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The perception of pain in others: how gender, race, and age influence pain expectations
P84
The Journal of Pain
Abstracts
(432) Neighborhood SES and chronic pain: impact on quality of life of cancer survivors
(434) The perception of pain in others: how gender, race, and age influence pain expectations
C Green and T Hart-Johnson; University of Michigan, Ann Arbor, MI
C Scipio, L Wandner, and M Robinson; University of Florida, Gainesville, FL
Cancer-related chronic pain is rarely discussed regarding cancer survivors. Gender and racial disparities in pain exist. However, little is known about the effect of neighborhood socio-economic status (nSES) or the interaction between race, nSES and pain on quality of life (QOL). Black and white survivors of breast, colorectal, lung or prostate cancer or multiple myeloma from the Michigan State Cancer Registry were randomly invited to participate in a cross-sectional mail survey study. Participants (N=152, 23% black, 77% white; 51% male, 49% female) answered questions about socio-demographics, cancer and treatment history, pain, and quality of life. Study addresses were also matched to census data and neighborhood poverty, education, and unemployment were calculated. Structural equation modeling was used to test the relationships between demographics (age, race, gender), nSES, present and past cancer-related pain, and QOL. Black race, but not age or gender, predicted nSES. nSES predicted current pain, pain since diagnosis and all seven outcome variables negatively, though emotional functioning only at trend level. Black race was related to lower pain rates, a finding not mediated by removing the nSES relationship which explains variance in the other direction. Current pain predicted general health and physical, role and social functioning. Pain since diagnosis predicted depression, emotional and cognitive functioning. Relationships were further explored. These relationships are complex, but it is clear that neighborhood SES has a strong influence on the cancer pain experience and the subsequent outcomes. Thus, these results reveal important health disparities and the need for health policy relevant research.
One obvious component of pain assessment is the provider’s perception of pain in another. Age, race, and sex have been identified as cues that may influence the assessment of others’ pain. The current study explored the effects of age, race, and sex related expectations on the perception of pain. 105 healthy volunteers completed questionnaires that compared their own pain sensitivity and willingness to report pain to how they expected ‘‘typical’’ persons of a different age, race, and sex would respond. T tests indicated significant findings (p#.05) for all demographic cues. Participants viewed themselves as less pain sensitive/willing to report pain than all comparison racial groups. Similarly, participants viewed themselves as less pain sensitive/willing to report pain than all age comparison groups. Female participants were more likely than men to be willing to report pain than the ‘‘typical woman’’ on the Gender Role Expectations of Pain (GREP). Male participants were less willing, compared to female participants, to report pain compared to the ‘‘typical man’’. Taken together, the results suggest that women are more willing to report pain than men. These results indicate a self-enhancement bias suggesting that individuals perceive themselves as less sensitive and less willing to report pain than the general population. This is the first study to develop questionnaires that assess if individuals use age and race as cues in the perception of pain. Future investigations and additional measures are warranted to examine if healthcare providers would report a similar self-enhancement bias when comparing their own pain experiences to their perception of pain in patients of varying age and race. This study is also the first to validate the use of a computer-based format of the GREP questionnaire. This novel format could provide increased accessibility of the GREP, which may allow for more diverse study samples.
(433) Testing the relation between dispositional optimism and centrally-mediated pain inhibitory processes: does ethnicity matter?
