Making Pain Research More Inclusive: Why and How

Janevic, Mary R.; Mathur, Vani A.; Booker, Staja Q.; Moraís, Calia A.; Meints, Samantha M.; Yeager, Katherine A.; Meghani, Salimah H.

doi:10.1016/j.jpain.2021.10.004

Cited by 62 publications

(57 citation statements)

References 109 publications

(124 reference statements)

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“…20,57 Although this review focused on sex and gender, greater consideration of these multidimensional and intersectional elements needs to be considered. 82…”

Section: Implications and Future Directionsmentioning

confidence: 99%

Sex and gender differences in pain: past, present, and future

Keogh

2022

Pain

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“…20,57 Although this review focused on sex and gender, greater consideration of these multidimensional and intersectional elements needs to be considered. 82…”

Section: Implications and Future Directionsmentioning

confidence: 99%

Sex and gender differences in pain: past, present, and future

Keogh

2022

Pain

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“…Finally, representation of certain groups—including many who may be at greater risk for trauma—are underrepresented in the literature. Therefore, this study is limited by the extant data and the limitations that exist at the systemic level of research design 119,120…”

Section: Discussionmentioning

confidence: 99%

“…27 The consistency in methodology may suggest that heterogeneity in values reflect a representative spectrum of pain sensitivity seen across individuals that are exposed to psychological trauma. Another possibility is that other common features of QST studies that are less frequently assessed (eg, habituation in the context of repeated testing; acute stress-induced changes in pain modulatory systems in experimental contexts [117][118][119] ) introduce noise to the data and contribute to the observed heterogeneity. An important consideration is the variability in pain stimulus, target tissue and body site of testing, and these moderators should be considered in future reviews.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Life Experience and Pain Sensitization

Nanavaty

Thompson²,

Meagher

et al. 2022

The Clinical Journal of Pain

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Objectives: Psychological trauma often co-occurs with pain. This relationship has been explored using laboratory pain measures; however, findings have been mixed. Previous studies have limited operationalization of trauma (eg, posttraumatic stress disorder) or pain (eg, pain thresholds), which may contribute to conflicting results. Further, prior reviews likely underrepresent trauma experiences among people who are not receiving clinical care, limiting generalizability. Materials and Methods:We systematically reviewed the existing literature on the relationship between psychological trauma (eg, car accidents, sexual assault, childhood abuse, neglect) and laboratory pain (ie, quantitative sensory testing measures of pain threshold, intensity, summation, modulation), using inclusive criteria. The direction of the relationship between psychological trauma and pain sensitivity was evaluated, and moderation by purported pain mechanism (ie, pain detection, suprathreshold pain, central sensitization, inhibition) was explored.Results: Analyses were conducted using 48 studies that provided 147 effect sizes. A multivariate random-effects model with robust variance estimation resulted in a small but statistically significant overall effect size of g = 0.24 (P = 0.0002), reflecting a positive association between psychological trauma and enhanced laboratory pain sensitivity. Upon examination of mechanistic moderators, this relationship appears driven by effects on pain detection (g = 0.28, P = 0.002) and central sensitization (g = 0.22, P = 0.04). While effect sizes were similar across all moderators, effects on suprathreshold pain and inhibition were not statistically significant.Discussion: Findings demonstrate an overall pattern of traumarelated pain enhancement and point to central sensitization as a key underlying mechanism.

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“…1 Tragically, in many instances, the individuals who experience the greatest burden from pain are the same individuals who are underrepresented in studies that seek to understand and alleviate pain. 21 Thus, recent calls to action have been put forth to make pain research more inclusive, and to use antiracist principles in the conduct, reporting, and interpretation of pain research. 18,22,25 As editors of journals in the field of pain research and medicine (Canadian Journal of Pain, Clinical Journal of Pain, European Journal of Pain, Journal of Pain, Journal of Pain Research, PAIN, Pain Medicine, and PAIN Reports), we are united in our commitment to eliminate disparities in pain science and to provide an inclusive environment for scholarship and publishing.…”

mentioning

confidence: 99%

Promoting inclusion, diversity, and equity in pain science

Palermo

Davis

Bouhassira

et al. 2023

Pain

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S cience and medicine have a long and troubling history of reinforcing racist, anti-ethnic, and sexist attitudes and beliefs, as well as ignoring and mistreating marginalized people. In their editorial in Nature, 26 entitled "Science must overcome its racist legacy", Nobles et al describe how the scientific enterprise has reinforced racist beliefs and cultures over time. For example, the authors discuss the impact of colonization on racism, including how apartheid, imperialism, colonialism, slavery, and eugenics were memorably endorsed by science. They then assert that acknowledging and learning this history is necessary if we are to restore, rebuild, and avoid perpetuating these injustices. Similarly, there is a long history of exclusion of women from science and medicine as a profession due to structural discrimination as well as exclusion of women from research participation in clinical trials to develop pharmacologically-based therapeutics. 4 The science of pain is no exception. As Bourke 5 explores in an article on the history of pain sensitivity, misconceptions about pain sensitivity put forth by physicians and scientists from 1800 to 1965 reified existing social hierarchies. It was believed that

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Making Pain Research More Inclusive: Why and How

Cited by 62 publications

References 109 publications

Sex and gender differences in pain: past, present, and future

Sex and gender differences in pain: past, present, and future

Traumatic Life Experience and Pain Sensitization

Promoting inclusion, diversity, and equity in pain science

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