Racial disparities in pain experience: Neuroimaging and behavioral investigations

疼痛体验的种族差异：神经影像学和行为研究

• 批准号: 8294621
• 负责人: JOAN Y CHIAO
• 金额: $ 19.06万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8294621
• 关键词: Acute Pain; Address; Affect; African American; Age; American; Anterior; Area; Behavioral; Bilateral; Biological; Brain; Brain imaging; Brain region; Caring; Centers for Disease Control and Prevention (U.S.); Chronic; Clinical; Communities; Conscious; Data; Diabetes Mellitus; Diagnosis; Empathy; Environmental Risk Factor; Feeling; Frequencies; Functional Magnetic Resonance Imaging; Gender; Genes; Genetic; Globin; Health; Health Professional; Healthcare; Heart Diseases; Heating; Hematological Disease; Intervention; Investigation; Judgment; Lead; Link; Malignant Neoplasms; Measures; Medical; Methods; Mutation; Neurobiology; Ochroma; Pain; Pain Measurement; Pain Threshold; Participant; Patient Self-Report; Patients; Perception; Persistent pain; Persons; Physicians; Physiological; Population; Prejudice; Prevalence; Race; Regression Analysis; Relative (related person); Research; Series; Sickle Cell Anemia; Sickle Hemoglobin; Socioeconomic Status; Source; Stereotyping; Stimulus; Testing; Unconscious State; Workplace; base; behavior measurement; caucasian American; chronic pain; experience; health care quality; health disparity; mortality; neuroimaging; novel; population health; psychologic; racial discrimination; relating to nervous system; response; social

DESCRIPTION (provided by applicant): Racial disparities exist in access to and quality of health care treatment of pain (e.g. Todd et al., 1993 & 2000), a medical condition that affects more Americans than heart disease, diabetes, and cancer combined (CDC, 2006). Compared to Caucasian-Americans, African Americans experience clinical (Edwards et al., 2001) and experimental pain to a greater extent and with greater frequency, likely due to both genetic and environmental factors, and yet are more likely to be undertreated for pain in medical settings (Green et al., 2003; Bonham, 2001). Racial disparities in pain may result from both basic biological differences in how pain is experienced and perceived across racial groups as well as how the pain of different racial groups is perceived and treated in medical settings by healthcare professionals. First, African-Americans are more likely to suffer from acute and chronic pain that accompanies sickle cell disease, a genetic blood disorder characterized by the predominance of hemoglobin S (Hb S) arising from a known mutation of a single SNP of the 2-globin gene (Kwiatkowski, 2005). Second, due to these negative stereotypes, African-Americans typically encounter increased experience with racial discrimination or race-based social pain in interpersonal and work settings, which decreases health, increases mortality (Williams et al., 1997), and may lead to increased sensitivity to and experience of physical pain in this population. Third, racial stereotypes and prejudice can also affect perception and medical judgments of pain (Freeman & Payne, 2000, van Ryn & Burke, 2000), leading to under or inappropriate treatment of pain conditions particularly for African-Americans (Freeman & Payne, 2000). Finally, the potential difficulty or inability to readily receive appropriate medical treatment for pain can lead African-Americans to mistrust or avoid medical settings (Corbie-Smith, Thomas, St George, 2002) which may further exacerbate existing or emerging pain conditions and lead to persistent racial disparities in pain. The aim of the proposed series of neuroimaging and behavioral studies is to investigate the effect of race on the neural response to pain perception and experience, as well as whether racial stereotypes and prejudice affect how both doctors and lay people respond to the physical pain of others. Findings from the proposed research may have important implications for addressing the neurobiological and psychological mechanisms underlying population health disparities in pain experience and care across racial groups.

描述（由申请人提供）：在疼痛的医疗保健治疗的获得和质量方面存在种族差异（例如，托德等人，1993年和2000年），这是一种影响美国人的疾病，比心脏病，糖尿病和癌症的总和还要多（CDC，2006年）。与白种美国人相比，非裔美国人经历临床（Edwards等人，2001）和实验性疼痛，可能是由于遗传和环境因素，但更可能在医疗环境中对疼痛治疗不足（绿色等人，2003;博纳姆，2001）。疼痛的种族差异可能是由于不同种族群体如何体验和感知疼痛的基本生物学差异以及医疗保健专业人员如何在医疗环境中感知和治疗不同种族群体的疼痛造成的。首先，非裔美国人更可能患有伴随镰状细胞病的急性和慢性疼痛，镰状细胞病是一种遗传性血液疾病，其特征在于由2-珠蛋白基因的单个SNP的已知突变引起的血红蛋白S（Hb S）占优势（Kwiatkowski，2005）。其次，由于这些负面的刻板印象，非洲裔美国人通常在人际关系和工作环境中遇到更多的种族歧视或基于种族的社会痛苦，这降低了健康，增加了死亡率（威廉姆斯等人，1997），并可能导致该人群对身体疼痛的敏感性和体验增加。第三，种族刻板印象和偏见也会影响疼痛的感知和医学判断（Freeman & Payne，2000，货车瑞恩& Burke，2000），导致疼痛状况的治疗不足或不适当，特别是对非洲裔美国人（Freeman & Payne，2000）。最后，潜在的困难或不能容易地接受适当的疼痛治疗可能导致非洲裔美国人不信任或避免医疗机构（Corbie-Smith，托马斯，St乔治，2002），这可能进一步加剧现有或新出现的疼痛状况，并导致疼痛的持续种族差异。拟议的一系列神经成像和行为研究的目的是调查种族对疼痛感知和体验的神经反应的影响，以及种族刻板印象和偏见是否影响医生和外行人对他人身体疼痛的反应。拟议研究的结果可能对解决不同种族群体在疼痛体验和护理方面的人群健康差异的神经生物学和心理机制具有重要意义。

项目成果

Cultural Variation in Implicit Mental Illness Stigma.

• DOI: 10.1177/0022022112455457
• 发表时间: 2012-10-01
• 期刊: Journal of cross-cultural psychology
• 影响因子: 3
• 作者: Cheon BK;Chiao JY
• 通讯作者: Chiao JY

Constraints, Catalysts and Coevolution in Cultural Neuroscience: Reply to Commentaries.

• DOI: 10.1080/1047840x.2013.773599
• 发表时间: 2013
• 期刊: Psychological inquiry
• 影响因子: 9.3
• 作者: Cheon BK;Mrazek AJ;Pornpattananangkul N;Blizinsky KD;Chiao JY
• 通讯作者: Chiao JY

A central mechanism enhances pain perception of noxious thermal stimulus changes.

一个中心机制增强了有害热刺激变化的疼痛感知。

• DOI: 10.1038/s41598-017-04009-9
• 发表时间: 2017
• 期刊: Scientific reports
• 影响因子: 4.6
• 作者: Petre,B;Tetreault,P;Mathur,VA;Schurgin,MW;Chiao,JY;Huang,L;Apkarian,AV
• 通讯作者: Apkarian,AV

The role of culture-gene coevolution in morality judgment: examining the interplay between tightness-looseness and allelic variation of the serotonin transporter gene.

• DOI: 10.1007/s40167-013-0009-x
• 发表时间: 2013
• 期刊: Culture and brain
• 作者: Mrazek AJ;Chiao JY;Blizinsky KD;Lun J;Gelfand MJ
• 通讯作者: Gelfand MJ

Current emotion research in cultural neuroscience.

当前的文化神经科学研究。

• DOI: 10.1177/1754073914546389
• 发表时间: 2015-07
• 期刊: Emotion review : journal of the International Society for Research on Emotion
• 作者: Chiao JY