event). Previous research showed that physical
pain is harder to relive than social pain (Chen et al.,
2008), leading us to question whether the effects on all four
basic needs would emerge for currently inicted physical or
social pain.
In Experiment 2, we sought to replicate and extend the nd-
ings of Experiment 1 using manipulations that currently
inicted social and physical pain. Similar to Experiment 1,
we tested the hypothesis that both social and physical pain
can threaten basic need satisfaction and increase both negative
affect and desire to aggress. Moreover, to further explore the
commonalities in the psychological responses, we considered
feelings of ostracism (i.e., feeling ignored and excluded) as a
common response to social and physical threats. Feelings of
ostracism have been shown to derive from the detection of so-
cial threats (Williams, 2009), yet, based on the extent social
and physical pain overlap in the brain, they may be a common
psychological response of pain.
One hundred undergraduate students (53 women; M=19.02
years, SD=.27; 59% Caucasian) received course credit for par-
ticipating. The participants were randomly assigned to a 2
(Pain Induction: Yes versus No)2 (Type of Pain: Social
versus Physical) between-subjects design.
Procedure and Materials
Social Pain Manipulation
To manipulate social pain, the participants played a virtual
online ball-tossing gameCyberball (Williams et al., 2000).
The participants believed they were playing with two others,
who were actually computer-controlled confederates. The par-
ticipants were either included, receiving the ball about a third
Table 1. Means, standard deviation, and univariate Fvalues and their associated p-values. Experiment 1.
Social pain (n=40) Physical pain (n=38) Control condition (n=37)
NRS pain index (α=.87) 5.76 (2.80)
6.30 (2.71)
1.14 (1.88)
F(2,112)=47.85, p<.001
McGill pain quest. (α=.96) 2.57 (2.38)
3.49 (2.16)
.93 (1.72)
F(2,112)=14.36, p<.001
Overall needs index (α=.92) 2.15 (.83)
2.98 (.62)
3.96 (.78)
F(2,112)=56.06, p<.001
Belonging (α=.86) 2.42 (1.11)
4.20 (.85)
4.50 (.72)
F(2,112)=52.68, p<.001
Control (α=.89) 1.53 (.83)
1.48 (.78)
3.04 (1.06)
F(2,112)=36.74, p<.001
Self-esteem (α=.92) 1.65 (1.01)
1.86 (.81)
3.82 (.89)
F(2,112)=59.93, p<.001
Meaningful existence (α=.91) 2.97 (1.24)
4.36 (1.00)
4.48 (.94)
F(2,112)=23.80, p<.001
Negative affect (α=.93) 2.91 (.85)
2.57 (.76)
.86 (.87)
F(2,112)=63.42, p<.001
Desire to aggress (α=.94) 5.17 (1.93)
4.27 (1.29)
2.45 (1.15)
F(2,112)=32.04, p<.001
Notes. Different letters indicate statistical differences, according to the Fishers Least Signicant Difference test (p<.05). Standard deviations appear in
NRS, Numerical Rating Scale.
Common social and physical pain consequences 683
Copyright © 2011 John Wiley & Sons, Ltd. Eur. J. Soc. Psychol. 41, 681687 (2011)
of the time throughout, or ostracized, receiving the ball once
from each computer controlled player at the beginning and
then never again. We adopted a shortened version of the game
(21 throws), so it would last the same amount of time as parti-
cipants who were asked to submerge their hand in water (i.e.,
Physical Pain Manipulation
To induce feelings of physical pain, the participants completed
a standard pain induction manipulation (e.g., Mitchell,
MacDonald, & Brodie, 2004). The participants were ran-
domly assigned to place the non-dominant hand up to their
wrist into a bucket of water maintained either at a cold temper-
ature (5C6C; the physical pain induction) or room temper-
ature (24C26C; the physical pain control). Subjects were
told they could remove their hand at any time if the distress
of the experience became too intense. However, in order to
standardize the amount of physical stimulation, the partici-
pants were asked to try to keep their hand inside the cold water
for 1minute (equal to the Cyberball duration).
After completing either the social or the physical task, the
participants completed all of the same measures used in Exper-
iment 1 with the addition of items assessing feelings of ostra-
cism (I felt ignoredand I felt excluded) assessed on a 1
(Not at all)to5(Extremely) scale.
