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Cognitive-Affective-Behavioral Pathways Linking Adversity and Discrimination to Daily Pain in African-American Adults
Harrison Dickens1, Stephen Bruehl2, Uma Rao3,4
1Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
Journal of Racial and Ethnic Health Disparities
|November 10, 2022
Summary
Pain catastrophizing, not resilience, mediates the link between adversity and daily pain in African-American adults. Targeting pain catastrophizing may reduce racial disparities in chronic pain development.
Area of Science:
- Psychology
- Public Health
- Pain Management
Background:
- Pain catastrophizing, characterized by rumination and helplessness, strongly predicts pain outcomes and is linked to adversity.
- Resilience, the ability to function despite adversity, also impacts pain experiences.
- Understanding these factors in African-American adults can inform pain risk assessment and address racial disparities.
Purpose of the Study:
- To investigate how pain catastrophizing and resilience influence the relationship between adversity and daily pain in African-American adults.
- To explore the role of early-life and recent-life adversity, as well as racial discrimination, in this relationship.
- To identify potential targets for interventions to mitigate racial disparities in the transition to chronic pain.
Main Methods:
- A study involving 160 African-American adults (98 women).
- Assessment of daily pain intensity, pain interference, childhood trauma, family adversity, chronic burden, perceived stress, and lifetime racial discrimination.
- Analysis using bootstrapped multiple mediation models to examine mediating roles of pain catastrophizing and resilience.
Main Results:
- Increased pain catastrophizing correlated with higher adversity (early and recent), racial discrimination, pain intensity, and pain interference.
- Decreased pain resilience correlated with increased recent-life adversity and pain intensity.
- Pain catastrophizing significantly mediated the relationship between all adversity/discrimination measures and pain outcomes; resilience did not.
Conclusions:
- Pain catastrophizing is a key mediator linking adversity and racial discrimination to daily pain in African-American adults.
- Interventions targeting pain catastrophizing may be effective in reducing persistent pain and addressing racial disparities.
- These findings underscore the importance of cognitive-affective-behavioral factors in pain management for at-risk populations.
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