Everyday Discrimination in Adults with Knee Pain: The Role of Perceived Stress and Pain Catastrophizing
Bibliographic record
Abstract
Ellen L Terry,1 M Dottington Fullwood,2 Staja Q Booker,1 Josue S Cardoso,3 Kimberly T Sibille,2 Toni L Glover,4 Kathryn A Thompson,5 Adriana S Addison,6 Burel R Goodin,5 Roland Staud,7 Laura B Hughes,6 Laurence A Bradley,6 David T Redden,8 Emily J Bartley,9 Roger B Fillingim3,9 1Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, United States; 2Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida, United States; 3Pain Research and Intervention Center of Excellence (PRICE), Gainesville, Florida, United States; 4Oakland University, School of Nursing, Rochester, MI, United States; 5Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, United States; 6University of Alabama at Birmingham, Division of Clinical Immunology & Rheumatology, Birmingham, Alabama, United States; 7Department of Medicine, University of Florida, Gainesville, Florida, United States; 8Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States; 9University of Florida, Community Dentistry and Behavioral Science, Gainesville, Florida, United StatesCorrespondence: Ellen L TerryDepartment of Biobehavioral Nursing Science, University of Florida, PO Box 100197, Gainesville FL 32610-0197 Tel ( +352) 273-6441Email elterry@ufl.eduPurpose: Research indicates pain-related disparities in the impact of knee osteoarthritis (OA) across both sex and ethnicity/race. While several factors likely contribute to these disparities, experiences of discrimination are associated with poor OA-related pain, disability, and functional performance. However, the mechanisms that mediate experiences of discrimination and OA-related outcomes are unclear. The current cross-sectional study examined the associations between everyday experiences of discrimination and clinical pain, disability and functional performance among non-Hispanic Black (NHB) and non-Hispanic White (NHW) persons with or at risk of knee OA and assessed the serial mediated model of perceived stress and pain catastrophizing on these relationships in women only.Patients and Methods: Participants were 188 community-dwelling adults who presented with unilateral or bilateral knee pain and screened positive for clinical knee pain. Participants completed several measures including experiences of discrimination, Perceived Stress Scale, Coping Strategies Questionnaire-Revised (CSQ-R): Pain Catastrophizing subscale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Graded Chronic Pain Scale (GCPS), and Short Physical Performance Battery (SPPB).Results: As compared to NHW participants, NHB individuals reported experiencing significantly higher levels of discrimination (F(1, 175)=26.660, p< 0.001), greater levels of pain catastrophizing (F(1, 180)=12.919, p< 0.001), higher levels of clinical pain and disability, and lower levels of physical function (ps< 0.05). However, perceived stress was positively correlated with discrimination in the NHW group only (NHW females: r=0.40, p< 0.01; NHW males: r=0.37, p< 0.05). Further, perceived stress and pain catastrophizing mediated the relationship between discrimination and outcome variables (WOMAC pain, GCPS interference [pain disability], and SPPB function) in female participants after controlling for relevant sociodemographic variables (study site, age, race, income, and body mass index).Conclusion: These results may have implications for the treatment of perceived stress and catastrophizing as a means to reduce the negative impact of experiences of discrimination on the experience of chronic pain, particularly for women.Keywords: experiences of discrimination, Perceived Stress Scale, pain catastrophizing, knee osteoarthritis, pain, disability, physical function
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".