Scores on the dependent measures were examined using a 2
(Pain Induction: Yes versus No)2 (Type of Pain: Social ver-
sus Physical) MANOVA. Supporting the main hypothesis of
the present study, Wilkslrevealed a signicant effect of Pain
Induction, F(10,87)=22.68,
=.72. An effect of Type of
Pain was also present (F(10,87)=10.805,
=.55) as well as
an interaction between Pain Induction and Type of Pain, F
Univariate analyses, using a Bonferroni adjusted alpha
level of .005, revealed that each of the considered dependent
variables contributed to the overall multivariate effect of Pain
Induction. First, the participants in the pain conditions
reported higher pain intensity on the NRS-11 and SF-MPQ-2
than the participants assigned to the no pain induction condi-
tions (F(1,96)=190.19, p<.001,
=.66 and F(1,96)=73.
95, p<.001,
=.44, respectively). See Table 2 for means
and standard deviations.
Then, as hypothesized, the Pain Induction had a signicant
effect on the basic needs overall (F(1,96) = 108.52, p<.001,
=.53). For each need individually, the participants in the
pain conditions, compared with the no pain induction condi-
tions, felt a threatened sense of belongingness (F(1,96)=
59.71, p<.001,
=.38), self-esteem (F(1,96)= 58.31,
=.38), sense of control (F(1,96)= 26.54, p<.001,
=.22), and meaningful existence (F(1,96) = 64.31, p<.001,
Furthermore, compared with control conditions, pain in-
duction increased negative affect, F(1,96)=169.38, p<.001,
=.64. Additionally, the participants in the pain conditions
had a higher desire to aggress than the participants in the no
pain induction conditions, F(1,96)=18.66, p<.001,
Finally, feelings of being ignored were higher in the pain
conditions compared with the no pain induction conditions,
F(1,96)=51.04, p<.001,
=.35. A similar pattern emerged
for feelings of being excluded: individuals in the pain condi-
tions felt more socially excluded than individuals in the no
pain induction conditions, F(1,96)=71.44, p<.001,
This pattern of results provides further evidence of the overlap
between social and physical pain: individuals who experienced
either social or physical pain reported higher levels of
Univariate analyses on Type of Pain revealed that physical
pain had a greater effect than social pain on pain measures
(NRS-11 and SF-MPQ-2; smallest Fwas for NRS-11,
F(1,96)=15.11, p<.001,
=.13). Yet, social pain had
greater impact than physical pain on each of the remaining de-
pendent variables (except for negative affect (p=.78); smallest
Fwas for desire to aggress, F(1,96) = 6.58, p= .012,
Table 2. Means and standard deviations for pain induction. Experiment 2.
Pain induction No pain induction
Cyberball Ostracism (n=25) Cold water (n=26) Cyberball inclusion (n= 23) Warm water (n=26)
NRS pain index (α=.97) 4.84 (2.3) 7.63 (2.5) 1.20 (.54) 1.26 (.47)
McGill overall index (α=.98) 2.55 (1.8) 5.13 (2.1) 1.21 (.44) 1.41 (.62)
Overall needs index (α=.91) 1.84 (.64) 2.88 (.56) 3.44 (.49) 3.68 (.57)
Belonging (α=.86) 2.09 (1.0) 3.51 (1.1) 4.26 (.85) 4.33 (.74)
Self-esteem (α=.79) 1.77 (.61) 2.07 (.81) 2.75 (.68) 3.34 (.79)
Control (α=.66) 1.34 (.46) 2.16 (.71) 2.31 (.80) 2.70 (.87)
Meaningful existence (α=.89) 2.14 (.97) 3.76 (.96) 4.43 (.77) 4.34 (.82)
Negative affect (α=.92) 2.45 (.69) 2.64 (.68) 1.04 (.44) 0.93 (.53)
Ignored 4.24 (1.2) 2.65 (1.3) 1.78 (1.0) 1.77 (1.0)
Excluded 4.36 (1.1) 2.46 (1.2) 1.70 (0.9) 1.62 (.85)
Desire to aggress (α=.92) 4.29 (1.2) 3.49 (.99) 3.16 (.78) 2.99 (.56)
Notes. Standard deviations appear in parenthesis.
NRS, Numerical Rating Scale.
684 Paolo Riva et al.
Copyright © 2011 John Wiley & Sons, Ltd. Eur. J. Soc. Psychol. 41, 681687 (2011)
Consistently, univariate analyses of the interaction effect be-
tween Pain Induction and Type of Pain showed thatwhen pain
was inductedphysical pain had a greater effect on NRS-11 and
SF-MPQ-2 (ps <.001) whereas social pain had a greater
effect than physical pain on basic needs overall (p<.001)
sense of belonging (p<.001), meaningful existence (p<.001),
and feelings ignored (p<.001) and excluded (p<.001). By
contrast, no signicant effect emerged for self-esteem,
control, negative affect and desire to aggress (all ps>.097).
