Psychosomatic Medicine, Vol 52, Issue 5 544-557, Copyright © 1990 by American Psychosomatic Society

ORIGINAL ARTICLES

Cultural variations in response to painful stimuli

DF Zatzick and JE Dimsdale
Department of Psychiatry, University of California, San Francisco.

This review updates the literature on cultural differences in response to laboratory-induced pain. Thirteen studies were located, and there was great diversity among the investigations with regard to racial and ethnic groups studied, methods of pain induction, and experimental outcome. There appear to be no racial/ethnic differences in the ability to discriminate painful stimuli. More difficult to assess is cultural variation in the response to laboratory-induced pain. Age, sex, experimenter ethnicity and the subjects' working conditions may affect and confound the response to painful stimuli. Given these confounds, there is no consistent experimental evidence to suggest cultural differences in pain response. Perspectives derived from the social sciences may help future laboratory researchers better delineate cultural variations in the pain response. The difficulties inherent in the translation of pain descriptors across cultural boundaries make pain tolerance, rather than pain threshold, the more relevant transcultural pain measure. Since tremendous cultural heterogeneity can exist within one racial group and since even ethnic groups within a single racial category demonstrate variations in the response to pain, this field might now profitably focus on the study of ethnic group differences. Delineation of ethnic groups for study will require assessment of variations in intra-ethnic acculturation and assimilation which certainly affect group demarcation and may influence pain behavior. Specific guidelines are presented so that future experimental researchers may better operationalize culture in the laboratory setting.

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