A comparison of blacks and whites seeking treatment for chronic pain.
OBJECTIVE
Most conceptualizations of chronic pain acknowledge the importance of culture and social circumstances. Cultural and social influences may differ for persons of different racial or ethnic groups, and this circumstance may lead them to experience and adjust differently to pain. The current study compared adjustment to chronic pain by blacks and whites seeking treatment for chronic pain.


METHODS
Fifty-seven black and 207 white patients completed measures of anxiety, depression, disability, pain, and physical symptoms during their initial visit to a university pain clinic.


RESULTS
Comparisons showed that the groups did not differ with regard to age, sex, education, chronicity of pain, pain location, work status, previous surgeries, medical diagnosis, medication, wage replacement, or involvement in litigation. However, the black group reported higher pain severity, more avoidance of activity, more fearful thinking, more physical symptoms, and greater physical and psychosocial disability. The groups remained significantly different with regard to avoidance, fearful thinking, and physical symptoms after pain severity was statistically controlled for; however, they did not remain different on disability.


CONCLUSIONS
These results show that blacks and whites with chronic pain experience pain differently. Several factors may underlie these differences, including family situation, health care experiences, or other unmeasured behavioral, environmental, or social influences. Other investigators should attempt to replicate these findings and more closely examine variables that may explain them.
McCracken
L M
LM
Department of Psychiatry, The University of Chicago, Illinois, USA. lance.mccracken@rnhrd-tr.swest.nhs.uk
Matthews
A K
AK
Tang
T S
TS
Cuba
S L
SL
D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001362:Avoidance Learning; D002908:Chronic Disease; D005239:Fear; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D044465:White People / Q000523:psychology*