Ethnocultural influences on variation in chronic pain perception.

In multiple studies cultural affiliation has been found to have an important influence on perception of and response to experimental and acute pain. Despite that evidence little work has been directed to understanding the cultural dimensions of the chronic pain experience. We present the results of a quantitative study of reported chronic pain perception in 372 chronic pain patients in six ethnic groups, who were under treatment at a multidisciplinary pain-management center. The role of ethnic and cultural experiences in the complex array of physical, cultural, psychological and social factors which influence the chronic pain experience is identified. Ethnocultural affiliation is important to chronic pain perception and response variation. In this study population the best predictors of pain intensity variation are ethnic group affiliation and locus of control (LOC) style (ethnic group identity is also a predictor of LOC style). It appears that pain intensity variation may be affected by differences in attitudes, beliefs and emotional and psychological states associated with the different ethnic groups. This study suggests a biocultural model may be useful in conceptualizing the complex interaction of biological, cultural and psychosocial factors in the process of human pain perception. Although it is likely that intense pain affects attitudes and emotions, it is also very likely that attitudes and emotions influence reported perceptions of pain intensity. Pain intensity variation in this study population is not significantly associated with diagnosis, present medication types, or types of past treatments or surgeries for pain.