Pain-related anxiety promotes pronociceptive processes in Native Americans: bootstrapped mediation analyses from the Oklahoma Study of Native American Pain Risk.
Ethnic differences
Mediation
Native Americans
Pain modulation
Pain-related affect
Quantitative sensory testing
Journal
Pain reports
ISSN: 2471-2531
Titre abrégé: Pain Rep
Pays: United States
ID NLM: 101683899
Informations de publication
Date de publication:
Historique:
received:
26
10
2019
revised:
11
12
2019
accepted:
14
12
2019
entrez:
20
2
2020
pubmed:
20
2
2020
medline:
20
2
2020
Statut:
epublish
Résumé
Evidence suggests Native Americans (NAs) experience higher rates of chronic pain than the general US population, but the mechanisms contributing to this disparity are poorly understood. Recently, we conducted a study of healthy, pain-free NAs (n = 155), and non-Hispanic whites (NHWs, n = 150) to address this issue and found little evidence that NAs and NHWs differ in pain processing (assessed from multiple quantitative sensory tests). However, NAs reported higher levels of pain-related anxiety during many of the tasks. The current study is a secondary analysis of those data to examine whether pain-related anxiety could promote pronociceptive processes in NAs to put them at chronic pain risk. Bootstrapped indirect effect tests were conducted to examine whether pain-related anxiety mediated the relationships between race (NHW vs NA) and measures of pain tolerance (electric, heat, ischemia, and cold pressor), temporal summation of pain and the nociceptive flexion reflex (NFR), and conditioned pain modulation of pain/NFR. Pain-related anxiety mediated the relationships between NA race and pain tolerance and conditioned pain modulation of NFR. Exploratory analyses failed to show that race moderated relationships between pain-related anxiety and pain outcomes. These findings imply that pain-related anxiety is not a unique mechanism of pain risk for NAs, but that the greater tendency to experience pain-related anxiety by NAs impairs their ability to engage descending inhibition of spinal nociception and decreases their pain tolerance (more so than NHWs). Thus, pain-related anxiety may promote pronociceptive processes in NAs to place them at risk for future chronic pain.
Identifiants
pubmed: 32072102
doi: 10.1097/PR9.0000000000000808
pii: PAINREPORTS-D-19-0132
pmc: PMC7004502
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e808Subventions
Organisme : NIMHD NIH HHS
ID : R01 MD007807
Pays : United States
Organisme : NIA NIH HHS
ID : T32 AG049673
Pays : United States
Informations de copyright
Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
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