In Experiment 2, by using minimal manipulations of pain on
healthy volunteers, we provided experimental evidence
thatin keeping with responses to social painphysical pain
can also threaten satisfaction of belonging, control, self-esteem,
and meaningful existence and raise negative affect and desire to
aggress. In addition, we found that both social and physical pain
produce feelings of being ignored and excluded; previously,
only social pain was found to lead to these effects. Therefore,
it appears that the common psychological responses between
social and physical pain might mirror their physiological
Many studies now demonstrate that social and physical pain
overlap in their physiological consequences. Neurological ev-
idence (e.g., DeWall et al., 2010; Eisenberger et al., 2003,
2007; Krill & Platek, 2009; Onoda et al., 2010) and genetic ev-
idence (Way et al., 2009) support the Pain Overlap Theory
(Eisenberger & Lieberman 2004; MacDonald & Leary,
2005), which contends social pain piggybacked onto the exist-
ing circuitry used to detect physical pain. Until this point, im-
portant converging evidence, in the form of common
psychological responses, has been missing. Common psycho-
logical responses between social and physical pain would pro-
vide further evidence for an overlapping evolution of these
two forms of pain.
We tested the hypothesis that both social and physical
paineven in a short-term episodecould reduce satisfaction
of basic human needs and increase both negative affect and de-
sire to aggress. Experiment 1 showed that recalling a past
physical pain episode can be associated with memories of
low self-esteem, poor control, and increased negative affect
and desire to aggress, akin to recalling a socially painful epi-
sode. In Experiment 2, a currently inicted experience of pain
resulted in lowered satisfaction on all the needs tested for both
physical and social pain. Furthermore, social and physical pain
increased negative affect and produced higher desire to
aggress than the control conditions.
Taken all together, these results suggest that even minimal
inductions of physical pain threaten the individuals psycho-
logical equilibrium, going far beyond the mere perception of
physical discomfort. Thus, from a theoretical standpoint, our
results showed for the rst time that social pain is not unique
in its ability to affect needs satisfaction and mood, and to
induce feelings of ostracism. The latter effect is particularly
striking: Experiment 2 extended our investigation to explore
feelings of being excluded and ignored among the set of com-
mon psychological responses of pain, ultimately demonstrat-
ing that even physical pain can lead to feelings of ostracism.
This represents the rst experimental evidence that physical
pain can lead an individual to report feeling more excluded
and ignored than an individual who did not receive pain.
Within an evolutionary account, we posit that feelings of
ostracism (being excluded and ignored) during the experience
of physical pain might serve to elicit immediate help seeking
from allies and thus could potentially be a survival advantage.
This would be consistent with the adaptive function of other
similar processes that have been designed to offer the pain suf-
ferer a chance to get support from her social environment. In-
deed, the mere existence of the facial expression of pain is
thought to be the result of adaptive evolutionary forces aimed
at providing the sufferers with the opportunity to translate a
pain state into an observable message that can be perceived
by someone in the environment (A. Williams, 2002). In a com-
plementary way, past research shows thatwhen social sup-
port or help are anticipated (Maner, DeWall, Baumeister, &
Schaller, 2007)feelings of ostracism increase the desire for
social connections. Thus, in a similar way in which a child
looks for her caregivers after falling and being hurt, individuals
in physical pain are likely to increase their odds of survival by
feeling an urgency to seek social connections that can provide
immediate aid, support, and protection from further threats
and damages.
Our ndings dovetail nicely with recent ndings indicating
that inammatory processes increase feeling of social discon-
nection (Eisenberger et al., 2010). The current work offers a
novel extension to this previous work by showing that physi-
cal pain affects a broad set of psychological responses that
were previously noted to only be produced by the experience
of social pain. Furthermore, the notion that physical pain is re-
lated to the feeling excluded and ignored seems coherent with
studies that show that social support buffers the perception of
physical pain (Master et al., 2009). As a matter of fact, if feel-
ings of ostracism represent a common response to physical
pain, fullling the social needs might counteract some of the
aversive psychological effects of physical pain, thus increasing
the pain tolerance. On one hand, natural selection might have
selected observable pain behaviors (e.g., the facial expression
of pain) aimed to attract potential helpers and, on the other
hand, emotional responses that lead the physically injured
individuals to seek support from their kin.
