Department of Psychology, The University of Tulsa, Tulsa, OK, USA.
Stanford University, 450 Serra Mall, Stanford, Stanford, CA94305, USA.
Scand J Pain. 2022 Mar 16;22(3):587-596. doi: 10.1515/sjpain-2021-0174. Print 2022 Jul 26.
Native Americans (NAs) have the highest prevalence of chronic pain of any racial/ethnic group. This issue has received little attention from the scientific community. One factor that may contribute to racial pain disparities is pain catastrophizing. Pain catastrophizing is a construct related to negative pain outcomes in persons with/without chronic pain. It has been suggested that the relationship between trait catastrophizing and pain is mediated by situation-specific (state) catastrophizing. The present study has 2 aims: (1) to investigate whether state pain catastrophizing mediates the relationship between trait catastrophizing and experimental pain (e.g., cold, ischemic, heat and electric tolerance), and (2) to investigate whether this relationship is stronger for NAs.
145 non-Hispanic Whites (NHWs) and 137 NAs completed the study. Bootstrapped indirect effects were calculated for 4 unmoderated and 8 moderated mediation models (4 models with path moderated and 4 with path ).
Consistent with trait-activation theory, significant indirect effects indicated a tendency for trait catastrophizing to be associated with greater state catastrophizing which in turn is associated with reduced pain tolerance during tonic cold ( × =-0.158) and ischemia stimuli ( × =-0.126), but not during phasic electric and heat stimuli. Moderation was only noted for the prediction of cold tolerance (path a). Contrary to expectations, the indirect path was stronger for NHWs ( × for NHW=-.142).
Together, these findings suggest that state catastrophizing mediates the relationship between trait catastrophizing and some measures of pain tolerance but this indirect effect was non-significant for NAs.
美洲原住民（NA）是所有种族/民族中慢性疼痛发生率最高的群体。这一问题很少受到科学界的关注。导致种族间疼痛差异的一个因素可能是疼痛灾难化。疼痛灾难化是与慢性疼痛患者/无慢性疼痛患者的负面疼痛结果相关的一种结构。有人认为，特质灾难化与疼痛之间的关系是由特定情境（状态）灾难化介导的。本研究有两个目的：（1）调查状态疼痛灾难化是否介导特质灾难化与实验性疼痛（如冷、缺血、热和电耐受）之间的关系，以及（2）调查这种关系对 NA 是否更强。
145 名非西班牙裔白人（NHW）和 137 名 NA 完成了研究。为 4 个未调节和 8 个调节中介模型（4 个路径调节和 4 个路径 ）计算了 bootstrap 间接效应。
与特质激活理论一致，显著的间接效应表明，特质灾难化倾向于与更大的状态灾难化相关，而状态灾难化又与在持续冷（ × = -0.158）和缺血刺激期间的疼痛耐受力降低相关，但在瞬态电和热刺激期间则不相关。仅对冷耐受力的预测注意到调节（路径 a）。出乎意料的是，间接路径在 NHW 中更强（NHW 的 × = -0.142）。
总的来说，这些发现表明，状态灾难化介导了特质灾难化与一些疼痛耐受力测量之间的关系，但这种间接效应在 NA 中不显著。
