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Sex differences in fear of pain: item-level analysis of the Fear of Pain Questionnaire III

Authors Vambheim SM, Øien RA

Received 28 November 2016

Accepted for publication 3 March 2017

Published 7 April 2017 Volume 2017:10 Pages 825—831

DOI https://doi.org/10.2147/JPR.S128850

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Katherine Hanlon

Sara M Vambheim,1 Roald A Øien1,2

1Department of Psychology, UiT, The Arctic University of Norway, Tromsø, Norway; 2Yale University, School of Medicine, Child Study center, New Haven, CT, USA

Objectives: This study aimed to investigate sex differences in fear of pain (FOP) measured by the Fear of Pain Questionnaire III (FPQ-III) in a nonclinical sample. The FPQ-III is a self-report inventory measuring FOP, with 30 items, divided into three subscales: Severe, Minor and Medical Pain.
Methods: A total of 185 subjects participated (49.7% females) in this study. Sex differences on overall FOP, the subscales, and at item level were examined. One-way analysis of variance tested the association between sex and FOP, measured by overall FOP and the subscales. Ordinal regression analysis enabled item-level analysis of the FPQ-III and was conducted to explore further specificity of FOP in males compared to females.
Results: Overall FOP and fear of Severe Pain was significantly higher in females than in males, as measured by the FPQ-Total and the FPQ-Severe. Moreover, females were more likely to report higher FOP than males on 16 items (p<0.05). Further inspection revealed that females scored significantly higher than males on all items on the Severe Pain subscale. When controlling for multiple comparisons six items reached significance (p<0.001). Five of these items belonged to the subscale Severe Pain. When controlling for overall FOP one item, also from the Severe Pain subscale, reached significance (p<0.001).
Conclusion: There are sex differences in severe FOP, with higher FOP in females compared to males. Potential explanations are sex differences in the 1) psychosocial mechanisms of fear and anxiety, and 2) emotional reactions to and interpretation of FPQ-III Severe Pain items.

Keywords: fear of pain, FOP, fear of pain questionnaire III, FPQ-III, pain, sex differences

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