Implications for Pain Management
Understanding of the common psychological responses of
social and physical pain have important implications for pain
management. First, studies have repeatedly found that obser-
vers tend to doubt the pain reported by sufferers showing
psychological distress (Tait, Chibnall, & Kalauokalani, 2009).
The tendency to attribute pain complaints to psychological
distressrather than the oppositemight lead healthcare
professional to disregard the severity of patientspain or their
analgesic needs because of the idea that pain complaints result
from the experience of psychological distress, rather than the
Common social and physical pain consequences 685
Copyright © 2011 John Wiley & Sons, Ltd. Eur. J. Soc. Psychol. 41, 681687 (2011)
pain itself (Wallis, Lord, & Bogduk, 1997). Conversely, the
present ndings showed that psychological distressin the
form of threatened human needsintrinsically follows even
very minimal inductions of pain. Adopting experimental
manipulations, the present ndings extend early correlational
studies that reported resolution of psychological distress after
pain relief in patients with chronic pain (Haythornthwaite, Sieber,
& Kerns, 1991; Wallis et al., 1997).
Second, our study brings support to the bio-psychosocial
approaches of health and disease. In several healthcare settings
of western society, pain management still tends to take a bio-
medical approach, which often concentrates on the organic
origin of pain, regarding it mostly as a potential diagnostic tool
and therefore undervaluing its psychological and psychosocial
consequences (Bendelow & Williams, 1995; Kugelmann,
2003; Scarry, 1994). Several investigations noted that the
bio-psychosocial model is only partially adopted withat
bestattention given to cognitive and behavioral factors, but
with no consideration of the social implications of pain and
disease (e.g., Harding, Campbell, Parsons, Rahman, & Under-
wood, 2010). More than three decades after its rst proposal
(Engel, 1977), the translation of the bio-psychosocial approach
into practice seems still to be problematic. Practitioners still
anchored to a bio-medical view might benet from consider-
ing the social and psychological vulnerability of people in
pain. Showing that physical pain decreases ones satisfaction
of belonging, self-esteem, control and meaningful existence,
our ndings could support healthcare professionals in appreci-
ating why and how they can take the socialcomponent of
the bio-psychosocial model into consideration. Our ndings
add to Engels (1977) claim that the ultimate criteria for the
patientswell-being are psychosocial, even when the complaint
is physical in origin (e.g., pain).
Third, the present ndings provided insight into the likely
underestimation of the damaging effects to individualspsycho-
logical well-being caused by numerous pain conditions, includ-
ing chronic pain disorders, or pain arising from life-threatening
diseases (e.g., cancer). We found that one-minute inductions of
social or physical pain can threaten need satisfaction. However,
this effect is likely to extend beyond acute episodes to indivi-
duals experiencing chronic social and physical pain. Support
for this hypothesis arises from the commonalities that emerged
comparing the experiences of persistent social (Zadro, 2004)
and physical pain (Walker, Sofaer, & Holloway, 2006). There-
fore, future research should consider the shared experiences of
social and physical chronic pain within the theoretical frame-
work of pain overlap theories.
Limitations and Future Directions
Nevertheless, it should be noted that converging evidence of
physiological and psychological commonalities does not im-
ply that social and physical pain are equivalent constructs,
with identical psychological features and consequences. In-
deed, distinctions between the two painful experiences have
been pointed out in past research. Chen et al. (2008) showed
that social pain can be relived and re-experienced more readily
than physical pain. Moreover, several researchers used physi-
cal pain to investigate the specicity of the effects of social
exclusion, nding social pain to be uniquely able to lead to a
deconstructed state and impair cognition and self-regulation
(e.g., Baumeister, DeWall, Ciarocco, & Twenge, 2005).
Consistent with this literature, we found lower basic needs
satisfaction for the participants who experienced social com-
pared with physical pain. In Experiment 1, the intensity of pain
associated with episodes of social and physical pain did not
differ; nevertheless, social pain was associated with lower
needs satisfaction than physical pain. In Experiment 2, even
though the participants in the physical pain condition reported
higher pain scores than those in the social pain condition,
social pain still had a greater impact on basic needs. Critically,
there was no difference in negative affect between social and
physical pain, suggesting negative affect cannot explain
worsened basic needs satisfaction for those in social compared
with physical pain. Although comparisons in Experiment 2
should be interpreted with caution as social and physical pain
were induced with two different manipulations, the results
similarly suggest social and physical pain are not equivalent
We note that our ndings are mostly based on measures that
were created and framed to assess psychological variables
threatened by instance of social pain such as ostracism, social
exclusion, and loneliness. Thus, future research should further
compare the strength of social and physical pain induction in
frustrating the psychological equilibrium by considering a larger
set of basic human needs (e.g., safetyor predictability)and
a larger variety of psychological responses (e.g., ego depletion).
