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Claudia Campbell,

Pam and John are currently in physical therapy following similar car accidents. They both are receiving therapy for strained necks. However, Pam appears more “down” and catastrophizes that her physical therapy sessions are more painful than helpful. John, on the other hand, routinely trades jokes with his physical therapist during each session and remarks positively on the improvements to his health and functioning. Why do these two patients have such different responses to pain, and are their responses linked to their personalities or their gender?

A variety of characteristics, from genetics to psychosocial processes, contribute to how people perceive pain. A person’s sex (a more biologically-driven term)/gender (a sociocultural term) emerged as a critical factor in shaping the experience of pain. Over the last 15 years an explosion of research has documented differences between how men and women respond to pain and analgesic medications meant to reduce pain (see Greenspan et al., 2007 for a comprehensive review).

Women are more likely than men to report acute and chronic pain, and they use pain-relieving medication more often, even when equating for pain severity. Women also have greater prevalence (in many cases, 50-100% higher relative to men) of many chronic pain conditions including headache, temporomandibular joint disorder (TMD), fibromyalgia, irritable bowel syndrome, and arthritis8, and they report greater pain than men in experimental models, where healthy individuals undergo standard noxious stimuli2.

A number of psychosocial and interpersonal variables also contribute to pain; a few of the well-studied factors include age, race/ethnicity, mood, and coping. A great deal of study has focused on catastrophizing, a maladaptive coping strategy characterized by a negative cognitive and affective response to pain (like feelings of helplessness, magnification, and ruminative thoughts about pain), which is more common in women. Sex differences in catastrophizing may mediate the difference between men and women with chronic pain and in experimental settings1. Similarly, depressive symptoms are more frequently reported by women and have been found to predict future musculoskeletal disorders like low back pain.

More here.