Background & Aims
Research suggests that ethnicity is a powerful predictor of pain-related outcomes; however, studies comparing the differences in central pain mechanisms between Hispanic and non-Hispanic White (NHW) are scarce. Evidence has also considered the influence of sociocultural factors on pain perception. Authors have suggested that disparities in health outcomes exist between populations, where chronic pain is more common among Hispanic Americans (HA); however, limited research has been done to compare central pain mechanisms and sociocultural factors between older adults Hispanics and Non-Hispanic Whites (NHW). The present study investigated the differences in central pain mechanisms among older adults Hispanics and NHW, and the influence of resilience, optimism, and ethnic identity in the U.S.-Mexico border.
Methods
Demographic information and medical history were gathered at the beginning of the session. Subjects also completed the Brief Resilience Scale (BRS), the Revised Life Orientation Test (LOT-R), and the Multigroup Ethnic Identity Measure (MEIM). Participants underwent quantitative sensory testing which included pain threshold and tolerance (assessed with thermal stimuli in both forearms), Suprathreshold Heat Pain Response (SHPR), and Conditioned Pain Modulation (CPM). SHPR was induced by repeated thermal stimuli in both thenar eminences. CPM was assessed using SHPR as the experimental stimulus, generated with repeated thermal stimuli, and cold pressor task (7°C) as the conditioning stimulus. Independent T-tests were performed to assess differences in pain sensitivity, central pain mechanisms, and sociocultural factors between HA and Non-(NHW). Pearson Correlation were performed to examine the association among variables.
Results
The preliminary analysis included 24 participants (58.3% females, 15 HA, 9 NHW, mean age 68.12 years). Independent t-tests revealed there was not a significant difference in the level of inhibitory process [t(21)=-1.636, p=0.117], in SHPR at 50 °C [t(18)=1, p=0.331], in resilience [t(10.22)=0.55, p=0.59], or ethnic identity [t(21)=0.95, 0= 0.35] between HA and NHW. However, there was a significant difference in the level of optimism [t(20.16)=3.449, p=0.003], where HA had a significantly higher levels of optimism (Mean=2.07, SD=0.44) than NHW (Mean=1.62, SD= 0.18). Significant correlations were found between inhibitory process and level of optimism (r=-0.577, p=0.004), and between inhibitory process and resilience (r=-0.432, p=0.04).
Conclusions
Preliminary results on this study have demonstrated that ethnicity does not play a significant role in central pain mechanisms between older adults HA and NHW; however, HA do seem to display greater levels of optimism. Regardless of ethnicity, one’s level of optimism and resiliency seems to affect their central pain mechanisms. Further analyses in a larger sample are needed before drawing stronger conclusions about the potential relationship between ethnicity, central pain mechanisms, and psychosocial factors.
References
Siddall PJ and Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg. 2004;99:510-20, table of contents.
Valencia C, Kindler LL, Fillingim RB and George SZ. Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models. J Pain. 2012;13:81-9.
Valencia C, Fillingim RB and George SZ. Suprathreshold heat pain response is associated with clinical pain intensity for patients with shoulder pain. J Pain. 2011;12:133-40.
Kim MJ, Lee H, Kim EH, Cho MH, Shin DW, Yun JM and Shin JH. Disparity in Health Screening and Health Utilization according to Economic Status. Korean J Fam Med. 2017;38:220-225.
Edwards RR, Doleys DM, Fillingim RB and Lowery D. Ethnic differences in pain tolerance: clinical implications in a chronic pain population. Psychosom Med. 2001;63:316-23.
Lasch KE. Culture, pain, and culturally sensitive pain care. Pain Manag Nurs. 2000;1:16-22.
Hastie BA, Riley JL and Fillingim RB. Ethnic differences and responses to pain in healthy young adults. Pain Med. 2005;6:61-71.
Rahim-Williams FB, Riley JL, 3rd, Herrera D, Campbell CM, Hastie BA and Fillingim RB. Ethnic identity predicts experimental pain sensitivity in African Americans and Hispanics. Pain. 2007;129:177-84.
Smith EP, Walker K, Fields L, Brookins CC and Seay RC. Ethnic identity and its relationship to self-esteem, perceived efficacy and prosocial attitudes in early adolescence. J Adolesc. 1999;22:867-80.
Phinney JS and Chavira V. Ethnic identity and self-esteem: an exploratory longitudinal study. J Adolesc. 1992;15:271-81.
Lara M, Gamboa C, Kahramanian MI, Morales LS and Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367-97.
Schwartz SJ, Unger JB, Zamboanga BL and Szapocznik J. Rethinking the concept of acculturation: implications for theory and research. Am Psychol. 2010;65:237-51.
Jimenez N, Dansie E, Buchwald D and Goldberg J. Pain among older Hispanics in the United States: is acculturation associated with pain? Pain Med. 2013;14:1134-9.
Bui Q, Doescher M, Takeuchi D and Taylor V. Immigration, acculturation and chronic back and neck problems among Latino-Americans. J Immigr Minor Health. 2011;13:194-201.
Chan MY, Hamamura T and Janschewitz K. Ethnic differences in physical pain sensitivity: role of acculturation. Pain. 2013;154:119-23.
Edwards RR, Campbell CM and Fillingim RB. Catastrophizing and experimental pain sensitivity: only in vivo reports of catastrophic cognitions correlate with pain responses. J Pain. 2005;6:338-9.
Campbell CM, Edwards RR and Fillingim RB. Ethnic differences in responses to multiple experimental pain stimuli. Pain. 2005;113:20-6.
Edwards RR, Ness TJ, Weigent DA and Fillingim RB. Individual differences in diffuse noxious inhibitory controls (DNIC): association with clinical variables. Pain. 2003;106:427-37.
Cleeland CS and Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23:129-38.
Sullivan MJ, Bishop, S. R., Pivik, J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment. 1995;7:524-532.
Valencia C, Fillingim RB, Bishop M, Wu SS, Wright TW, Moser M, Farmer K and George SZ. Investigation of central pain processing in postoperative shoulder pain and disability. Clin J Pain. 2014;30:775-86.
Presenting Author
Carolina Valencia
Poster Authors
Carolina Valencia
PhD
The University of Texas at El Paso
Lead Author
Isaac Medina
The University of Texas at El Paso
Lead Author
Jose L. Rivera
The University of Texas at El Paso
Lead Author
Pablo Quiroz
The University of Texas at El Paso
Lead Author
Leonardo Caro Gallegos
The University of Texas at El Paso
Lead Author
Fredy Solis
University of Texas at El Paso
Lead Author
Manuel Morales
The University of Texas at El Paso
Lead Author
Topics
- Mechanisms: Psychosocial and Biopsychosocial