Gender Differences in Pain Anxiety: A Cross-Sectional Study

Background: Pain anxiety, defined as fear of pain and pain-related sensations, is an important transdiagnostic construct influencing pain perception, avoidance behaviour, and functional outcomes. Research consistently suggests that females report higher anxiety across multiple domains; however, the specific nature of gender differences in pain anxiety, as measured by the Pain Anxiety Symptoms Scale (PASS-20), remains understudied in young Indian adults.
Objective: To examine gender differences in pain anxiety using the PASS-20 and its four subscales — cognitive, escape/avoidance, fear, and physiological anxiety — in a sample of healthy young adults aged 18–35 years.
Methods: A cross-sectional survey design was employed. Eighty participants (41 males, 39 females) aged 18–35 years were recruited via convenience sampling. Data were collected using an online Google Form incorporating the validated PASS-20 questionnaire. Descriptive statistics including mean, median, mode, and standard deviation were computed for total and subscale scores for each gender.
Results: The majority of both males (58.5%) and females (74.4%) scored in the moderate pain anxiety category (35–67). Females demonstrated a higher mean total PASS-20 score (47.07 ± 15.49) compared to males (38.00 ± 15.01), indicating greater overall pain anxiety. Across all four subscales, females scored higher than males, with cognitive anxiety showing the highest subscale scores in both groups (females: 14.86 ± 4.40; males: 11.31 ± 5.94) and physiological anxiety showing the lowest scores in both (females: 9.33 ± 5.31; males: 7.43 ± 5.73).
Conclusion: Females exhibit higher pain anxiety than males across all PASS-20 subscales, with cognitive anxiety being the dominant component in both genders. These findings support the need for gender-sensitive approaches in pain assessment and management. Clinicians should account for cognitive and emotional dimensions of pain anxiety, particularly in female patients.

Pain Anxiety, Gender Differences, PASS-20, Cognitive Anxiety, Pain Perception, Cross-Sectional Study

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