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J Pain. 2019 Aug;20(8):965-979. doi: 10.1016/j.jpain.2019.02.009. Epub 2019 Feb 22.

Sensory, Affective, and Catastrophizing Reactions to Multiple Stimulus Modalities: Results from the Oklahoma Study of Native American Pain Risk.

Author information

1
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma. Electronic address: jamie-rhudy@utulsa.edu.
2
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma.
3
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma; University of Washington School of Medicine, Department of Psychiatry & Behavioral Sciences, Seattle, Washington.
4
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma; Cincinnati Children's Hospital Medical Center, Department of Anesthesiology, Cincinnati, Ohio.
5
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma; Northeastern State University, Department of Psychology, Tahlequah, Oklahoma.
6
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma; University of Alabama at Birmingham, Department of Psychology, Birmingham, Alabama.
7
The University of Tulsa, Department of Psychology, Tulsa, Oklahoma; University of Oklahoma-Tulsa, Department of Social Work, Tulsa, OK.

Abstract

Native Americans (NAs) have a higher prevalence of chronic pain than any other U.S. racial/ethnic group; however, little is known about the mechanisms for this pain disparity. This study used quantitative sensory testing to assess pain experience in healthy, pain-free adults (n = 137 NAs (87 female), n = 145 non-Hispanic whites (NHW; 68 female)) after painful electric, heat, cold, ischemic, and pressure stimuli. After each stimulus, ratings of pain intensity, sensory pain, affective pain, pain-related anxiety, and situation-specific pain catastrophizing were assessed. The results suggested that NAs reported greater sensory pain in response to suprathreshold electric and heat stimuli, greater pain-related anxiety to heat and ischemic stimuli, and more catastrophic thoughts in response to electric and heat stimuli. Sex differences were also noted; however, with the exception of catastrophic thoughts to cold, these finding were not moderated by race/ethnicity. Together, findings suggest NAs experience heightened sensory, anxiety, and catastrophizing reactions to painful stimuli. This could place NAs at risk for future chronic pain and could ultimately lead to a vicious cycle that maintains pain (eg, pain → anxiety/catastrophizing → pain). PERSPECTIVE: NAs experienced heightened sensory, anxiety, and catastrophizing reactions in response to multiple pain stimuli. Given the potential for anxiety and catastrophic thoughts to amplify pain, this characteristic may place them at risk for pain disorders and could lead to a vicious cycle that maintains pain.

KEYWORDS:

Native Americans; Quantitative sensory testing; anxiety; catastrophizing; ethnic differences; pain; pain coping

PMID:
30797963
PMCID:
PMC6689438
[Available on 2020-08-01]
DOI:
10.1016/j.jpain.2019.02.009

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