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... According to preliminary findings from functional magnetic resonance imaging studies, CBT-induced structural changes in the prefrontal cortex may cause the release of pain-inhibiting neurotransmitters that "gate" or prevent pain impulse passage from the spinal cord to the brain [23]. Thus, CBT-mediated descending inhibitory mechanisms result in decreased pain perception, thereby helping Physiotherapists to proceed with paced activities, progressive strengthening, and return to work so that it aids in the overall recovery of the patient with chronic pain [24]. There is also increasing evidence that supports the use of CBT strategies by Physiotherapists during their treatment to obtain a positive outcome for chronic pain patients. ...
... Many studies have demonstrated even when the complaint is of a physical nature (such as pain), patients' well-being is psychosocial [24]. This study provided an opportunity to highlight the application of Cognitive Behavioral Therapy (CBT) in treatment of chronic pain by the Physiotherapists in India. ...
Purpose: To evaluate the awareness, practice and beliefs about CBT strategies for chronic pain management among Physiotherapists. Relevance: Chronic pain can be defined as pain that persists for 3 months or longer and, while not necessarily maladaptive, often leads to physical decline, limited functional ability and emotional distress. CBT has been increasingly used as an effective tool by psychologists in the management of chronic pain that is delivered through individual or group counselling sessions. Cognitive restructuring, relaxation techniques, activity pacing and good sleep hygiene are a few strategies of cognitive behavioral pain management therapies. There is also increasing evidence that supports the use of CBT strategies by Physiotherapists during their treatment for obtaining a positive outcome for chronic pain patients. Method and Analysis: A Google Form was formulated with relevant questions about awareness, practice and beliefs about CBT strategies for chronic pain. The questionnaire was face validated by 3 independent psychologists who practice CBT for chronic pain in their regular practice. This form was then distributed through various Physiotherapy groups in Bangalore via snowball sampling method. The data obtained from the responses were then complied, decoded and quantitatively analysed through content analysis using the SPSS-22. Result: The result showed strikingly contrasting responses from the Physiotherapists, as even though the majority of them were aware of CBT (34.1%), they applied it relatively less (15.3%). Of 63.5% Physiotherapists believed that pain perception is affected by automatic thoughts, while 52.9% agreed that negative thoughts need to be changed into positive coping thoughts. Around 49.4% of Physiotherapists believe in teaching relaxation techniques to their patients with chronic pain. Activity pacing and good sleep hygiene are important, as believed by 25.9% and 47.1% respectively. Physiotherapists (56.5%) accepted that patient needs to be mindful while exercising. Conclusion: Majority of Physiotherapists are aware and have positive beliefs about CBT strategies for chronic pain management. However, comparatively, we can see variations in the application of CBT strategies in their treatment plan. KEY WORDS: Cognitive Behavioral Therapy, chronic pain, Physiotherapy.
... Therefore, ostracism can result in some mental problems like anxiety, depression and anxiety disorders, diminishing performance and motivation, and decrease in academic and professional performance (Erdemli, & Kurum, 2021). Riva, Wirth, and Williams (2011) found that cyberostracism has a medium and positive correlation with psychological problems. Correspondingly, it is thought that cyberostracism may have a negative predictive role on the psychological adjustment of university students. ...
... According to this finding, as the cyberostracism of the university students increased, their psychological adjustment problems also increased. Parallel to this finding, Riva, Wirth, and Williams (2011) found that cyberostracism is moderately correlated with psychological problems. In the study conducted by Hatun (2021), exposure to virtual social ostracism was found to increase the depression and anxiety levels of the participants and negatively affect their self-esteem. ...
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Today, one of the environments where most of the people interact with other people is virtual environments. In these environments, some individuals may be exposed to ostracism by others. This state of exclusion can also have some adverse effects on the psychological adjustment of individuals. In this context, the purpose of the current study is to investigate the mediator role of emotional stability in the relationship between university students' problems of psychological adjustment and cyberostracism. The study employed the relational survey model. The study group of the study is comprised of 320 undergraduate students in the 2021-2022 academic year. In the analysis of the collected data, Pearson Moments Correlation Coefficient analysis was conducted in SPSS-22 and the mediaton analysis was conducted. As a result of the analyses conducted within the context of the current study, it was found that the cyberostracism of the university students negatively and significantly predicted their emotional stability, while it positively and significantly predicted their psychological adjustment problems. In addition, it was determined that emotional stability played a mediator role in the relationship between university students' problems of psychological adjustment and cyberostracism. The findings of the study were discussed in relation to literature and suggestions were made.
