Does Cultural Identity Moderate the Relationship Between Experienced Discrimination and Cognitive-Affective Pain Amplifiers?: Results from the Oklahoma Study of Native American Pain Risk (OK-SNAP)

Native Americans (NAs) experience higher rates of chronic pain than other U.S. ethnic/racial groups. This partly results from stress due to interpersonal discrimination that promotes pain-related catastrophizing and anxiety. The present study examined whether NA acculturation moderates the relationship between discrimination and these cognitive-affective pain amplifiers. Participants were 145 healthy, chronic pain-free NAs from OK-SNAP. NA acculturation was assessed with the Native American Acculturation Scale. Interpersonal discrimination was assessed with the Everyday Discrimination Scale. Following several pain tasks, situational pain catastrophizing was assessed with the Pain Catastrophizing Scale and pain-related anxiety was assessed with a visual analogue scale, which were averaged across tasks. PROCESS was used to conduct moderated regression analyses. A significant interaction was found between discrimination and acculturation when predicting pain catastrophizing (∆R2=0.032, p=0.027). Lower acculturation (greater identification with NA culture) was associated with a significant positive relationship between discrimination and pain catastrophizing (B=4.50, p=0.0001), whereas higher acculturation was associated with a non-significant relationship (B=0.91, p=0.042) Although discrimination was associated with higher pain-related anxiety (B=4.46, p=0.047), this was not moderated by acculturation (∆R2=0.009, p=0.26). To further understand these findings, discrimination was regressed on acculturation which showed that NAs who identified more with NA culture experienced more discrimination (R2 =0.041, p=0.014). Together, these findings suggest that NAs who identify more with NA culture reported more interpersonal discrimination and for these individuals’ discrimination is associated with greater pain catastrophizing. Future research should examine other cultural processes that may serve as buffers to negative outcomes related to discrimination and pain catastrophizing. Funded by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD007807, and by the University of Tulsa Office of Research and Sponsored Programs.