Copyright by Yiwei Wang 2020 The Dissertation Committee for Yiwei Wang Certifies that this is the approved version of the following dissertation: Talking about Torment: Agency Assignment and Grammatical Metaphor in Pain Communication Committee: Matthew McGlone, Supervisor Anita Vangelisti Erin Donovan Elena Bessarabova Talking about Torment: Agency Assignment and Grammatical Metaphor in Pain Communication by Yiwei Wang Dissertation Presented to the Faculty of the Graduate School of The University of Texas at Austin in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy The University of Texas at Austin May 2020 Dedication This dissertation is dedicated to my father, Longming Wang; mother, Xiazhen Li; grandmother, Shumei Pan; and to my grandfather, Wengen Li, who passed away last year —I love you all so deeply. 谨以此文献给我的父亲，王龙明；母亲，李霞珍；外婆，潘书妹；以及我去年离世 的外公，李文根——我深深地爱你们。 Acknowledgements I would like to express my deepest gratitude to my advisor, Dr. Matthew McGlone, for his guidance, support, and encouragement which helped me tremendously during the dissertation process. Dr. McGlone has been my advisor since the beginning of my doctoral studies. His passion for research and his kindness as a mentor have inspired me to become a better scholar. My gratitude extends to the members of my dissertation committee, Dr. Anita Vangelisti, Dr. Erin Donovan, and Dr. Elena Bessarabova. Their immense knowledge and insightful feedback has helped to improve the quality of my work. I would also like to pay my special regards to Dr. Michael Beatty who encouraged me to pursue a Ph.D. in Communication Studies. I am deeply indebted to my participants, without whom this project would have not been possible. Finally, many thanks to my family, friends, and partner who have always believed in me and my work. v Abstract Talking about Torment: Agency Assignment and Grammatical Metaphor in Pain Communication Yiwei Wang, PhD The University of Texas at Austin, 2020 Supervisor: Matthew McGlone People suffering from pain often express their experience in metaphor. Empirical research suggests that the metaphors they use may shed light on their adjustment to pain conditions. While linguistic agency and pain metaphors often co-occur, no study has examined how people assign agency when describing pain and the impact of agency assignment on message receivers’ perceptions and responses. This research investigated 1) patterns of linguistic agency assignment in individuals’ descriptions of pain differing in intensity and duration, and 2) the impact of linguistic cues (i.e., agency assignment and grammatical category) used in fictitious pain narratives on audience’s pain perception. Two studies are reported. Study 1 investigated the language people spontaneously use to articulate their experience of mild vs. severe and acute vs. chronic pain. The author hypothesized that participants would be more likely to assign agency to pain or body parts where pain is localized (e.g., back) when describing chronic and/or severe pain than when describing acute and/or mild pain. As predicted, pain/body agency assignment rate was vi higher in the chronic vs. acute pain condition. However, there was no significant difference in the pain/body agency assignment rate between the severe and mild pain conditions. Study 2 featured a 3 (pain location: back, head, or joint) × 2 (agency assignment: person or pain/body) × 2 (pain process encoding: verb or nominalization) factorial experimental design. Participants read a pain narrative differing in linguistic cues and then rated their perception of the speaker and their pain. Findings from univariate analyses of covariance indicated that pain/body agency predicted higher ratings of perceived pain intensity and duration and lower ratings of internal locus of control and pain responsibility than human agency. However, no significant effect of agency assignment and nominalization were found on perceived pain affect, pain-related disability, sympathy, and support for higher dose. Pain perception was also subjected to individual differences in medical expertise, personal pain history, and experience of caretaking. This research offers insight to researchers and healthcare professionals about the influence of various linguistic choices in pain description on others’ interpretation of sufferers’ experience and their subsequent reactions. vii Table of Contents List of Tables ............................................................................................................... xi Chapter 1: Introduction ...............................................................................................1 Chapter 2: Theoretical Background ............................................................................7 Chronic Illness and Lexical Metaphor ..................................................................7 Agency Assignment in Language .......................................................................12 Ideational Metaphor and Nominalization ...........................................................17 Chapter 3: Hypotheses ..............................................................................................20 Chapter 4: Method ....................................................................................................32 Participants .........................................................................................................32 Study 1 ................................................................................................................35 Design and procedure .............................................................................35 Agency coding and reliability .................................................................37 Study 2 ................................................................................................................39 Experimental design and procedure ........................................................39 Dependent measures ...............................................................................41 Perceived pain intensity .................................................................41 Perceived pain duration ..................................................................41 Perceived pain affect ......................................................................41 Perceived pain-related disability ....................................................42 Perceived pain locus of control ......................................................43 Perceived pain responsibility .........................................................43 Sympathy .......................................................................................44 viii Perceived need for higher dose ......................................................44 Individual differences ....................................................................44 Chapter 5: Results .....................................................................................................46 Study 1 ................................................................................................................46 Study 2 ................................................................................................................47 Agency assignment .................................................................................48 Nominalization ........................................................................................55 Individual differences ...........................................................................59 Medical training .............................................................................59 Personal pain history ......................................................................61 Experience of being a primary caretaker .......................................62 Regular interactions with chronic pain patients .............................63 Chapter 6: Discussion ...............................................................................................65 Theoretical implications .........................................................................66 Practical implications ..............................................................................72 Limitations ..............................................................................................74 Conclusion ..............................................................................................75 Tables ...........................................................................................................................77 Appendices ...................................................................................................................83 Appendix A: Questionnaire for Study 1 .............................................................83 Appendix B: Questionnaire for Study 2 .............................................................85 Appendix C: Demographic questions for Study 2 ..............................................87 Appendix D: Pain narratives for Study 2 ............................................................89 ix Works Cited .................................................................................................................93 x List of Tables Table 1: Means and standard deviations for rate of each agency type by condition (i.e., chronic and acute pain; severe and mild pain) of each coder in Study 1 .................................................................................................... 77 Table