(483) Examining race differences in pain-related coping: a meta-analysis

Abstract

Compared to White individuals, Blacks report higher pain for a number of clinical conditions and demonstrate lower tolerance across most experimental pain modalities. These racial differences in pain sensitivity may be due, in part, to differences in pain-related coping. Several studies examined the relationship between race and pain coping, however, no meta-analytic review has summarized this relationship or attempted to account for differences in results across studies. The goal of this meta-analytic review was to quantify racial differences in the overall use of pain coping strategies as well as specific coping strategies. Relevant studies were identified using PubMed, PsychINFO, Embase, Ovid, and Web of Science as well as an ancestry search of all identified articles. Additionally, we contacted authors for unpublished data. Of 350 studies identified, 19 met inclusion criteria for this meta-analysis, resulting in 6495 participants and 93 effect sizes. Standardized mean differences were corrected using Hedge’s correction for small sample size and weighted using the inverse variance weight for each study. Mean effect sizes were calculated using a random effects model. Compared to White individuals, Blacks used more overall pain coping strategies as well as the specific strategies of praying, catastrophizing, diverting attention, and reinterpreting pain, with the largest differences observed for praying (d=0.67; 95%CI 0.44 - 0.90) and catastrophizing (d=0.35; 95%CI 0.23 - 0.46). White individuals did, however, engage in task persistence more than Blacks (d=-0.28; 95%CI -0.41 - -0.15). Moderation analyses indicated that race differences in coping were larger for non-clinical than clinical samples. Additionally, race differences in catastrophizing decreased as the age of the sample increased. These results suggest that Black individuals use more coping strategies overall, specifically strategies associated with poor pain outcomes. Future research should examine the extent to which the use of these strategies mediates the race differences in pain sensitivity.