Gender Bias in Pediatric Pain Assessment

Objective: Observer rating of pain is central to diagnosis and treatment in healthcare, especially in pediatrics. However, there are few studies examining potential biases in observer ratings of pediatric pain. Cohen et al. (2014) reported that adult participants rated a video of a child undergoing a needle stick as experiencing more pain when the child was described as a boy as compared to a girl, suggesting a possible gender bias. To confirm, clarify, and extend this finding, we conducted a replication experiment and follow-up study examining the role of explicit gender stereotypes in shaping such asymmetric judgments. Method: In an independent, pre-registered, direct replication and extension study with open data and materials (osf.io/6tj58), we showed participants the same video from Cohen et al. (2014), with the child described as a boy or a girl depending on condition. We then asked adults to rate how much pain the child experienced and displayed, how typical the child was in these respects, and how much they agreed with explicit gender stereotypes concerning pain response in boys versus girls. Results: Similar to Cohen et al. (2014), but with a larger and more demographically diverse sample, we found that the ‘boy’ was rated as experiencing more pain than the ‘girl’ despite identical clinical circumstances and identical pain behavior cross conditions. Controlling for explicit gender stereotypes eliminated the effect. Conclusions: Explicit gender stereotypes—e.g., that boys are more ‘stoic’ or girls are more emotive—may bias adult assessment of children’s pain.

目标：在医疗保健领域，尤其是儿科，观察者对疼痛的评估对于诊断和治疗至关重要。然而，关于儿科疼痛观察者评分中潜在偏见的探讨研究寥寥无几。Cohen 等人（2014年）报告称，成年参与者认为，当儿童被描述为男孩而非女孩时，观看儿童接受针头穿刺的视频，他们所感受到的疼痛更甚，这暗示了可能存在的性别偏见。为验证、阐明并扩展这一发现，我们进行了一项复制实验及后续研究，旨在探究显性性别刻板印象在塑造此类不对称判断中所起的作用。方法：在独立、预先注册、直接复制和扩展研究中，我们向参与者展示了与 Cohen 等人（2014年）相同的视频，视频中儿童被描述为男孩或女孩，取决于条件。随后，我们请成年人对儿童所经历及表现的疼痛程度、在这些方面的典型性，以及他们对男孩与女孩疼痛反应的显性性别刻板印象的认同程度进行评分。结果：与 Cohen 等人（2014年）的研究相似，但样本量更大且人口统计学上更为多样化，我们发现，在相同的临床环境和相同的疼痛行为条件下，'男孩'被评定为比'女孩'感受到更多的疼痛。控制显性性别刻板印象消除了这一效应。结论：显性性别刻板印象，例如，男孩更‘坚忍’或女孩更‘情感丰富’，可能会偏见成年人对儿童疼痛的评估。