Bakhshaie Jafar, Penn Terence M, Doorley James, Pham Tony V, Greenberg Jonathan, Bannon Sarah, Saadi Altaf, Vranceanu Ana-Maria
Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama.
J Pain. 2022 Oct;23(10):1697-1711. doi: 10.1016/j.jpain.2022.04.013. Epub 2022 May 27.
Black communities are disproportionally affected by Chronic Musculoskeletal Pain (CMP), but little is known about the psychological predictors of CMP outcomes and their contextual determinants among Black individuals. To address this gap, we conducted a narrative review of extant literature to (1) report the major conceptual models mentioned in prior work explaining the link between contextual determinants and psychological responses to pain among Black individuals with CMP; and (2) describe psychological factors related to CMP outcomes in this population that are highlighted in the literature. We searched 4 databases (APA PsycNet, PubMed/MEDLINE, Scopus, and Google Scholar) using the following search terms: musculoskeletal pain, chronic pain, mental health, psychological, coping, health disparities, contextual factors, conceptual models, psychosocial, Black, African American, pain, disability, and outcomes. We illustrate 3 relevant conceptual models - socioecological, cumulative stress, and biopsychosocial - related to contextual determinants and several psychological factors that influence CMP outcomes among Black individuals: (1) disproportionate burden of mental health and psychiatric diagnoses, (2) distinct coping strategies, (3) pain-related perceived injustice and perceived racial/ethnic discrimination, and (4) preferences and expectations related to seeking and receiving pain care. The detailed clinical and research implications could serve as a blueprint for the providers and clinical researchers to address health disparities and improve care for Black individuals with CMP. PERSPECTIVE: This narrative review illustrates conceptual models explaining the link between contextual determinants and psychological responses to pain among Black individuals with chronic musculoskeletal pain. We discuss 3 relevant conceptual models - socioecological, cumulative stress, biopsychosocial -, and 4 psychological factors: disproportionate burden of mental health, distinct coping strategies, perceived injustice/discrimination, preferences/expectations.
黑人社区受慢性肌肉骨骼疼痛（CMP）的影响尤为严重，但对于CMP结果的心理预测因素及其在黑人个体中的背景决定因素却知之甚少。为了填补这一空白，我们对现有文献进行了叙述性综述，以（1）报告先前工作中提到的主要概念模型，这些模型解释了CMP黑人个体的背景决定因素与对疼痛的心理反应之间的联系；（2）描述文献中强调的该人群中与CMP结果相关的心理因素。我们使用以下搜索词搜索了4个数据库（美国心理学会心理学文摘数据库、医学期刊数据库、Scopus数据库和谷歌学术）：肌肉骨骼疼痛、慢性疼痛、心理健康、心理、应对、健康差异、背景因素、概念模型、社会心理、黑人、非裔美国人、疼痛、残疾和结果。我们阐述了3个与背景决定因素相关的概念模型——社会生态模型、累积压力模型和生物心理社会模型，以及几个影响黑人个体CMP结果的心理因素：（1）心理健康和精神疾病诊断的负担过重；（2）独特的应对策略；（3）与疼痛相关的感知不公正和感知种族/民族歧视；（4）与寻求和接受疼痛治疗相关的偏好和期望。详细的临床和研究意义可为医疗服务提供者和临床研究人员解决健康差异问题并改善对CMP黑人个体的护理提供蓝图。观点：本叙述性综述阐述了解释慢性肌肉骨骼疼痛黑人个体的背景决定因素与对疼痛的心理反应之间联系的概念模型。我们讨论了3个相关概念模型——社会生态模型、累积压力模型、生物心理社会模型——以及4个心理因素：心理健康负担过重、独特的应对策略、感知不公正/歧视、偏好/期望。
