The Association Between Adverse Life Events, Psychological Stress, and Pain-Promoting Affect and Cognitions in Native Americans: Results from the Oklahoma Study of Native American Pain Risk

The relationship between college students' belief in a just world and internet addiction: the moderating effect of legal cognition

Background

Previous studies have explored various personality and emotional variables influencing internet addiction. However, few have examined the impact mechanism of legal cognition on internet addiction. This study examined the relationship between belief in a just world and internet addiction, investigating whether legal cognition could moderate the effect of belief in a just world on internet addiction.

Methods

The study used the Belief in a Just World Scale, the Internet Addiction Scale, and the Legal Cognition Assessment Scale to survey 532 college students from universities in mainland China.

Results

Correlation analysis indicated a significant negative correlation between belief in a just world and internet addiction; belief in a just world negatively predicted internet addiction, and both the overall score of legal cognition and abstract legal cognition moderated this relationship.

Conclusions

College students' internet addiction was influenced by belief in a just world and legal cognition, suggesting that interventions for internet addiction among college students could involve cognitive-behavioral therapy and education on the rule of law.

Using intensive longitudinal assessment to study mechanisms of the Native American pain inequity among persons experiencing depression and/or anxiety: The role of interpersonal discrimination and stress

Native Americans (NA) experience higher rates of chronic pain than other U.S. racial/ethnic groups. Our research has indicated discrimination and stress play a role in chronic pain onset. However, chronic pain research has mostly relied on retrospective reports that may be impacted by recall bias. The current study was a secondary analysis of data from 208 NA, 206 Black, 202 Latinx, and 206 non-Hispanic White (NHW) participants from an efficacy trial of a mobile health intervention for depression and anxiety. Participants were prompted to complete 6 months of twice daily ecological momentary assessments (EMAs) that included stress and pain. Discrimination was assessed at baseline. Pain EMAs were used to reduce recall bias and estimate chronic pain prevalence. Dynamic structural equation modeling assessed the impact of race/ethnicity and discrimination on stress-pain relationships, as well as pain and stress dynamics. To assess chronic pain (pain ≥3-months), participants had to complete ≥3-months of consecutive EMAs, leaving 578 participants available for primary analyses (there were no racial/ethnic differences in EMA completion). Results showed NAs had the highest rate of chronic pain that was statistically significantly higher than NHW and Black participants. Controlling discrimination eliminated the NA-NHW, but not the NA-Black, pain inequity. Moreover, a reciprocal stress-pain relationship was found and was stronger in NAs than other groups. Discrimination did not exacerbate stress-pain relationships but was associated with higher rates of chronic pain and greater pain fluctuations, regardless of race/ethnicity. These findings indicate that targeting stress and discrimination could help reduce the NA pain inequity. PERSPECTIVE: Native Americans experienced a self-reinforcing stress-pain cycle in which stress predicted future pain and pain predicted future stress. This cycle was stronger than Black, Latinx, and non-Hispanic White groups. Discrimination was associated with chronic pain but not stronger stress-pain relationships. These findings have implications for treatment.

The influence of negative events on adolescents' mobile phone addiction: the chain mediating role of personality traits and emotional regulation style

Introduction

Teenagers' excessive dependence on mobile phones has aroused widespread concern in society. However, the complex mechanisms underlying the relationship between negative events and adolescent mobile phone addiction have not been thoroughly studied. The study aims to delve into the specific relationship between negative events and adolescent mobile phone addiction, and further explore the mediating role of personality traits (neuroticism) and emotional regulation (expression inhibition) in this relationship.

Methods

This article is based on an empirical study involving 1399 randomly selected survey questionnaires from ordinary higher education institutions in Jiangsu and Zhejiang regions of China. The Adolescent Life Events Scale is employed to assess the impact of negative events on adolescents. The College Student Mobile Phone Addiction Scale is utilized to explore adolescent mobile phone usage behavior and addiction tendencies. The Big Five Personality Questionnaire is used to analyze personality tendencies, while the Emotion Regulation Scale is used to evaluate the frequency of using emotion regulation strategies.

Results

(1) A notable positive correlation exists between negative events and mobile phone addiction. (2) Neurotic personality and expression inhibition play a mediating role in the chain effect between negative events and mobile phone addiction.

Discussion

This study enriches relevant research on adolescent mobile phone addiction and offers a guide for educators and parents to solve the issue of adolescent mobile phone addiction. Negative events are positively correlated with mobile phone addiction, and neurotic personality and expressive inhibition play a chain mediating role between them.

Mediating roles of perceived social support and hopelessness in the relationship between negative life events and self-identity acquisition among Chinese college students with left-behind and/or migrant experiences

Introduction

Although research examining the status of self-identity of college students has been conducted, few studies have explored the intrinsic mechanisms underlying the formation of self-identity acquisition (SIA) among college students with experiences of being left behind and/or migrant. The acquisition of self-identity is a crucial task during the college years, becoming even more significant in the aftermath of stressful life events.