... L'inclusione rappresenta, quindi, la capacità di una persona di contribuire pienamente ed efficacemente a un'organizzazione (Miller, 1998;Mor Barak e Cherin, 1998); essa è, quindi, favorita dal raggiungimento dell'equilibrio tra l'appartenenza a un gruppo e l'essere apprezzati per caratteristiche individuali uniche (Shore et al., 2011). Man mano che gli individui sentono di essere membri importanti dell'organizzazione e che i loro talenti e le loro caratteristiche uniche sono riconosciuti e apprezzati, aumentano il grado di inclusione (Nishii, 2013;Riva et al., 2011). Ricerche emergenti hanno suggerito che quando i dipendenti si sentono inclusi nel loro ambiente di lavoro, l'impegno organizzativo, la fiducia, il benessere, la creatività e l'innovazione migliorano (Brimhall et al., 2014;Mor Barak et al., 2006;Riva et al., 2001). ...
Conference Paper
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Framing of the research. The academic research field on diversity and inclusion is very broad and embraces different disciplines such as management, sociology, psychology, education sciences, and gender studies. Such variety suggests the need to analyse these themes from a perspective more oriented to organizational and managerial aspects. Purpose of the paper. The purpose of this study is to conduct a bibliometric analysis of the literature concerning the topic of Diversity & Inclusion and consequently a scientific mapping of the conceptual, social and intellectual framework. Methodology. Using Bibliometrix, an R Studio package, 592 publications were analyzed from the Web of Science database, as of 2010. Results. The research highlights as much the performance in terms of authors, institutions and countries dealing with the topic as the conceptual (keyword co-occurrence analysis), social (co-authorship relationship analysis) and intellectual (historiographical tracing) structures. Research limitations. Like other reviews, the choice of database used, the imposition of time and language limits, as well as the choice of keywords may have limited the comprehensiveness of the literature analyzed. Managerial implications. The results may be useful in guiding corporate culture and strategic decisions in the context of a policy oriented toward sustainability and social inclusion. Originality of the paper. This paper adopts a broader perspective, taking into account the performance of scholars, institutions and countries, mapping the conceptual, social and intellectual structures of the relevant literature.
... Different studies have been conducted and provided evidence that ostracized individual shows depressed mood (Leary, 1990;Williams et al., 2002). However, past research has shown that ostracism can be uniquely painful experience; the social pain caused by ostracism has even been linked to physical pain (Eisenberger, 2012;Riva, Wirth, & Williams, 2011). ...
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Workplace Ostracism and Counterproductive Work Behaviors Via Organizational Cynicism and Moderating role of Neuroticism
... There are two types of pain experiences: physical and emotional pain (Chiong, 2016). Physical pain is usually caused by physical injury whereas emotional pain is an unpleasant experience caused by a loss or a potential threat to something a person values (Riva et al., 2011). Effectively coping with physical pain is of high importance as it influences the experience of emotional pain (Phalen et al., 2021), with long-term ineffective coping being associated with psychopathology-related difficulties such as increased anxiety and depression levels (Zaehringer et al., 2020). ...
This study compared acceptance vs. avoidance coping with acute physical pain, in a pain-induction experiment and examined both between and within-group differences, multi-methodically and multi-dimensionally using behavioral, physiological and self-report measures. The sample consisted of 88 University students (76.1% females; Mage = 21.33 years). Participants were randomly assigned to four instructed groups and participated twice in the Cold Pressor Task: (a) Acceptance followed by avoidance; (b) Avoidance followed by acceptance; (c) No instructions (control) followed by acceptance, and (d) No instructions (control) followed by avoidance. All analyses were conducted using repeated-measures ANOVAs. Randomized techniques analyses showed that participants receiving no instructions followed by acceptance reported significantly greater changes in physiological and behavioral measures across time. Low adherence to acceptance instructions was found, especially during the first phase. Exploratory analyses on actual techniques used (as opposed to taught technique) showed that participants using avoidance followed by acceptance exhibited significantly greater changes in physiological and behavioral measures across time. No significant differences were found for the self-report of negative affect outcome. Overall, our findings provide support to ACT theory, as participants might have to use firstly ineffective coping to understand what works best to cope with pain. This is the first study examining acceptance vs. avoidance coping both between and within individuals in physical pain, multi-methodically and multi-dimensionally.