(435) Ethnic differences in experimental pain perception
T Kronfli, B Goodin, R Fillingim, J Haythornthwaite, and R Edwards; University of Maryland-Baltimore County, Baltimore, MD A preponderance of research to date has focused on risk factors of negative pain-related outcomes and the mechanisms explaining such relations. Far less research has examined variables thought to promote adaptive pain responses and the explanatory processes that may protect individuals from the deleterious effects of pain. Optimism has been shown to beneficially influence a number of health-related factors. Although limited research has suggested an association between optimism and the pain experience, whether optimism is related to pain modulatory processes has not yet been examined. Further, because the health promoting effects of an optimistic disposition may vary according to cultural dynamics, assessing the optimism-pain relation across different ethnic groups is warranted. The current study examined the association of optimism and diffuse noxious inhibitory controls (DNIC), and whether this relation was moderated by individuals’ ethnic background. A total of 149 (52% women) healthy, ethnically diverse (58% Caucasian American, 23% Asian American, 19% African American) young adults were subjected to algometry, a cold pressor task (CPT), and completed the Life Orientation Test-Revised (LOT-R). Controlling for ethnicity, sex, catastrophizing and depressive ratings, results demonstrated a significant positive association between optimism and DNIC, such that greater optimism was related to enhanced endogenous pain inhibitory processes (b = .193, p = .04). The association between optimism and DNIC was not moderated by individuals’ ethnic background (R2 D = .007, p = .61), meaning the strength of the association did not significantly differ as a function of being Asian (p =.88) or African American (p = .36) when compared to Caucasian Americans. These findings suggest that an optimistic disposition may potentiate endogenous pain inhibition. Of particular interest is that the optimism-DNIC relation did not vary as a function of ethnic background in our study, which may mean that the association is of similar magnitude across a wide range of people.
T Burnight, A Uysal, and Q Lu; University of Houston, Houston, TX A growing body of literature in experimental pain studies suggests important ethnic differences in pain responses. However, a majority of the studies only compared African Americans with Caucasians. The purpose of the present study is to explore ethnic differences in experimental pain outcomes across multiple groups. 119 healthy undergraduate students (23 Asian, 25 African American, 37 Caucasian, and 34 Hispanic) underwent a cold-pressor task (5 C +0.1). It was found that African Americans had a significantly lower pain tolerance (M = 63.2) than both Caucasians (M= 148.92, p=.003) and Asians (M= 132.57, p= .03). Asians had higher pain intensity (M=8.99) than Hispanics (M= 7.74, p=.028). A non-significant trend emerged for Asians reporting the highest pain threshold compared to all groups, (p =.10). The study revealed important ethnic differences in pain. Consistent with previous studies, African Americans have a decreased pain tolerance relative to other ethnic groups. Findings that Asians had increased pain sensitivity but higher pain tolerance and threshold are intriguing and should be replicated in the future. Future research should also investigate potential psychosocial and physiological mediators of ethnic differences in pain responses.
The Journal of Pain
Abstracts
(432) Neighborhood SES and chronic pain: impact on quality of life of cancer survivors
(434) The perception of pain in others: how gender, race, and age influence pain expectations
C Green and T Hart-Johnson; University of Michigan, Ann Arbor, MI
C Scipio, L Wandner, and M Robinson; University of Florida, Gainesville, FL
Cancer-related chronic pain is rarely discussed regarding cancer survivors. Gender and racial disparities in pain exist. However, little is known about the effect of neighborhood socio-economic status (nSES) or the interaction between race, nSES and pain on quality of life (QOL). Black and white survivors of breast, colorectal, lung or prostate cancer or multiple myeloma from the Michigan State Cancer Registry were randomly invited to participate in a cross-sectional mail survey study. Participants (N=152, 23% black, 77% white; 51% male, 49% female) answered questions about socio-demographics, cancer and treatment history, pain, and quality of life. Study addresses were also matched to census data and neighborhood poverty, education, and unemployment were calculated. Structural equation modeling was used to test the relationships between demographics (age, race, gender), nSES, present and past cancer-related pain, and QOL. Black race, but not age or gender, predicted nSES. nSES predicted current pain, pain since diagnosis and all seven outcome variables negatively, though emotional functioning only at trend level. Black race was related to lower pain rates, a finding not mediated by removing the nSES relationship which explains variance in the other direction. Current pain predicted general health and physical, role and social functioning. Pain since diagnosis predicted depression, emotional and cognitive functioning. Relationships were further explored. These relationships are complex, but it is clear that neighborhood SES has a strong influence on the cancer pain experience and the subsequent outcomes. Thus, these results reveal important health disparities and the need for health policy relevant research.