Methods

This study employed Self-identity Acquisition (SIA), College Students Self-Rating Life Events Checklist, Perceived Social Support Scale (PSSS), Hopelessness scale to explore the impact of negative life events on the acquisition of self-identity among college students with left-behind and/or migrant experiences. A total of 1,240 college students were surveyed, comprising 180 with both left behind and migrant experiences (Group 1), 556 with only left-behind experiences (Group 2), 117 with migrant experiences (Group 3), and 387 with no left-behind or migrant experiences (Group 4).

Results

Students in Group 1 exhibited the lowest levels of SIA, followed by those in Group 2, while participants in Group 4 demonstrated superior outcomes. The results of the correlation analysis showed that four variables were significantly correlated exclusively within the two groups of students experiencing left behind (Group 1 and Group 2), meeting the conditions for conducting a mediation test. In Group 2, perceived social support (PSSS) and hopelessness played separate mediating roles between negative life events and SIA. However, for individuals who experienced both left behind and migrant situations, there was no significant mediating effect of PSSS between negative life events and SIA; instead, hopelessness served as a stronger mediator compared to its role within the left-behind group. The two groups characterized by left-behind experiences, PSSS and hopelessness play chain mediating roles.

Discussion

These findings suggest that such dual experiences may lead to an increased perception of available support while simultaneously fostering despair that hinders the development toward acquiring a solid sense of identity. When individuals with left-behind experiences encounter feelings associated with despair following adverse life events, they tend to diminish their utilization of available supportive resources, which is not conducive to making positive and firm self-identity exploration and commitment.

COVID-19 Pandemic-Related Stressors, Distress, and Bodily Pain in Native Americans: Results from the Oklahoma Study of Native American Pain Risk

The COVID-19 pandemic disproportionately impacted minoritized individuals. This study examined the relationships between pandemic-related stressors/distress and bodily pain in 79 Native American (NA) and 101 non-Hispanic White (NHW) participants from the Oklahoma Study of Native American Pain Risk. Online surveys were administered in May/June 2020 (wave 1), March/April 2021 (wave 2), and Sept/Oct 2021 (wave 3). Pandemic-related stressors (e.g., resource loss and added responsibilities) and distress were assessed from a custom-built questionnaire. Bodily pain was assessed from pain items on the Patient Health Questionnaire-15 (PHQ-15). The results indicate NAs and NHWs reported similar pandemic-related stressors and distress at wave 1, which remained at similar levels across all waves in NHWs. By contrast, stressors and distress increased in NAs at waves 2 and 3. Moreover, bodily pain was higher in NAs than NHWs across all waves. Regression-based multilevel analyses predicting bodily pain found that NHWs with more pandemic-related stressors/distress experienced more bodily pain, but stress/distress did not predict bodily pain in NAs. Findings demonstrated that NAs experienced more bodily pain and pandemic-related stressors/distress than NHWs. However, pandemic-related stressors/distress did not further exacerbate NA pain as observed in NHWs. This implies NAs may have demonstrated resiliency that buffered the pronociceptive effects of pandemic-related stress.

The Relationship Between Neighborhood Disadvantage and Markers of Chronic Pain Risk: Findings From the Oklahoma Study of Native American Pain Risk (OK-SNAP)

Socioeconomic disadvantage contributes to health inequities, including chronic pain. Yet, research examining socioeconomic disadvantage and pain risk in Native Americans (NAs) is scant. This exploratory analysis assessed relationships between socioeconomic position (SEP), ethnicity, and neighborhood disadvantage on pronociceptive processes in 272 healthy, chronic pain-free NAs (n = 139) and non-Hispanic Whites (NHWs, n = 133) from the Oklahoma Study of Native American Pain Risk (OK-SNAP). Neighborhood disadvantage was quantified using the Area Deprivation Index (ADI). Regression models tested whether ADI predicted pain-promoting outcomes (ie, peripheral fiber functionality, pain sensitivity, pain and nociceptive amplification, and endogenous pain inhibition) above-and-beyond SEP and ethnicity. The Ethnicity × ADI interaction was also tested. Of the 11 outcomes tested, 9 were not statistically significant. Of the significant findings, neighborhood disadvantage predicted impaired inhibition of the nociceptive flexion reflex above-and-beyond SEP and ethnicity. Additionally, ethnicity moderated the relationship between ADI and warm detection threshold; disadvantage was associated with higher thresholds for NAs, but not for NHWs. Together, the results suggest neighborhood disadvantage is associated with reduced C-fiber function and impaired spinal inhibition, thus pointing to a role of neighborhood disadvantage in the relationship between the environment and pain inequities. PERSPECTIVE: This study assessed neighborhood socioeconomic disadvantage and pronociceptive processes in chronic pain-free Native Americans (NAs) and non-Hispanic Whites (NHWs). Irrespective of ethnicity, greater neighborhood disadvantage predicted less descending inhibition of spinal nociception. Neighborhood disadvantage was associated with a marker of C-fiber impairment (higher warm detection threshold) in NAs only.

