The Role of Chronic Psychosocial Stress in Explaining Racial Differences in Stress Reactivity and Pain Sensitivity.
To examine the role of psychosocial factors in mediating the relationship between African American (AA) race and both increased pain sensitivity and blunted stress reactivity.



Participants included 133 AA and non-Hispanic white (nHW) individuals (mean [SD] age, 37 [9]) matched for age, sex, and socioeconomic status. Participants underwent mental stress testing (Trier Social Stress Test) while cardiovascular, hemodynamic, and neuroendocrine reactivity were measured. Participants completed questionnaires assessing potential sources of psychosocial stress and were tested for pain responses to cold pain and the temporal summation of heat pulses. Mediation analyses were used to determine the extent to which exposure to psychosocial stress accounted for the observed racial differences in stress reactivity and pain.



Chronic stress exposure and reactivity to mental stress was largely similar among AAs and nHWs; however, AAs exhibited heightened pain to both cold (p = .012) and heat (p = .004). Racial differences in the relationship between stress reactivity and pain were also observed: while greater stress reactivity was associated with decreased pain among nHWs, reactivity was either unrelated to or even positively associated with pain among AAs (e.g., r = -.21 among nHWs and r = .41 among AAs for stroke volume reactivity and cold pressor intensity). Adjusting for minor racial differences in chronic psychosocial stress did not change these findings.



Accounting for psychosocial factors eliminated racial differences in stress reactivity but not racial differences in sensitivity to experimental pain tasks. Increased exposure to chronic stress may not explain AAs' increased pain sensitivity in laboratory settings.
From the Department of Psychiatry (Gordon, Johnson, Nau, Girdler), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychology (Mechlin), Earlham College, Richmond, Indiana.
Jennifer L
JL
Gordon
Jacqueline
J
Johnson
Samantha
S
Nau
Beth
B
Mechlin
Susan S
SS
Girdler
D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold / Q000208:ethnology*; D013315:Stress, Psychological / Q000208:ethnology*; D044465:White People / Q000208:ethnology*
Chronic Dis Can. 2000;21(3):114-8
11082347
Proc Natl Acad Sci U S A. 1998 Aug 4;95(16):9608-13
9689128
Mol Psychiatry. 1999 Sep;4(5):476-83
10523821
Psychosom Med. 2005 Nov-Dec;67(6):948-56
16314600
Am J Hypertens. 1995 Jun;8(6):552-7
7662238
Neuropsychobiology. 1993;28(1-2):76-81
8255414
Nature. 1983 Dec 15-21;306(5944):686-8
6656869
Arch Gen Psychiatry. 1997 Mar;54(3):279-85
9075469
Psychosom Med. 1993 Jul-Aug;55(4):347-63
8416085
Pain. 1977 Feb;3(1):57-68
876667
Psychophysiology. 2011 Jun;48(6):762-73
21039586
Eur J Pain. 2014 Nov;18(10):1367-75
24700605
Pain. 1998 Mar;75(1):121-7
9539681
Psychosom Med. 1997 Mar-Apr;59(2):152-60
9088052
J Health Soc Behav. 2000 Sep;41(3):314-32
11011507
J Gen Intern Med. 2003 Jul;18(7):549-57
12848838
Pain. 2004 Jun;109(3):488-96
15157710
Biol Psychol. 1995 Feb;39(2-3):173-86
7734629
Psychol Sci. 2007 Nov;18(11):953-7
17958708
Pain. 2012 Aug;153(8):1610-9
22717102
Psychophysiology. 2007 Sep;44(5):759-66
17584185
Prog Neurobiol. 2000 Jun;61(2):169-203
10704997
Brain Res. 1982 Apr 8;237(1):137-45
6122488
Neurosci Biobehav Rev. 2004 Jul;28(4):395-414
15341037
Psychophysiology. 2014 Apr;51(4):309-18
24397365
Psychol Med. 2002 Aug;32(6):1059-73
12214787
Ann N Y Acad Sci. 1999;896:30-47
10681886
Pain Manag Nurs. 2014 Jun;15(2):530-8
24882030
Pain. 2007 May;129(1-2):177-84
17296267
Psychosom Med. 2014 May;76(4):302-10
24804882
Neuropsychopharmacology. 2000 Feb;22(2):108-24
10649824
Behav Med. 1995 Fall;21(3):141-50
8789650
Health Psychol. 2003 May;22(3):300-9
12790258
J Consult Clin Psychol. 1978 Oct;46(5):932-46
701572
J Psychosom Res. 1993;37(2):177-93
8385216
J Am Acad Child Adolesc Psychiatry. 2014 Apr;53(4):395-7
24655648
Int J Behav Med. 1994;1(3):229-46
16250799
Mod Probl Pharmacopsychiatry. 1974;7(0):151-69
4412100
Health Psychol. 2007 Mar;26(2):201-13
17385972
Pain. 1992 Mar;48(3):463-7
1594268
Neuropsychopharmacology. 2000 Oct;23(4):411-8
10989268
Prog Neurobiol. 2014 Oct;121:1-18
25010858
J Pers Soc Psychol. 1989 Feb;56(2):267-83
2926629
AIDS Patient Care STDS. 2008 May;22(5):403-11
18373416
J Pain. 2007 Nov;8(11):861-8
17644044
Pain. 1998 May;76(1-2):71-81
9696460
Neuron. 2012 Feb 9;73(3):435-44
22325197
Psychosom Med. 1996 Jan-Feb;58(1):4-15
8677288
J Pers Soc Psychol. 1986 Jul;51(1):191-200
3735067
Pain. 2015 May;156(5):917-22
25734994
Health Psychol. 2006 Nov;25(6):723-39
17100501
J Appl Physiol (1985). 1998 Oct;85(4):1413-20
9760335
Hypertension. 1996 Sep;28(3):494-504
8794839
Clin J Pain. 2005 Sep-Oct;21(5):398-405
16093745
Psychol Bull. 1989 Jan;105(1):89-105
2648440
Science. 1979 Sep 21;205(4412):1299-301
472749
Pain. 2001 Nov;94(2):133-7
11690726
J Pers Soc Psychol. 1986 Dec;51(6):1173-82
3806354
Circulation. 1991 Apr;83(4 Suppl):II36-42
2009628
Psychol Assess. 2007 Dec;19(4):369-81
18085930
Pharmacol Biochem Behav. 1993 Mar;44(3):527-31
8451256