One obvious component of pain assessment is the provider’s perception of pain in another. Age, race, and sex have been identified as cues that may influence the assessment of others’ pain. The current study explored the effects of age, race, and sex related expectations on the perception of pain. 105 healthy volunteers completed questionnaires that compared their own pain sensitivity and willingness to report pain to how they expected ‘‘typical’’ persons of a different age, race, and sex would respond. T tests indicated significant findings (p#.05) for all demographic cues. Participants viewed themselves as less pain sensitive/willing to report pain than all comparison racial groups. Similarly, participants viewed themselves as less pain sensitive/willing to report pain than all age comparison groups. Female participants were more likely than men to be willing to report pain than the ‘‘typical woman’’ on the Gender Role Expectations of Pain (GREP). Male participants were less willing, compared to female participants, to report pain compared to the ‘‘typical man’’. Taken together, the results suggest that women are more willing to report pain than men. These results indicate a self-enhancement bias suggesting that individuals perceive themselves as less sensitive and less willing to report pain than the general population. This is the first study to develop questionnaires that assess if individuals use age and race as cues in the perception of pain. Future investigations and additional measures are warranted to examine if healthcare providers would report a similar self-enhancement bias when comparing their own pain experiences to their perception of pain in patients of varying age and race. This study is also the first to validate the use of a computer-based format of the GREP questionnaire. This novel format could provide increased accessibility of the GREP, which may allow for more diverse study samples.
(433) Testing the relation between dispositional optimism and centrally-mediated pain inhibitory processes: does ethnicity matter?
(435) Ethnic differences in experimental pain perception
T Kronfli, B Goodin, R Fillingim, J Haythornthwaite, and R Edwards; University of Maryland-Baltimore County, Baltimore, MD A preponderance of research to date has focused on risk factors of negative pain-related outcomes and the mechanisms explaining such relations. Far less research has examined variables thought to promote adaptive pain responses and the explanatory processes that may protect individuals from the deleterious effects of pain. Optimism has been shown to beneficially influence a number of health-related factors. Although limited research has suggested an association between optimism and the pain experience, whether optimism is related to pain modulatory processes has not yet been examined. Further, because the health promoting effects of an optimistic disposition may vary according to cultural dynamics, assessing the optimism-pain relation across different ethnic groups is warranted. The current study examined the association of optimism and diffuse noxious inhibitory controls (DNIC), and whether this relation was moderated by individuals’ ethnic background. A total of 149 (52% women) healthy, ethnically diverse (58% Caucasian American, 23% Asian American, 19% African American) young adults were subjected to algometry, a cold pressor task (CPT), and completed the Life Orientation Test-Revised (LOT-R). Controlling for ethnicity, sex, catastrophizing and depressive ratings, results demonstrated a significant positive association between optimism and DNIC, such that greater optimism was related to enhanced endogenous pain inhibitory processes (b = .193, p = .04). The association between optimism and DNIC was not moderated by individuals’ ethnic background (R2 D = .007, p = .61), meaning the strength of the association did not significantly differ as a function of being Asian (p =.88) or African American (p = .36) when compared to Caucasian Americans. These findings suggest that an optimistic disposition may potentiate endogenous pain inhibition. Of particular interest is that the optimism-DNIC relation did not vary as a function of ethnic background in our study, which may mean that the association is of similar magnitude across a wide range of people.
T Burnight, A Uysal, and Q Lu; University of Houston, Houston, TX A growing body of literature in experimental pain studies suggests important ethnic differences in pain responses. However, a majority of the studies only compared African Americans with Caucasians. The purpose of the present study is to explore ethnic differences in experimental pain outcomes across multiple groups. 119 healthy undergraduate students (23 Asian, 25 African American, 37 Caucasian, and 34 Hispanic) underwent a cold-pressor task (5 C +0.1). It was found that African Americans had a significantly lower pain tolerance (M = 63.2) than both Caucasians (M= 148.92, p=.003) and Asians (M= 132.57, p= .03). Asians had higher pain intensity (M=8.99) than Hispanics (M= 7.74, p=.028). A non-significant trend emerged for Asians reporting the highest pain threshold compared to all groups, (p =.10). The study revealed important ethnic differences in pain. Consistent with previous studies, African Americans have a decreased pain tolerance relative to other ethnic groups. Findings that Asians had increased pain sensitivity but higher pain tolerance and threshold are intriguing and should be replicated in the future. Future research should also investigate potential psychosocial and physiological mediators of ethnic differences in pain responses.