The Physiological and Psychological Pain of Racial Discrimination and Potential Pain-mitigating Effects of Acknowledgement from an Ally
Open AccessBlack people in the U.S. continue to experience unequal health outcomes in a variety of domains, including physiological pain. Extant research establishes that racism is responsible for racial health inequities. Despite research documenting racial pain inequalities, past pain research seldom examined racism as a causal factor of acute pain for Black people. Pain Overlap Theory proposes that social pain and physical pain have overlapping neurological mechanisms. Allostatic Load Theory posits that over time, re-activation of this overlapping pathway could lead to disruption in pain experience. The present study examined whether acute racial exclusion (discrimination), perceived as racism, influenced participants’ pain sensitivity in a cold pressor task. Past research on the causal impacts of racism on health identify negative affect and perceived control as potential mediators of the effect of racism on health. In addition, I tested whether control or negative affectivity mediated effects of racial exclusion on physiological pain. Past research on pain inequities, and health inequities in general, also tends to focus on the individual level of analysis. Social interventions – such as acknowledgment of racist experiences from an ally – may be another potential avenue for health intervention research. Thus, I also examined whether acknowledgment of racial exclusion could mitigate the psychological (i.e., psychological needs satisfaction, negative affect) and/or physiological pain of racial exclusion. Black young adults (aged 18-30; N = 92) were racially included (i.e., received the ball an equal number of times) or excluded (i.e., received the ball only once) by other White players in a ball-tossing computer game called Cyberball; White experimenters acknowledged the exclusion for half of the excluded participants. Participants completed a cold-pressor task twice to measure pain sensitivity (threshold, tolerance, and unpleasantness): immediately prior, and after the Cyberball (and acknowledgment) manipulation. Participants also completed a post-manipulation survey examining the psychological effects of racial exclusion and acknowledgment (i.e., psychological needs satisfaction, negative affect, control). Racially excluded participants reported significantly lower psychological needs satisfaction (i.e., belonging, meaningful existence, perceived control, self-esteem), and significantly higher pain sensitivity compared to included participants. Furthermore, acknowledgment marginally mitigated the effect of racial exclusion on self-control and self-esteem, and significantly mitigate the effect of racial exclusion on change in pain threshold and tolerance (but not change in pain unpleasantness). No effects were found with negative affective measures, or with mediation analyses, likely due to the underpowered sample. These findings support Pain Overlap Theory and Allostatic Load Theory, and the overall proposition that racism is a causal contributor to pain inequities among Black people in the U.S. Furthermore, these findings provide proof-of-concept for the notion of social-level interventions for health equity. I discuss the limitations of these findings and provide applications and future directions for this important topic of study.
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AuBuchon_gwu_0075A_16473.pdf | 2023-11-14 | Open Access |
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