Blacks and White Patients Perceive and Cope With Pain Differently Interview with:

Adam T. Hirsh PhD Assistant Professor, Psychology Indiana University Indianapolis, IN

Dr. Adam T. Hirsh

Adam T. Hirsh PhD
Assistant Professor, Psychology
Indiana University
Indianapolis, IN 

Medical Research: What is the background for this study? What are the main findings?

Dr. Hirsh: Pain is highly prevalent and is a major cause of disability. How patients cope with pain affects how much pain they feel and how much that pain interferes with their lives. Compared to White individuals, Black individuals experience greater pain across a number of clinical conditions, as well as in response to experimentally-delivered stimuli. These race differences may be due to differences in pain-related coping. We conducted a meta-analysis of clinical and experimental studies (including 2,719 Black and 3,770 White adults) to quantify race differences in the overall use of pain coping strategies as well as specific coping strategies. The results indicated that, compared to White individuals, Black individuals used pain coping strategies more frequently overall. In particular, Black individuals more frequently used strategies that involved praying and catastrophizing, whereas White individuals more frequently used strategies that involved task persistence. These results suggest that Black individuals use coping strategies more frequently, specifically strategies associated with poorer pain outcomes.

Medical Research: What should clinicians and patients take away from your report?

Dr. Hirsh: How patients think about their pain matters. Moreover, the same coping strategies may have different functional consequences for different patients. For example, pain-related catastrophizing may lead to increased suffering for some patients (a negative outcome) but increased social support for other patients (a positive outcome). It is important that clinicians are aware that cultural background may strongly influence the types of strategies patients use to cope with pain, as well as the consequences of those strategies. Given our increasingly diverse society, clinicians should ask about the coping strategies patients use to manage their pain, and they should make good use of what the patient tells them. In addition to the time barrier, some clinicians may not feel equipped to help their patients cope more adaptively with pain. While there are no easy answers to such concerns, the simple act of asking patients about their pain coping and/or having them complete a coping measure may enhance pain coping itself. Both require patients to reflect on their coping strategies and the effectiveness of such strategies. It also exposes them to coping strategies they may not be familiar with. And it may even lead to more productive conversations between patient and clinician – ones that help the patient lead a more fulfilling life. I think most clinicians are well-suited to such discussions.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Hirsh: Research is needed to clarify how differences in pain-related prayer and catastrophizing are related to race differences in pain. Research is also need to further examine race differences in intra- and inter-personal values and goals within the context of pain. This is particularly important given cultural differences along the individualism – collectivism spectrum. Such research will advance our understanding of race differences in pain, as well as the provision of patient-centered, culturally-sensitive care.


Differences in pain coping between Black and White Americans: A meta-analysis

Meints, Samantha M. et al.

The Journal of Pain , Volume 0 , Issue 0 ,

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Adam T. Hirsh PhD (2016). Blacks and White Perceive and Cope With Pain Differently

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