Automatic Detection of Pain from Spontaneous Facial Expressions

This paper presents a new approach for detecting pain in sequences of spontaneous facial expressions. The motivation for this work is to accompany mobile-based self-management of chronic pain as a virtual sensor for tracking patients' expressions in real-world settings. Operating under such constraints requires a resource efficient approach for processing non-posed facial expressions from unprocessed temporal data. In this work, the facial action units of pain are modeled as sets of distances among related facial landmarks. Using standardized measurements of pain versus no-pain that are specific to each user, changes in the extracted features in relation to pain are detected. The activated features in each frame are combined using an adapted form of the Prkachin and Solomon Pain Intensity scale (PSPI) to detect the presence of pain per frame. Painful features must be activated in N consequent frames (time window) to indicate the presence of pain in a session. The discussed method was tested on 171 video sessions for 19 subjects from the McMaster painful dataset for spontaneous facial expressions. The results show higher precision than coverage in detecting sequences of pain. Our algorithm achieves 94% precision (F-score=0.82) against human observed labels, 74% precision (F-score=0.62) against automatically generated pain intensities and 100% precision (F-score=0.67) against self-reported pain intensities

Perceiving Pain in Others: Automatic and Controlled Mechanisms

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Personalized Automatic Estimation of Self-reported Pain Intensity from Facial Expressions

Pain is a personal, subjective experience that is commonly evaluated through visual analog scales (VAS). While this is often convenient and useful, automatic pain detection systems can reduce pain score acquisition efforts in large-scale studies by estimating it directly from the participants' facial expressions. In this paper, we propose a novel two-stage learning approach for VAS estimation: first, our algorithm employs Recurrent Neural Networks (RNNs) to automatically estimate Prkachin and Solomon Pain Intensity (PSPI) levels from face images. The estimated scores are then fed into the personalized Hidden Conditional Random Fields (HCRFs), used to estimate the VAS, provided by each person. Personalization of the model is performed using a newly introduced facial expressiveness score, unique for each person. To the best of our knowledge, this is the first approach to automatically estimate VAS from face images. We show the benefits of the proposed personalized over traditional non-personalized approach on a benchmark dataset for pain analysis from face images.Comment: Computer Vision and Pattern Recognition Conference, The 1st International Workshop on Deep Affective Learning and Context Modelin

Machine Analysis of Facial Expressions

No abstract

Chronic-Pain Protective Behavior Detection with Deep Learning

In chronic pain rehabilitation, physiotherapists adapt physical activity to patients' performance based on their expression of protective behavior, gradually exposing them to feared but harmless and essential everyday activities. As rehabilitation moves outside the clinic, technology should automatically detect such behavior to provide similar support. Previous works have shown the feasibility of automatic protective behavior detection (PBD) within a specific activity. In this paper, we investigate the use of deep learning for PBD across activity types, using wearable motion capture and surface electromyography data collected from healthy participants and people with chronic pain. We approach the problem by continuously detecting protective behavior within an activity rather than estimating its overall presence. The best performance reaches mean F1 score of 0.82 with leave-one-subject-out cross validation. When protective behavior is modelled per activity type, performance is mean F1 score of 0.77 for bend-down, 0.81 for one-leg-stand, 0.72 for sit-to-stand, 0.83 for stand-to-sit, and 0.67 for reach-forward. This performance reaches excellent level of agreement with the average experts' rating performance suggesting potential for personalized chronic pain management at home. We analyze various parameters characterizing our approach to understand how the results could generalize to other PBD datasets and different levels of ground truth granularity.Comment: 24 pages, 12 figures, 7 tables. Accepted by ACM Transactions on Computing for Healthcar

Facial expression of pain: an evolutionary account.

This paper proposes that human expression of pain in the presence or absence of caregivers, and the detection of pain by observers, arises from evolved propensities. The function of pain is to demand attention and prioritise escape, recovery, and healing; where others can help achieve these goals, effective communication of pain is required. Evidence is reviewed of a distinct and specific facial expression of pain from infancy to old age, consistent across stimuli, and recognizable as pain by observers. Voluntary control over amplitude is incomplete, and observers can better detect pain that the individual attempts to suppress rather than amplify or simulate. In many clinical and experimental settings, the facial expression of pain is incorporated with verbal and nonverbal vocal activity, posture, and movement in an overall category of pain behaviour. This is assumed by clinicians to be under operant control of social contingencies such as sympathy, caregiving, and practical help; thus, strong facial expression is presumed to constitute and attempt to manipulate these contingencies by amplification of the normal expression. Operant formulations support skepticism about the presence or extent of pain, judgments of malingering, and sometimes the withholding of caregiving and help. To the extent that pain expression is influenced by environmental contingencies, however, "amplification" could equally plausibly constitute the release of suppression according to evolved contingent propensities that guide behaviour. Pain has been largely neglected in the evolutionary literature and the literature on expression of emotion, but an evolutionary account can generate improved assessment of pain and reactions to it