Magel, Brooke, Coates McCall, Iris, Donner, Kayle, Bosma, Rachel, Burke, Emerelda, Chandler, Jennifer A., Lo, Christopher, Patmore, Dwayne, Sukhera, Javeed, Davis, Karen D., and Buchman, Daniel Z. (2026) Exploring the effect of disease explanations of chronic pain on stigma. Journal of Pain, 4. 106299.

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Abstract

Chronic pain is a subjective experience, and the absence of objective medical evidence can contribute to stigma. Despite being classified as a disease in the ICD-11 and research findings showing brain dysfunction associated with chronic pain, the framing of chronic pain can shape public perceptions and influence stigma. In this study, we investigated whether framing chronic pain as a brain disease reduces the stigma that adults without chronic pain place on a fictional person with chronic pain. A total of 508 participants without chronic pain from the US and Canada anonymously completed a survey to assess stigma through the proxy measures of social distance and pain-related judgments. Participants were randomly assigned to read 1 of 5 contrastive vignette explanations of the cause of a fictional person’s chronic pain: No Physical Cause, Biopsychosocial Model, Disease Model, Brain Disease Model, or Brain Disease Model, Biomarker, and Image. We found a main effect on pain-related judgments, specifically disease explanations compared to the No Physical Cause explanation. However, there was no effect on social distance. Demographic variables showed group-level associations with social distance (age 35–44, Asian, right-leaning political affiliation, not knowing anyone and low familiarity with chronic pain, and Canadian) and pain-related judgments (age 35–44 and 65–74, men, right-leaning political affiliation, and college diplomas or undergraduate degrees). Our findings suggest that framing chronic pain as a disease may reduce negative judgments, but may not influence social distance. This study has implications for public health communication strategies aimed at reducing chronic pain stigma.

Item ID:	91299
Item Type:	Article (Research - C1)
ISSN:	1528-8447
Copyright Information:	© 2026 The Author(s). Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Date Deposited:	29 Apr 2026 02:57
FoR Codes:	50 PHILOSOPHY AND RELIGIOUS STUDIES > 5001 Applied ethics > 500106 Medical ethics @ 33% 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems @ 33% 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 34%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200103 Human pain management @ 33% 20 HEALTH > 2004 Public health (excl. specific population health) > 200409 Mental health @ 33% 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280121 Expanding knowledge in psychology @ 34%
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