The roles of race, sex and cognitions in response to experimental pain

Abstract

Background This study reports a multivariate test of sex and race differences in experimental pain, and the degree to which these differences could be uniquely attributable to three levels of cognition: primary appraisals (threat, challenge), secondary appraisals (pain catastrophizing) and/or cognitive processes (mindful observing, non‐reactivity). Both the predictive and mediator role of the cognitive variables was of interest. Methods The study employed a cross‐sectional experimental design, with the cold pressor task employed as the pain stimulus. The total sample included N = 355 healthy adults (67% female, 33% male; 70% Caucasian, 30% Asian). Results Significant sex and race differences on pain tolerance were found, with females and racial minorities reporting less pain tolerance (ps < 0.001). Males reported significantly higher challenge appraisals and non‐reactivity, and lower pain catastrophizing than females; Asians reported significantly higher threat appraisals and pain catastrophizing than Caucasians. In multivariate analyses, challenge appraisals and non‐reactivity emerged as the strongest predictors of pain tolerance. Furthermore, challenge appraisals mediated the sex‐pain tolerance association (p = .017). Conclusions This study showed that race and sex differences, at least in part, may be accounted for by differences in pain‐related cognitions. Significance The three levels of cognition investigated in this research represent changeable, important processes for potentially mitigating the impact of pain in vulnerable groups.

Age and Sex Differences of Virtual Reality Pain Alleviation Therapeutic During Pediatric Burn Care: A Randomized Clinical Trial

“…Pain is a subjective experience, with pain perception and rating differing based on sex. 16,17 However, many studies use experimental pain conditions, [18][19][20] which are different from pain caused by medical conditions such as burn injury. Around puberty, sex differences in pain emerge, with adolescent girls reporting more pain than adolescent boys.…”