Cognitive-Affective-Behavioral Pathways Linking Adversity and Discrimination to Daily Pain in African-American Adults

The tendency to ruminate, magnify, and experience helplessness in the face of pain - known as pain catastrophizing - is a strong predictor of pain outcomes and is associated with adversity. The ability to maintain functioning despite adversity - referred to as resilience - also influences pain outcomes. Understanding the extent to which pain catastrophizing and resilience influence relations between adversity and daily pain in healthy African-American adults could improve pain risk assessment and mitigate racial disparities in the transition from acute to chronic pain. This study included 160 African-American adults (98 women). Outcome measures included daily pain intensity (sensory, affective) and pain impact on daily function (pain interference). Adversity measures included childhood trauma exposure, family adversity, chronic burden from recent stressors, and ongoing perceived stress. A measure of lifetime racial discrimination was also included. Composite scores were created to capture early-life adversity (childhood trauma, family adversity) versus recent-life adversity (perceived stress, chronic burden). Increased pain catastrophizing was correlated with increased adversity (early and recent), racial discrimination, pain intensity, and pain interference. Decreased pain resilience was correlated with increased recent-life adversity (not early-life adversity or racial discrimination) and correlated with increased pain intensity (not pain-related interference). Bootstrapped multiple mediation models revealed that relationships between all adversity/discrimination and pain outcomes were mediated by pain catastrophizing. Pain resilience, however, was not a significant mediator in these models. These findings highlight opportunities for early interventions to reduce cognitive-affective-behavioral risk factors for persisting daily pain among African-American adults with greater adversity exposure by targeting pain catastrophizing.

Disparities in Pain Management

Health disparities in pain management remain a pervasive public health crisis. Racial and ethnic disparities have been identified in all aspects of pain management from acute, chronic, pediatric, obstetric, and advanced pain procedures. Disparities in pain management are not limited to race and ethnicity, and have been identified in multiple other vulnerable populations. This review targets health care disparities in the management of pain, focusing on steps health care providers and organizations can take to promote health care equity. A multifaceted plan of action with a focus on research, advocacy, policy changes, structural changes, and targeted interventions is recommended.

Exploration of the trait-activation model of pain catastrophizing in Native Americans: results from the Oklahoma Study of Native American pain risk (OK-SNAP)

OBJECTIVES

Native Americans (NAs) have the highest prevalence of chronic pain of any racial/ethnic group. This issue has received little attention from the scientific community. One factor that may contribute to racial pain disparities is pain catastrophizing. Pain catastrophizing is a construct related to negative pain outcomes in persons with/without chronic pain. It has been suggested that the relationship between trait catastrophizing and pain is mediated by situation-specific (state) catastrophizing. The present study has 2 aims: (1) to investigate whether state pain catastrophizing mediates the relationship between trait catastrophizing and experimental pain (e.g., cold, ischemic, heat and electric tolerance), and (2) to investigate whether this relationship is stronger for NAs.

METHODS

145 non-Hispanic Whites (NHWs) and 137 NAs completed the study. Bootstrapped indirect effects were calculated for 4 unmoderated and 8 moderated mediation models (4 models with path a moderated and 4 with path b).

RESULTS

Consistent with trait-activation theory, significant indirect effects indicated a tendency for trait catastrophizing to be associated with greater state catastrophizing which in turn is associated with reduced pain tolerance during tonic cold (a × b=-0.158) and ischemia stimuli (a × b=-0.126), but not during phasic electric and heat stimuli. Moderation was only noted for the prediction of cold tolerance (path a). Contrary to expectations, the indirect path was stronger for NHWs (a × b for NHW=-.142).

CONCLUSIONS

Together, these findings suggest that state catastrophizing mediates the relationship between trait catastrophizing and some measures of pain tolerance but this indirect effect was non-significant for NAs.

The Relationship Between Adverse Life Events and Endogenous Inhibition of Pain and Spinal Nociception: Findings From the Oklahoma Study of Native American Pain Risk (OK-SNAP)

Adverse life events (ALEs) are a risk factor for chronic pain; however, mechanisms underlying this association are not understood. This study examined whether cumulative ALE exposure impairs endogenous inhibition of pain (assessed from pain report) and spinal nociception (assessed from nociceptive flexion reflex; NFR) in healthy, pain-free Native Americans (n = 124) and non-Hispanic Whites (n = 129) during a conditioned pain modulation (CPM) task. Cumulative ALE exposure was assessed prior to testing by summing the number of potentially traumatic events experienced by each participant across their lifespan. Multilevel modeling found that ALEs were associated with NFR modulation during the CPM task even after controlling for general health, body mass index, sex, age, blood pressure, sleep quality, stimulation intensity, stimulus number, perceived stress, and psychological distress. Low exposure to ALEs was associated with NFR inhibition, whereas high exposure to ALEs was associated with NFR facilitation. By contrast, pain perception was inhibited during the CPM task regardless of the level of ALE exposure. Race/ethnicity did not moderate these results. Thus, ALEs may be pronociceptive for both Native Americans and non-Hispanic Whites by impairing descending inhibition of spinal nociception. This could contribute to a chronic pain risk phenotype involving latent spinal sensitization. PERSPECTIVE: This study found that adverse life events were associated with impaired descending inhibition of spinal nociception in a sample of Native Americans and non-Hispanic Whites. These findings expand on previous research linking adversity to chronic pain risk by identifying a proximate physiological mechanism for this association.