School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
Department of Rehabilitation Medicine, The University of Washington, Seattle, WA, USA.
Eur J Pain. 2020 Jul;24(6):1072-1083. doi: 10.1002/ejp.1552. Epub 2020 Mar 14.
This study reports a multivariate test of sex and race differences in experimental pain, and the degree to which these differences could be uniquely attributable to three levels of cognition: primary appraisals (threat, challenge), secondary appraisals (pain catastrophizing) and/or cognitive processes (mindful observing, non-reactivity). Both the predictive and mediator role of the cognitive variables was of interest.
The study employed a cross-sectional experimental design, with the cold pressor task employed as the pain stimulus. The total sample included N = 355 healthy adults (67% female, 33% male; 70% Caucasian, 30% Asian).
Significant sex and race differences on pain tolerance were found, with females and racial minorities reporting less pain tolerance (ps < 0.001). Males reported significantly higher challenge appraisals and non-reactivity, and lower pain catastrophizing than females; Asians reported significantly higher threat appraisals and pain catastrophizing than Caucasians. In multivariate analyses, challenge appraisals and non-reactivity emerged as the strongest predictors of pain tolerance. Furthermore, challenge appraisals mediated the sex-pain tolerance association (p = .017).
This study showed that race and sex differences, at least in part, may be accounted for by differences in pain-related cognitions.
The three levels of cognition investigated in this research represent changeable, important processes for potentially mitigating the impact of pain in vulnerable groups.
本研究报告了一项实验性疼痛的性别和种族差异的多变量检验，以及这些差异在多大程度上可以归因于三个认知水平：初级评估（威胁、挑战）、次级评估（疼痛灾难化）和/或认知过程（正念观察、不反应）。认知变量的预测和中介作用都很重要。
该研究采用了横断面实验设计，以冷压任务作为疼痛刺激。总样本包括 N = 355 名健康成年人（女性占 67%，男性占 33%；白种人占 70%，亚洲人占 30%）。
在疼痛耐受力方面发现了显著的性别和种族差异，女性和少数族裔报告的疼痛耐受力较低（p < 0.001）。男性报告的挑战评估和不反应显著高于女性，疼痛灾难化显著低于女性；亚洲人报告的威胁评估和疼痛灾难化显著高于白种人。在多变量分析中，挑战评估和不反应成为疼痛耐受力的最强预测因素。此外，挑战评估中介了性别与疼痛耐受力之间的关联（p = 0.017）。
本研究表明，种族和性别差异至少部分可以用与疼痛相关的认知差异来解释。
本研究调查的三个认知水平代表了潜在脆弱群体缓解疼痛影响的可改变的重要过程。
