All ETDs from UAB

Advisory Committee Chair

Burel R Goodin

Advisory Committee Members

Edwin Aroke

Olivio Clay

D Leann Long

Vani Mathur

Document Type

Dissertation

Date of Award

2022

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Chronic low back pain (CLBP) is among the most prevalent, disabling, and painful health conditions worldwide, contributing to significant economic and societal costs. In the United States, the burden of chronic pain – including CLBP – disproportionately affects non-Hispanic Blacks (“Blacks”) compared to non-Hispanic Whites (“Whites”), with Blacks consistently displaying greater pain severity and frequency across multiple studies. To help understand these racial pain disparities, researchers have adopted a biopsychosocial model of chronic musculoskeletal pain, examining how cognitive, behavioral, social/environmental, and biomedical factors collectively influence pain outcomes. Different lines of research have investigated the impact of distressing social experiences on pain physiology and perception. Experimental and clinical pain studies suggest that perceived racial discrimination is associated with greater bodily pain severity, most notably for racial minority populations. Similarly, social neuroscience experiments demonstrate the adverse effects of social rejection and exclusion on pain pathways in the brain, potentially mediated by stress and anger. Researchers speculate that positive psychological factors – including social support, optimism, and forgiveness – may buffer this association. Despite overlapping evidence, there is currently no complete integration of experimental/clinical pain research and social pain research in the literature. Therefore, the current study examined the effect of perceived racial discrimination on clinical pain severity and movement-evoked pain severity among community-dwelling adults with CLBP who identified as Black. Further, the current study examined whether anger and perceived stress help explain this potential association. Finally, we examined whether social support, optimism, and forgiveness buffer the potential association between perceived racial discrimination and self-reported pain outcomes. Results indicated that Blacks reported significantly greater frequency of perceived racial discrimination than Whites. When adjusting for relevant sociodemographic and psychosocial variables, perceived racial discrimination was not a significant predictor of our pain outcomes. There was no evidence that perceived racial discrimination exerts a significant indirect effect on our pain outcomes through anger or stress. Likewise, there was no evidence suggesting that the potential association between discrimination and pain varies by social support, optimism, or forgiveness. Findings from this study are further discussed.

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