... Previous studies revealed that the ostracism that an individual perceives leads to a range of negative work-related consequences, and it also harms the individual psychologically and physically (Ferris et al., 2008;Robinson et al., 2013;Williams, 2007). Other studies have even proven that the social pain resulting from ostracism is as painful as the physical pain (Eisenberger et al., 2003;Riva et al., 2011;Robinson et al., 2013). Most of the studies apply the frameworks of belongingness theory (Baumeister, 2012), conservation of resources theory (Hobfoll, 1989), and need-threat/need fortification theory (Williams, 1997) to understand how an ostracized individual responds to ostracism (Bedi, 2019). ...
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Workplace ostracism is a construct that requires further studies since it potentially affects ostracized individuals' attitudes and behaviors, yet it is still understudied. The present study aimed to analyze the mechanism of the emergence of workplace ostracism through coworker envy and its effect on employee creativity. Creative process engagement was also used as a mediating variable for the effect of workplace ostracism on creativity. The data were gathered using a self-report questionnaire distributed to employees in the service sector. Out of 592 questionnaires filled out online, 201 met the criteria for further analysis. The result showed that coworker envy significantly and positively affects workplace ostracism. The finding also suggested that workplace ostracism has a negative and significant effect on creative process engagement but has no significant effect on employee creativity. However, this study revealed that creative process engagement fully mediated the negative effect of workplace ostracism on creativity.
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Social exclusion, that is being left out by others, can have adverse consequences for individuals’ psychological well-being. Even short-term experiences of social exclusion strongly threaten basic psychological needs and cause so-called social pain. Prior research suggests an overlap between the experience of social and physical pain that, amongst others, is reflected by the effectiveness of physical pain treatments in alleviating social pain. Drawing upon these prior findings, we here explore whether open-label placebos, which have previously been found to be effective in reducing physical pain, can alleviate social pain following social exclusion. Seventy-four healthy participants were randomly assigned to one of four conditions in a 2 × 2 between-subjects design: First, they either received an open-label placebo intervention or no treatment. Second, they either experienced inclusion or exclusion by their co-players in the interactive ball-tossing game Cyberball. We find that excluded participants in the open-label placebo condition experienced significantly less hurt feelings compared to those in the control condition (Cohen’s d = 0.77). There was no effect of treatment for need threat. The findings suggest new possibilities to alleviate social pain, which is of particular interest in the context of preventing destructive and maladaptive behaviors in situations where functional coping strategies are unavailable.
This study investigated whether level of social support would decrease emotional distress and physical pain sensitivity following rejection. Healthy undergraduate students received varying levels of social support from a close companion during the Partial Future Life Alone rejection paradigm. Participants also completed baseline and post-stressor measures of physical pain sensitivity as well as post-stressor measures of emotional distress. Results indicated that all levels of social support benefited rejected participants by either buffering and/or improving fundamental needs, mood, and pain to levels comparable to non-rejected participants; however, passive support resulted in the fewest beneficial outcomes. The current study provides preliminary evidence that even minimal levels of support during rejection benefits or at least neutralizes associated pain and distress outcomes.
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This article presents the first meta-analysis of experimental research on rejection, sampling 88 studies. The results are consistent with a needs account, which states that rejection frustrates basic psychological needs, but not with a numbness account, which states that rejection causes physical and emotional numbness. Rejection moderately lowers mood (d = -0.50) and self-esteem (d = -0.70), but does not decrease arousal or flatten affect. Both belonging (d = 0.69) and control (d = 1.16) are frustrated by rejection. Aggressive responses to rejection, considered paradoxical by some, appear to be due to attempts to gain control; measures that contrast belonging and control (d = -1.17) cause antisocial responding, whereas measures that do not allow for control to be restored cause prosocial responding (d = 1.21). These findings suggest that rejection makes individuals feel bad-ready to act to restore control or belonging-and that they will prioritize restoring control even if it requires being antisocial. © 2009 Association for Psychological Science.
