Multiple Levels of Suffering: Discrimination in Health-Care Settings is Associated With Enhanced Laboratory Pain Sensitivity in Sickle Cell Disease. Academic Article uri icon


  • OBJECTIVE: People living with sickle cell disease (SCD) experience severe episodic and chronic pain and frequently report poor interpersonal treatment within health-care settings. In this particularly relevant context, we examined the relationship between perceived discrimination and both clinical and laboratory pain. METHODS: Seventy-one individuals with SCD provided self-reports of experiences with discrimination in health-care settings and clinical pain severity, and completed a psychophysical pain testing battery in the laboratory. RESULTS: Discrimination in health-care settings was correlated with greater clinical pain severity and enhanced sensitivity to multiple laboratory-induced pain measures, as well as stress, depression, and sleep. After controlling for relevant covariates, discrimination remained a significant predictor of mechanical temporal summation (a marker of central pain facilitation), but not clinical pain severity or suprathreshold heat pain response. Furthermore, a significant interaction between experience with discrimination and clinical pain severity was associated with mechanical temporal summation; increased experience with discrimination was associated with an increased correlation between clinical pain severity and temporal summation of pain. DISCUSSION: Perceived discrimination within health-care settings was associated with pain facilitation. These findings suggest that discrimination may be related to increased central sensitization among SCD patients, and more broadly that health-care social environments may interact with pain pathophysiology.

published proceedings

  • Clin J Pain

altmetric score

  • 4.5

author list (cited authors)

  • Mathur, V. A., Kiley, K. B., Haywood, C., Bediako, S. M., Lanzkron, S., Carroll, C. P., ... Campbell, C. M.

citation count

  • 48

complete list of authors

  • Mathur, Vani A||Kiley, Kasey B||Haywood, Carlton||Bediako, Shawn M||Lanzkron, Sophie||Carroll, C Patrick||Buenaver, Luis F||Pejsa, Megan||Edwards, Robert R||Haythornthwaite, Jennifer A||Campbell, Claudia M

publication date

  • December 2016