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Psychological pathways from daily discrimination to pain: a longitudinal mediation model
Nguyen P Nguyen1, Wajiha Masroor2, Nnenna Uche2
1Department of Educational Psychology, Texas A&M University, College Station, USA. nguyennguyen@tamu.edu.
Journal of Behavioral Medicine
|August 11, 2026
Summary
Discrimination negatively impacts chronic pain by reducing self-acceptance and self-esteem over time. Addressing discrimination
Area of Science:
- Psychology
- Health Sciences
- Sociology
Background:
- Perceived discrimination, self-esteem, and self-acceptance are linked to pain outcomes.
- Few studies have jointly examined these psychological factors and their mediating pathways.
- The Biopsychosocial framework guides the investigation of these relationships.
Purpose of the Study:
- To explore the longitudinal mediating roles of self-esteem and self-acceptance.
- To examine the relationship between perceived daily discrimination and pain interference.
- To understand the psychological pathways connecting discrimination to pain outcomes.
Main Methods:
- Utilized archival data from the Midlife in the United States (MIDUS) study (MIDUS II and MIDUS III).
- Employed multiple longitudinal mediation analysis.
- Included 501 participants with chronic pain at both timepoints (ages 34-83).
Main Results:
- Perceived daily discrimination predicted increased pain interference over time.
- This association was mediated by lower self-acceptance and self-esteem.
- Self-acceptance was a more significant mediator than self-esteem.
Conclusions:
- The long-term impact of discrimination on pain may stem from its erosion of self-perception, particularly self-acceptance.
- Interventions should consider addressing discrimination's effect on self-acceptance.
- Highlights critical pathways for prevention and future research in chronic pain management.
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