Multiple Levels of Suffering: Discrimination in Health-Care Settings is Associated With Enhanced Laboratory Pain Sensitivity in Sickle Cell Disease.

Authors

• Vani A Mathur
• Kasey B Kiley
• Carlton Haywood
• Shawn M Bediako
• Sophie Lanzkron
• C Patrick Carroll
• Luis F Buenaver
• Megan Pejsa
• Robert R Edwards
• Jennifer A Haythornthwaite
• Claudia M Campbell

Publication/Presentation Date

12-1-2016

Abstract

OBJECTIVE: People living with sickle cell disease (SCD) experience severe episodic and chronic pain and frequently report poor interpersonal treatment within health-care settings. In this particularly relevant context, we examined the relationship between perceived discrimination and both clinical and laboratory pain.

METHODS: Seventy-one individuals with SCD provided self-reports of experiences with discrimination in health-care settings and clinical pain severity, and completed a psychophysical pain testing battery in the laboratory.

RESULTS: Discrimination in health-care settings was correlated with greater clinical pain severity and enhanced sensitivity to multiple laboratory-induced pain measures, as well as stress, depression, and sleep. After controlling for relevant covariates, discrimination remained a significant predictor of mechanical temporal summation (a marker of central pain facilitation), but not clinical pain severity or suprathreshold heat pain response. Furthermore, a significant interaction between experience with discrimination and clinical pain severity was associated with mechanical temporal summation; increased experience with discrimination was associated with an increased correlation between clinical pain severity and temporal summation of pain.

DISCUSSION: Perceived discrimination within health-care settings was associated with pain facilitation. These findings suggest that discrimination may be related to increased central sensitization among SCD patients, and more broadly that health-care social environments may interact with pain pathophysiology.

Volume

32

Issue

12

First Page

1076

Last Page

1085

ISSN

1536-5409

Published In/Presented At

Mathur, V. A., Kiley, K. B., Haywood, C., Jr, Bediako, S. M., Lanzkron, S., Carroll, C. P., Buenaver, L. F., Pejsa, M., Edwards, R. R., Haythornthwaite, J. A., & Campbell, C. M. (2016). Multiple Levels of Suffering: Discrimination in Health-Care Settings is Associated With Enhanced Laboratory Pain Sensitivity in Sickle Cell Disease. The Clinical journal of pain, 32(12), 1076–1085. https://doi.org/10.1097/AJP.0000000000000361

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

26889615

Department(s)

Administration and Leadership

Document Type

Article