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Advisory Committee Chair

Laurence Bradley

Advisory Committee Members

Elizabeth Griffith

James Banos

Elizabeth Kvale

J Scott Richards

Document Type

Dissertation

Date of Award

2009

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

African Americans, compared to non-Hispanic whites, report greater levels of clinical pain and experience more pain-related disability (AmericanHeartAssociation, 2005; C. L.Edwards, Fillingim, & Keefe, 2001; R. R. Edwards, Doleys, Fillingim, & Lowery, 2001; McCracken, Matthews, Tang, & Cuba, 2001; J. L. Riley et al., 2002). Furthermore, African Americans consistently differ from primarily non-Hispanic white samples on experimentally induced pain. We examined ethnic group differences in the effects of exposure to a brief stressor on individuals' pain responses and changes in SBP and heart rate (HR). In addition, we examined the mediational role of perceived racial discrimination, and differences in the relationship between PA and NA on ethnic differences in pain and psychophysiological responses (SBP and HR). The results from our study are consistent with those of previous studies that have documented enhanced affective-motivational pain responses among African Americans compared to white Americans. Our study, then, is the first to find evidence of both positive and negative influences on the relationship between ethnicity and pain responses. These findings are consistent with our understanding of the function of the neuromatrix or gate control mechanisms that underlie variations in pain responses (Melzack & Loeser, 1999). Our findings represent important data that will be used to design studies of ethnic group differences in pain responses within patient samples. Future investigations will include use of psychosocial stressors that are highly relevant to patient participants, measurements of stressor-evoked changes in neuroendocrine factors involved in both pain and blood pressure regulation, and measures of negative and positive affect in order to advance the current understanding of ethnic group differences in pain regulatory systems. Furthermore, longitudinal studies designed to investigate the impact of experiences of discrimination and the possible role of PA and NA dynamics mediating the latter's impact on health outcomes among African Americans is recommended.

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