Sociocultural & biobehavioral influences on pain expression and assessment

今年，我们继续收集17-AT-0155“社会文化和生物行为对疼痛表达和评估的影响”的数据。该协议措施疼痛相关的面部反应，在不同的人群，以衡量是否疼痛的非语言反应不同的生物和社会文化因素的功能。然后，我们将测量个体（包括健康志愿者和医疗服务提供者）是否注意疼痛的不同特征，或者在组内相对于组外个体对疼痛进行不同的评估，以及我们是否可以制定干预措施来减少注意力或疼痛评估中的任何偏见。 在2019财年，我们有51名新受试者完成了第一项子研究的至少一次访视，其中33名完成了所有任务。这使得我们共有68例受试者完成了至少一次访视，共有48例完成者（1例FY 18受试者在FY 19期间完成了任务）。在首次访视期间，我们通过资格检查表、尿液筛查、护理评估和标准临床访谈诊断来评估合格性。在第二次访问期间，我们使用视频记录和面部肌电图来测量面部对疼痛刺激的反应。我们会给病人三种伤害性刺激：电击、热痛和冷水。我们正在使用专门的软件来通过视频测量面部反应，并避免隐含的偏见，如果我们使用人类编码器，可能会影响结果。我们将测量在面部反应中是否观察到与疼痛中的性别差异相似的性别差异，以及我们是否将面部反应或性别差异的差异视为种族，民族或种族或性别的身份中心性的函数。 完成后，询问子研究1参与者是否希望将其图像包含在将向其他参与者显示的数据库中。选择加入该数据库的参与者的图像将被用作我们后续子研究2和3的刺激，这些子研究使用眼动追踪来测量个人（天真的参与者和医疗提供者）如何看待和判断他们认为与他们相似或不同的其他人的疼痛。通过这一点，我们希望能够深入了解疼痛中健康差异的行为介质。如果我们确定了导致感知疼痛差异的目标，我们将使用这些目标来制定干预措施，并观察个体是否可以在子研究3中提高准确性。

This year, we continued data collection for 17-AT-0155, "Sociocultural & Biobehavioral Influences on Pain Expression and Assessment". This protocol measures pain-related facial responses in a diverse population to measure whether nonverbal responses to pain vary as a function of biological and sociocultural factors. We will then measure whether individuals (both healthy volunteers and medical providers) pay attention to different features of pain or assess pain differently in in-group relative to out-group individuals, and whether we can develop interventions to reduce any biases in attention or pain assessment. In FY19 we had 51 new subjects complete at least one visit for our first sub-study, 33 of which completed all tasks. This places us at 68 total subjects who have completed at least one visit and 48 total completers (one FY18 subject completed the task during FY19). During the first visit, we assess eligibility via eligibility checklist, urine screen, nursing assessment, and a standard clinical interview diagnostic. During the second visit, we use video recording and facial electromyography to measure facial responses to painful stimuli. We administer three types of noxious stimuli: electric shock, thermal pain, and cold water. We are using specialized software to measure facial responses via video and to avoid implicit biases that could affect results if we used human coders. We will measure whether sex differences are observed in facial responses that are similar to sex differences in pain, as well as whether we see differences in facial responses or sex differences as a function of race, ethnicity, or identity centrality of race or sex. Following completion, sub-study 1 participants are asked whether they want their images to be included in a database that will be shown to other participants. Images of participants who opt into this database will be used as stimuli for our subsequent sub-studies 2 and 3, which use eye tracking to measure how individuals (both naive participants and medical providers) view and judge pain in others that they perceive to be similar or different from them. Through this, we hope to gain insight on behavioral mediators of health disparities in pain. If we identify targets that contribute to differences in perceived pain, we will use these to develop interventions and see if individuals can improve accuracy in sub-study 3.