Portuguese woman joins international research on sexual and gender disparities in pain

“Several studies have shown how sex and gender play a fundamental role in the perception and modulation of pain”

Sónia Bernardes, researcher at the Center for Research and Social Intervention (CIS-Iscte) and professor at the School of Social and Human Sciences at Iscte-Instituto Universitário de Lisboa, was appointed to join a working group of the International Association for the Study of Pain ( IASP), which designated 2024 as the Global Year on Sexual and Gender Disparities in Pain.

The International Association for the Study of Pain (IASP) Global Year focuses on a particular aspect of pain to raise awareness not only within the pain research and intervention community, but also more broadly.

Global Year 2024 will examine the evidence on sex and gender differences in the perception and modulation of pain and will address sex and gender-related disparities in both pain research and treatment.

Sónia Bernardes was invited by the IASP presidency to join the working group dedicated to working on these issues in 2024, addressing potential disparities in terms of research, but also in the treatment of pain.

According to the CIS-Iscte researcher, “several studies have shown how sex and gender play a fundamental role in the perception and modulation of pain”. The researcher adds that “both biological factors associated with sex and psychological and social factors associated with gender contribute to explaining why, in general, women live more frequently with widespread and disabling chronic pain”.

Still according to the researcher, the integration of this knowledge in the development of new intervention programs is fundamental for promoting the quality of life of thousands of people living with chronic pain.

Sónia Bernardes has investigated various aspects of chronic pain throughout her academic and scientific career. She recently joined an international research team that explored the stigma surrounding people with chronic pain.

The results of this study published in 2023 suggest that the cognitive, affective and behavioral responses of the general population towards people with chronic pain seem to depend on the type of pain, whether it is associated with any visible health problem, but also on other factors. , such as the sex of the person in pain.

Specifically, public stigma was greater toward people with chronic pain that is not associated with another underlying illness or injury compared to people whose pain was associated with another illness or injury.

Despite previous evidence of greater stigmatization of women with chronic pain, in the study only men without chronic pain expected more public stigma towards women with chronic pain than men with chronic pain, a pattern that was not observed in the group of participants with pain chronic.

For the researcher, “these data indicate a need to consider multiple factors when examining public stigma in relation to chronic pain, as they can have complex and interconnected effects on individuals' experiences and well-being.”



Other social factors, such as country of origin, may also influence beliefs related to pain, and even adaptation and functioning responses among individuals with chronic pain, demonstrating the importance of understanding it.

“Part of the research carried out with people suffering from chronic pain also aims to inform practices in healthcare contexts”, says Sónia Bernardes. For example, a study carried out at CIS-Iscte examined how interaction with caregivers can help older people living with chronic pain.

But other types of support have also been explored in their research. In a study in collaboration with researchers from the University of Ottawa (Canada), social support was explored, namely the role of friendship in adjustment to chronic pain, a topic rarely investigated.

Analysis of participants' experiences revealed two themes. The first theme captured the way in which friends can help or hinder living with chronic pain, by being available and providing the necessary support, or by not accepting and not accommodating to support involvement in the life of the person with chronic pain.

The second theme captured the negative effect of chronic pain on the attitudes and behaviors of both parties regarding the relationship, leading to friendship networks becoming smaller and more homogeneous.

Sónia Bernardes, first author of this study concludes that “it seems to be relevant to include adult friends in interventions with patients to reduce the negative effect of chronic pain on friendships and daily life, taking advantage of their power to promote adjustment to chronic pain”.

The health community has recognized the contributions of research to the study of pain. In 2023, the work of the PhD student in Psychology at Iscte, Inês Oliveira, guided by CIS-Iscte researchers Sónia Bernardes and Margarida Garrido, was awarded by Hospital Garcia de Orta with the Garcia de Orta Prize 2023, and by the Grünenthal Foundation with the Grünenthal Dor Prize 2022.

In this study, competency profiles were identified regarding the self-reported experience of the ability to feel, interpret and self-regulate internal sensations in individuals with chronic musculoskeletal pain.

The study data not only allows us to refine theoretical models of pain, by explaining body-mind interactions, but also contributes to the development of personalized interventions, improving adjustment to chronic pain and the quality of life of people with this type of pain.

“Considering different psychosocial factors involved in chronic pain is essential for advancing research in this area, in order to develop high-quality, evidence-based interventions,” says Sónia Bernardes. “By considering sex and gender in chronic pain, I am confident that the IASP Global Year 2024 working group can inform future research and interventions,” he concludes.