Back to Search
Start Over
Psychosocial and cardiometabolic predictors of chronic pain onset in Native Americans: serial mediation analyses of 2-year prospective data from the Oklahoma Study of Native American Pain Risk
- Source :
- Pain
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Chronic pain results in considerable suffering, as well as significant economic and societal costs. Previous evidence suggests that Native Americans (NAs) have higher rates of chronic pain than other U.S. racial or ethnic groups, but the mechanisms contributing to this pain disparity are poorly understood. The Oklahoma Study of Native American Pain Risk was developed to address this issue and recruited healthy, pain-free NAs and non-Hispanic Whites. Cross-sectional analyses identified several measures of adversity (eg, trauma and discrimination), cognitive-affective factors (perceived stress and pain-related anxiety/catastrophizing), and cardiometabolic factors (eg, body mass index, blood pressure, and heart rate variability) that were associated with pronociceptive processes (eg, central sensitization, descending inhibition, and hyperalgesia). Every 6-months after enrollment, eligible participants (N = 277) were recontacted and assessed for the onset of chronic pain. This study examines predictors of chronic pain onset in the 222 participants (80%) who responded over the first 2 years. The results show that NAs developed chronic pain at a higher rate than non-Hispanic Whites (OR = 2.902, P0.05), even after controlling for age, sex, income, and education. Moreover, serial mediation models identified several potential pathways to chronic pain onset within the NA group. These paths included perceived discrimination, psychological stress, pain-related anxiety, a composite measure of cardiometabolic risk, and impaired descending inhibition of spinal nociception (assessed from conditioned pain modulation of the nociceptive flexion reflex). These results provide the first prospective evidence for a pain disparity in NAs that seems to be promoted by psychosocial, cardiometabolic, and pronociceptive mechanisms.
- Subjects :
- medicine.medical_specialty
Article
Nociceptive flexion reflex
Internal medicine
medicine
Humans
Heart rate variability
Prospective Studies
American Indian or Alaska Native
Mediation Analysis
business.industry
Chronic pain
Oklahoma
medicine.disease
Cross-Sectional Studies
Anesthesiology and Pain Medicine
Nociception
Neurology
Cardiovascular Diseases
Hyperalgesia
Anxiety
Neurology (clinical)
Chronic Pain
medicine.symptom
business
Body mass index
Psychosocial
Subjects
Details
- ISSN :
- 18726623 and 03043959
- Volume :
- 163
- Database :
- OpenAIRE
- Journal :
- Pain
- Accession number :
- edsair.doi.dedup.....1e7a543624dccd66a74ba06c5ca49f4d
- Full Text :
- https://doi.org/10.1097/j.pain.0000000000002458