Is racial bias in pain perception robust to self-reported pain experience? (Replication)

Recent work demonstrated that racial bias in pain care stems, at least in part, from a perceptual source (Mende-Siedlecki et al., 2019). Racial bias in pain perception arises from disruptions in configural face processing, cannot be explained by low-level stimulus features, persists even when identical expressions of pain are rendered on computer-generated targets, and predicts biases in treatment above and beyond explicit stereotypes and prejudice. However, within a medical context, judgments of pain are rarely made in the absence of other diagnostic information such as a patient’s report of their subjective pain level. That said, real-world disparities in pain care for Black Americans persist in medical contexts despite self-reported pain experience. This may suggest that although self-reported pain may be considered in judgements of patient pain, it does not entirely eliminate bias in pain care, perhaps due to the persistence of a perceptual bias. A previous investigation manipulated both target race and self-report but used a) larger windows of self-report (4-6 vs. 8-10 for ambiguous and high self-report, respectively), b) a non-clinical pain context (e.g., experimental pain stimulations), and c) a treatment measure that was comparable in scale to the pain self-report scale itself, which might have led participants to simply match their treatment recommendations to the self-report values. Here, we test if racial bias in pain perception is robust to information about self-reported pain experience in a task that a) compares between two specific self-report values (4 vs. 7; where a 7/10 in terms of pain experience would still qualify as severe, uncontrolled pain), b) a clinical pain context (specifically, targets will be described as patients in dealing with pain during physical therapy after orthopedic surgery), and c) a more ecologically valid treatment measure.