title: Gender differences in pain perception: a signal detection theory approach.
abstract: BACKGROUND
  Overseas studies suggest women report more pain and are more vulnerable to chronic pain conditions compared with men, however, it is unclear whether this difference in pain perception is due to sensory or non-sensory factors such as anxiety. Since gender differences in pain perception may have important implications for pain management, it is crucial that the relationship between pain, gender and anxiety in this culture be clarified.
  
  
  METHODS
  The Signal Detection Theory Approach was used to determine gender differences in sensory discrimination [P(A)] and response bias (B). One hundred and twenty six Hong Kong Chinese adults responded to thirty pairs of thermal stimuli (36 degrees C-48 degrees C) and their responses to these stimuli were analyzed by computer software. The adapted Chinese version of the State-Trait Anxiety Inventory (STAI-Y) was used to assess state and trait anxiety of participants.
  
  
  RESULTS
  Compared with men, women showed enhanced sensory discriminability (P = 0.004) and were less stoical in their response to pain (P = 0.03). Although there was no significant gender difference in state and trait anxiety, sensory discrimination was positively correlated with state anxiety (r = 0.19) and response bias was negatively correlated with trait anxiety (r = -0.18). The content validity index for the STAI-Y was 0.9 and the co-efficient alpha for reliability for state and trait anxiety was 0.88 and 0.92, respectively.
  
  
  CONCLUSIONS
  Enhanced sensory discriminability in women may explain why women report more pain and seek healthcare more frequently compared with men. Men showed more stoical response to pain possibly because of gender-role expectations. The Signal Detection Theory approach was instrumental in assessing the sensory and non-sensory dimensions of pain perception. Awareness of the effects of gender and anxiety in pain perception will enable clinicians to be more efficient pain managers.
authors.affiliation: School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
authors.forename: Angie L
authors.initials: AL
authors.lastname: Soetanto
authors.forename: Joanne W
authors.initials: JW
authors.lastname: Chung
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Wong
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D012737:Sex Factors; D017603:Signal Detection, Psychological / Q000502:physiology*