BACKGROUND: It is well known that individual factors are important in the facial recognition of pain. However, it is unclear whether vigilance to pain as a pain-related attentional mechanism is among these relevant factors.

OBJECTIVES: Vigilance to pain may have two different effects on the recognition of facial pain expressions: pain-vigilant individuals may detect pain faces better but overinclude other facial displays, misinterpreting them as expressing pain; or they may be true experts in discriminating between pain and other facial expressions. The present study aimed to test these two hypotheses. Furthermore, pain vigilance was assumed to be a distinct predictor, the impact of which on recognition cannot be completely replaced by related concepts such as pain catastrophizing and fear of pain.

METHODS: Photographs of neutral, happy, angry and pain facial expressions were presented to 40 healthy participants, who were asked to classify them into the appropriate emotion categories and provide a confidence rating for each classification. Additionally, potential predictors of the discrimination performance for pain and anger faces – pain vigilance, pain-related catastrophizing, fear of pain – were assessed using self-report questionnaires.

RESULTS: Pain-vigilant participants classified pain faces more accurately and did not misclassify anger as pain faces more frequently. However, vigilance to pain was not related to the confidence of recognition ratings. Pain catastrophizing and fear of pain did not account for the recognition performance.

CONCLUSIONS: Moderate pain vigilance, as assessed in the present study, appears to be associated with appropriate detection of pain-related cues and not necessarily with the overinclusion of other negative cues.