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Theories of pain have traditionally been dominated by biomedicine and concentrate upon its neurophysiological aspects, both in diagnosis and treatment. Hence, scientific medicine reduces the experience of pain to an elaborate broadcasting system of signals, rather than seeing it as moulded and shaped both by the individual and their particular socio-cultural context. Although pain lies at the intersection between biology and culture, making it an obvious topic for sociological investigation, scant attention has been paid to understanding beliefs about pain within the study of health and illness. A major impediment to a more adequate conceptualisation of pain is due to the manner in which it has been ‘medicalised’, resulting in the inevitable Cartesian split between body and mind. Consequently, the dominant conceptualisation of pain has focused upon sensation, with the subsequent inference that it is able to be rationally and objectively measured. Yet as well as being a medical ‘problem’, pain is an everyday experience. Moreover, sociological and phenomenological approaches to pain would add to, and enhance, existing bodies of knowledge and help to reclaim pain from the dominant scientific paradigm. In this paper, it is argued, firstly, that the elevation of sensation over emotion within medico-psychological approaches to pain, can be shown to be limiting and reductionist. Secondly, we attempt to show how insights from the newly-emerging sociological arenas of emotions and embodiment provide a framework which is able to both transcend the divide between mind and body and to develop a phenomenological approach to pain. Finally, in order to bring the meaning of pain into fuller focus, we draw attention to the importance of studying theodices and narratives, as well as the cultural shaping and patterning of beliefs and responses to pain.
Ostracism is such a widely used and powerful tactic that the authors tested whether people would be affected by it even under remote and artificial circumstances. In Study 1, 1,486 participants from 62 countries accessed the authors' on-line experiment on the Internet. They were asked to use mental visualization while playing a virtual tossing game with two others (who were actually computer generated and controlled). Despite the minimal nature of their experience, the more participants were ostracized, the more they reported feeling bad, having less control, and losing a sense of belonging. In Study 2, ostracized participants were more likely to conform on a subsequent task. The results are discussed in terms of supporting K. D. Williams's (1997) need threat theory of ostracism.
Social neuroscience is a young and thriving area of research in psychology that integrates diverse literatures and methodologies to address broad questions about the brain and behavior. But despite the excitement and activity generated by this approach, its contribution to ideas in social psychology is sometimes questioned. This article discusses the ways in which social neuroscience research may or may not contribute to theoretical issues in social psychology. Still a young field, much research in this area has focused on issues of brain mapping and methodological development, with less emphasis on generating and testing novel social psychological hypotheses. The challenges to theoretical advancement, including psychometric and methodological issues, are considered, and a set of guidelines for conducting theoretically-informative social neuroscience is offered. In the final analysis, it is argued that neuroscience has much to offer to social psychology, both theoretically and methodologically, but that like any new approach, these contributions will take time to realize.
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This article proposes a theoretical contribution to critical health psychology. Charles Sanders Peirce’s semiotics provide health psychology and related fields with an analytic that centers interest at the intersection where the co-constitution of reified categories occurs. I begin with the terms symptom and sign as used in medical contexts. Symptoms and signs can be reinterpreted, drawing on the Heideggerian notion of ‘attunement’, and upon Peirce’s semiotics. Next, I present Peirce’s concept of sign, with its triadic structure of object-representamen-interpretant. An understanding of pain as a sign in this sense is developed on this basis. The value of Peircian semiotics for a critical health psychology is illustrated with some examples drawn from a qualitative study. Pain is not only something of concern and the bearer of meanings, but a way of interpreting one’s situation. This semiotics of pain furthers the project, common to phenomenological and discursive approaches in health psychology and related fields, of studying the upsurge of meaning in speech and in other acts that co-constitute it.
It is well recognised that patients with chronic pain, in particular, chronic whiplash-associated neck pain, exhibit psychological distress. However, debate continues as to whether the psychological distress precedes and causes the chronic pain or, conversely, the psychological distress is a consequence of chronic pain. Using cervical zygapophysial joint pain as a model for chronic pain, the effect of a definitive neurosurgical treatment on the associated psychological distress was studied. Seventeen patients with a single painful cervical zygapophysial joint participated in a randomised, double-blind, placebo-controlled trial of percutaneous radiofrequency neurotomy. Their pain and psychological status were evaluated pre-operatively and 3 months post-operatively by medical interview and examination, a visual analogue pain scale, the McGill Pain Questionnaire, and the SCL-90-R psychological questionnaire. All patients who obtained complete pain relief exhibited resolution of their pre-operative psychological distress. In contrast, all but one of the patients whose pain remained unrelieved continued to suffer psychological distress. Because psychological distress resolved following a neurosurgical treatment which completely relieved pain, without psychological co-therapy, it is concluded that the psychological distress exhibited by these patients was a consequence of the chronic somatic pain.