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Predictors of pain tolerance and beliefs

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posted on 15.01.2017, 08:12 by Peter Kamerman, Antonia Wadley, Leeana Persad
The primary content of this repository includes the data, codebook, and analysis scripts (with associated markdown outputs and plots) for random forest analyses of predictors of cold-pain tolerance (cold-pain-tolerance.Rmd,, pressure-pain tolerance (pressure-pain-tolerance.Rmd,, and acceptance of pain behaviours in males (apbq-male.Rmd, in healthy black and white young adults of both sexes in South Africa. Only complete cases were used in the random forest analysis (pain tolerances: 156/212 participants; ABPQ-M: 167/212 participants).

The repository also includes the data and codebook used in all bivariate analyses. These analyses were completed using GraphPad Prism 6.0, and the results have not been uploaded to the repository (please contact or for more information).

In all cases the data provided are the cleaned, analysis data. Original hardcopies of completed questionnaires are on file.

Bibliographic information
Bagwath Persad LA, Kamerman PR, Wadley AL. Predictors of cold and pressure pain tolerance in healthy South African adults. Pain Med [Epub - ahead of print], 2017. DOI: 10.1093/pm/pnw291.

Pre-print copy:

MIT License
Copyright: Peter Kamerman (2016)

Overview of the study
Background: Studies on relationships between sex, ethnicity and pain largely have emanated from the US and Europe. We compared cold (CPT) and pressure pain tolerance (PPT) in male and female South Africans of African and European ancestry and assessed whether psychosocial factors (including pain beliefs) predicted differences in pain tolerance.   

Methods: We recruited 106 (62 female) students of African ancestry and 106 (55 female) of European ancestry and subjected them to a cold-pressor test and pressure algometry. Socioeconomic status (SES), pain catastrophizing, depression, anxiety and pain beliefs were assessed as predictors of pain tolerance.   

Results: CPT was lower in students of African compared to European ancestry (for both sexes), and PPT was lower in female than male students (for both ethnicities). Females were very  accepting of men expressing pain and males less so.  Males of African ancestry were least accepting but still tolerant. Multivariate analysis identified African ancestry, and particularly being a female of African ancestry as strong predictors of lower CPT. Anxiety was a weak predict of CPT. Sex was the only strong predictor of PPT on multivariate analysis (PPT females < males) and catastrophizing was a weak predictor . Female sex and African ancestry were strong predictors of acceptance of expression of pain in males. SES was a weak predictor of APBQ-M.   

Conclusions: Despite a different cultural and social background from US and European cohorts, we saw similar patterns of sex and ethnic differences in CPT and PPT in an African cohort. Traditional psychosocial predictors of pain sensitivity predicted variation in the outcome variables but were not strong predictors.