Behavioral markers of pain: Understanding the cognitive, motor, and societal interactions in the pain experience

Abstract The behavioral expression of pain is our best current understanding of how pain can be recognized through either research or clinical evaluation. We rely heavily on how an individual may express themselves after receiving a painful stimulus, and thus it is critical to understand the factors that go into and mediate the expression of pain in patients and research participants. In this chapter, we explore three dominant themes of pain behaviors: psychology and cognition, motor behaviors, and social interactions. We provide an up-to-date analysis of how these themes are expressed and what needs to be focused on in future research. We explore brain and behavioral correlates and comment on how pain-related behavior should be managed as more objective clinical tools, such as magnetic resonance imaging, are developed alongside techniques that leverage higher level computing (e.g., machine learning). We focus our discussion using a precision pain medicine perspective.