BACKGROUND: Chronic pain is prevalent among millions of Americans and can negatively impact cognitive processes, mental health, and overall quality of life. Even though pain affects all ethnic and racial groups equally, studies have shown a growing disparity in pain intensity and prevalence of pain conditions among underrepresented minority adult populations across the United States. Hispanics are among the fastest-growing populations in the U.S., yet chronic pain in Hispanic adults and adolescents remains severely understudied.
PURPOSE: This study aims to compare pain and related psychosocial factors (pain catastrophizing, anxiety and depression) and Fear of Pain Questionnaire scores (FOPQ) in Hispanic vs. Non-Hispanic White (NHW) youth with chronic pain. Based on prior literature from studies in adults, it was hypothesized that Hispanic youth would report greater pain catastrophizing, anxiety, depression, and higher FOPQ scores when compared to NHW youth. Further, potential differences in relations between anxiety, pain catastrophizing, and physical functioning on depression among Hispanic and NHW youth will be explored.
METHODS: Participant data were gathered from the Boston Children’s Hospital Chronic Pain Data Repository. The current study sample included 116 children and adolescents, ages 12-18 years (M = 15.49, SD = 1.71) from Hispanic and NHW backgrounds. Both groups had the same proportion of participants who identified as female (88%), and samples used for analysis were age-and-sex matched. Independent sample t-tests were performed to compare the mean differences in pain catastrophizing, PROMIS anxiety and depression scores, and FOPQ sum score between groups. Bivariate correlations for each group were also compared, and Hayes PROCESS Macro was used to compare the associations between pain catastrophizing, anxiety, and physical functioning on depression, based across patient ethnicities.
RESULTS: The results of independent samples t-tests did not reveal any significant differences across groups. However, significant correlations were found. Notably, PROMIS anxiety and depression t-scores were significantly correlated among each independent cohort of Hispanic youth (r = .612, p <.001), non-Hispanic White youth (r = .817, p<.001), and across the full sample (r = .719, p <.001). Pain catastrophizing was also found to be significantly and positively correlated with anxiety (r = .660, p<.001), depression (r = .582, p <.001) and patient FOPQ score (r = .740, p <.001) across both cohorts. From the moderation analysis, the association between pain catastrophizing and depression was found to be statistically significant based on ethnicity of patient [B = .0272, p<.05]. Similarly, ethnicity was found to significantly moderate the association between PROMIS anxiety and depression [B = .0340, p<.05].
CONCLUSIONS: This study is one of the first to explore how pain and psychosocial-related factors compare in an age-and-sex-matched cohort of Hispanic vs. NHW youth with chronic pain. The study is also novel in identifying patient ethnicity as a moderator between anxiety and pain catastrophizing on depression. Obtaining a significant correlation between pain catastrophizing, anxiety, and depression scores for both groups parallels previous findings in adult populations with chronic pain. Contrary to our hypotheses, no mean differences were found in variables associated with pain or psychosocial factors between the two groups, however it is possible that the small sample size used may have obscured group differences. The results highlight the need to increase diversity in research for pediatric populations with chronic pain to help reduce pain disparities among underrepresented minority youth populations.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48346 |
| Date | 06 March 2024 |
| Creators | Moreno, Joaquin Esteban |
| Contributors | Nelson, Sarah, Cohen, Ezra M. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-NonCommercial-NoDerivatives 4.0 International, http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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