The Journal of Pain Summary

Highlight from The Journal of Pain (Volume 19, No. 11, November 2018 Issue)

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Exploring the Role of Negative Cognitions in the Relationship Between Ethnicity, Sleep, and Pain in Women with Temporomandibular Joint Disorder

Sheera F. Lerman, Claudia M. Campbell, Luis F. Buenaver, Mary Medak, Jane Phillips, Michelle Polley, Michael T. Smith, Jennifer A. Haythornthwaite

Although there are documented ethnic differences in acute and chronic pain, the role of ethnicity in temporomandibular joint disorder (TMJD), as reported in several studies, is inconsistent.

According to researchers at Johns Hopkins University, ethnic differences in sleep quality are well documented, with African-Americans reporting poorer sleep quality, longer sleep onset latency, and shorter sleep duration compared with Caucasians. Although the relationships between ethnicity, negative connotations, sleep, and pain have been investigated, no study has tested all of these factors as a whole in clinical pain populations. To better understand the mechanisms by which ethnicity affects pain, the authors built on their previous findings that sleep disturbance mediates the relationship between pain catastrophizing and pain in TMJD by adding ethnicity as a new variable.

In a sample of 156 women diagnosed with TMJD and with high insomnia and pain catastrophizing scores, results showed ethnic differences in clinical pain, insomnia severity, and catastrophizing, but no ethnic differences in negative sleep-related cognitions. Therefore, pain catastrophizing, not insomnia, appears to be a significant mediator of the relationship between ethnicity and clinical pain.

The authors noted that a clinical implication of their results is that higher levels of catastrophizing have been associated with poorer treatment response in TMJD. Interventions targeting pain-related helplessness, therefore, could improve both sleep and pain, especially for African-Americans.