The publisher's final edited version of this article is available at Eur J Pain See other articles in PMC that cite the published article. Mean arterial pressure and HR measurements taken at rest and in response to speech stress were assessed. Perceived stress, anxiety, perfectionism, parental criticism, parental expectations and depressive symptoms were also measured.
The results indicated that for the cold pain test, Asians demonstrated significantly lower pain threshold and tolerance levels than Whites. Although no ethnic differences were seen for MAP or HR responses to stress, for whites higher stress MAP levels were correlated with reduced pain sensitivity, while for Asians higher baseline and stress HR levels were correlated with reduced pain sensitivity. Asians reported higher parental expectations and greater parental criticism than Whites. For Asians only, higher levels of perfectionism were related to more depressive symptoms, anxiety and perceived stress.
These results indicate that Asian Americans are more sensitive to experimental pain than Whites and suggest ethnic differences in endogenous pain regulatory mechanisms e. The results may also have implications for understanding ethnic differences in clinical pain. Few studies have examined pain sensitivity in Asians. Among patients with terminal and endstage chronic illness, patients of color Regarding sensitivity to experimental pain, Asians have lower sensory and pain thresholds in the trigeminal face region Komiyama et al.
There have been no studies examining the biopsychosocial determinants of pain sensitivity in Asians, though ethnic differences in endogenous pain regulatory mechanisms may play a role. Higher blood pressure BP levels are associated with decreased pain sensitivity, although the majority of this research has been conducted in Whites Campbell et al. The relationship between BP and pain sensitivity has been conceptualized within the context of the defense reaction, with evidence that sensory and autonomic responses to painful stimuli act in concert to modify pain perception Maixner, Increased BP stimulates mechanoreceptive afferents i.
Additionally, stimulation of these baroreceptors decreases cortical arousal and diminishes somatomotor reflexes evoked by noxious stimuli indicative of analgesic-like effects Dworkin et al.
Only one report exists examining ethnic differences in cardiovascular-somatosensory interactions. The purpose of this study was to examine the relationship of endogenous pain regulatory mechanisms to experimental pain sensitivity in Asians and Whites. We also compared the ethnic groups for depression and anxiety symptoms, since both predict pain sensitivity Bar et al. We also examined perfectionism since Asians endorse more perfectionism, including parental expectations and parential criticisms, than Whites Castro and Rice, ; Chang, ; Yoon and Lau, , and other studies indicate that perfectionism is associated with clinical pain Bottos et al.
We hypothesized that Asians, relative to non-Hispanic Whites, would show increased pain sensitivity and an absence of a relationship involving BP and pain sensitivity, similar to African Americans Mechlin et al. A secondary hypothesis was that Asians would report higher levels of perfectionism, depression, and anxiety than Whites.
Race was determined by self-identification on a questionnaire, and no individuals who self-identified as being of more than one race were included. Those born in Asia had lived in the US on average of 4 years. Participants were asked to refrain from any caffeine or over-the-counter medication, including analgesics, and to refrain from exercise for 24 hours prior to the onset of the experiment.
Three experimenters conducted the study: Race of the experimenter was randomized. Participants then filled out self-reported questionnaires: There was a maximum time limit 5 minutes imposed, though participants were not aware of the exact time limit.
Before the onset of the baseline, at least 3 manual stethoscopic BP measurements were taken simultaneously with the automated readings to ensure the accuracy of microphone placement, and cuff position, and to ensure accurate recordings. Baseline Rest The baseline period consisted of 10 minutes of quiet rest.
Baseline measures included HR and BP measurements taken at minutes 1, 3, 5, 7, and 9. For each variable HR and mean arterial pressure MAP , the 5 separate measurements were average to constitute one baseline value. Speech Stressor The average time between the start of the cold pressor task and the start of the speech stressor was on average 35 minutes range 24 — 50 minutes. The speech stressor included the following: Participants were instructed that they would be asked to give a 5 minute speech as a job interview for their ideal job.
Participants were left alone to make notes about their speech. They were told that they would not be able to refer to these notes during their speech. BP and HR were taken at minutes 1, 3, and 5, and were averaged to constitute preparation values; 3 Speech 5 min: Immediately following the preparation, participants were asked to deliver their speech in front of the interviewing committee.
If the participant was unable to talk for the entire time allotment 5 minutes , the experimenters asked prepared questions to ensure that the participant continued to speak for the duration of the task. During the speech, BP and HR measurements were taken at minutes 1, 3, and 5, and then averaged to constitute speech levels.
Blood pressure measures were not taken during the cold pressor test since inflation of the blood pressure cuff on the contralateral arm may have acted as a counter-irritant stimulus eliciting diffuse noxious inhibitory control mechanisms, and thereby altering pain sensitivity to the cold pressor Edwards et al.
Other studies have reliably used blood pressure responses to mental stress tests as predictors of pain sensitivity to cold pressor pain Girdler et al.