Bulls Hailey W, Lynch Mary K, Petrov Megan E, Gossett Ethan W, Owens Michael A, Terry Sarah C, Wesson-Sides Kate M, Goodin Burel R
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA.
Ann Behav Med. 2017 Oct;51(5):673-682. doi: 10.1007/s12160-017-9889-x.
Racial differences in endogenous pain facilitatory processes have been previously reported. Evidence suggests that psychological and behavioral factors, including depressive symptoms and sleep, can alter endogenous pain facilitatory processes. Whether depressive symptoms and sleep might help explain racial differences in endogenous pain facilitatory processes has yet to be determined.
This observational, microlongitudinal study examined whether depressive symptoms and sleep were sequential mediators of racial differences in endogenous pain facilitatory processes.
A total of 50 (26 African American and 24 non-Hispanic white) community-dwelling adults without chronic pain (mean 49.04 years; range 21-77) completed the Center for Epidemiological Studies Depression Scale prior to seven consecutive nights of sleep monitoring with actigraphy in the home environment. Participants subsequently returned to the laboratory for assessment of endogenous pain facilitation using a mechanical temporal summation protocol.
Findings revealed greater depressive symptoms, poorer sleep efficiency, and greater temporal summation of mechanical pain in African Americans compared to non-Hispanic whites. In a sequential mediation model, greater depressive symptoms predicted poorer sleep efficiency (t = -2.55, p = .014), and poorer sleep efficiency predicted enhanced temporal summation of mechanical pain (t = -4.11, p < .001), particularly for African Americans.
This study underscores the importance of examining the contribution of psychological and behavioral factors when addressing racial differences in pain processing. Additionally, it lends support for the deleterious impact of depressive symptoms on sleep efficiency, suggesting that both sequentially mediate racial differences in endogenous pain facilitation.
先前已有关于内源性疼痛促进过程中种族差异的报道。有证据表明，包括抑郁症状和睡眠在内的心理和行为因素可改变内源性疼痛促进过程。抑郁症状和睡眠是否有助于解释内源性疼痛促进过程中的种族差异尚待确定。
这项观察性微纵向研究探讨了抑郁症状和睡眠是否是内源性疼痛促进过程中种族差异的序贯中介因素。
共有50名（26名非裔美国人和24名非西班牙裔白人）无慢性疼痛的社区居住成年人（平均年龄49.04岁；范围21 - 77岁），在居家环境中通过活动记录仪连续监测七晚睡眠之前，完成了流行病学研究中心抑郁量表。参与者随后返回实验室，使用机械性时间总和方案评估内源性疼痛促进情况。
研究结果显示，与非西班牙裔白人相比，非裔美国人的抑郁症状更严重、睡眠效率更低，机械性疼痛的时间总和更大。在一个序贯中介模型中，更严重的抑郁症状预示着睡眠效率更低（t = -2.55，p = 0.014），而更低的睡眠效率预示着机械性疼痛的时间总和增强（t = -4.11，p < 0.001），尤其是对于非裔美国人。
这项研究强调了在探讨疼痛处理中的种族差异时，检查心理和行为因素贡献的重要性。此外，它支持了抑郁症状对睡眠效率的有害影响，表明两者均序贯介导内源性疼痛促进中的种族差异。
