Is it pain, anger, disgust, or sadness? Individual differences in expectations of pain facial expressions

Humans rely on facial expressions to assess others' affective states. However, pain facial expressions are poorly recognized and are often confused with other negative affective states, such as anger, disgust, sadness, and fear. Previous research has shown that individuals' expectations about the appearance of pain facial expressions are not optimal and do not perfectly reflect the facial features typically observed in individuals expressing pain. In the present study, we verified if expectations about pain facial expressions are also suboptimal by overlapping with other affective states. We relied on two published data sets (data collected between 2017 and 2020) containing images representing the expectations of the appearance of pain facial expressions according to 162 White participants. We then asked an independent group of White participants (N = 60, 30 women, M_age = 31.5) to rate the degree to which they perceived the six basic emotions (anger, disgust, fear, joy, sadness, and surprise) and pain in those images (data collected in 2023). The same pattern of findings was obtained in both data sets. Anger, disgust, and sadness were perceived as highly salient in expectations about pain facial expressions. Most importantly, three clusters of participants with distinct expectations were found. These results support the hypothesis that individual differences exist in how observers expect pain to be expressed. These individual differences might impact the ability of an observer to distinguish an expression of pain from other negative affective states, and raising awareness about them might help reduce mistakes with serious consequences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).