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Neural and sociocultural mediators of ethnic differences in pain

An Author Correction to this article was published on 03 March 2020

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Abstract

Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities.

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Fig. 1: fMRI thermal stimulation task design.
Fig. 2: Differences in pain rating across ethnic groups and mediation by discrimination.
Fig. 3: Results of whole-brain voxel-wise GLM analysis showing brain regions exhibiting a stronger dose–response effect of painful heat in AA participants.
Fig. 4: Mediation analyses showing that brain regions exhibiting a stronger dose–response effect of painful heat in AA participants in the whole-brain analysis mediate the relationship between painful stimulus intensity and pain rating differently in the AA group compared to the HA and WA groups.
Fig. 5: Relationship between NAc activity and discrimination frequency.
Fig. 6: NPS responses to painful heat and relationship with pain rating across ethnic groups.

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Data availability

The data that support the findings of this study are available from the corresponding author on request.

Code Availability

The Mediation Toolbox used to conduct the mediation analyses can be freely accessed at https://github.com/canlab.

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References

  1. Trawalter, S. & Hoffman, K. M. Got pain? Racial bias in perceptions of pain. Soc. Person. Psychol. Compass 9, 146–157 (2015).

    Google Scholar 

  2. Hoffman, K. M., Trawalter, S., Axt, J. R. & Oliver, M. N. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc. Natl Acad. Sci. USA 113, 4296–4301 (2016).

    CAS  PubMed  PubMed Central  Google Scholar 

  3. National Center for Health Statistics (US). Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities (National Center for Health Statistics (US), 2016).

  4. Anderson, K. O., Green, C. R. & Payne, R. Racial and ethnic disparities in pain: causes and consequences of unequal care. J. Pain 10, 1187–1204 (2009).

    PubMed  Google Scholar 

  5. Rahim‐Williams, B., Riley, J. L., Williams, A. K. & Fillingim, R. B. A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter? Pain Med. 13, 522–540 (2012).

    PubMed  Google Scholar 

  6. Kim, H. J. et al. Racial and ethnic differences in experimental pain sensitivity: systematic review and meta-analysis. PAIN 158, 194–211 (2017).

    PubMed  Google Scholar 

  7. Anderson, S. R. & Losin, E. A. R. A sociocultural neuroscience approach to pain. Culture Brain 5, 14–35 (2016).

  8. Craig, K. D. Social communication model of pain. PAIN 156, 1198–1199 (2015).

    PubMed  Google Scholar 

  9. Bates, M. S. Ethnicity and pain: a biocultural model. Soc. Sci. Med. 24, 47–50 (1987).

    CAS  PubMed  Google Scholar 

  10. Campbell, C. M. et al. Ethnic differences in diffuse noxious inhibitory controls. J. Pain 9, 759–766 (2008).

    PubMed  PubMed Central  Google Scholar 

  11. Campbell, C. M. et al. Ethnic differences in the nociceptive flexion reflex (NFR). PAIN 134, 91–96 (2008).

    PubMed  Google Scholar 

  12. Gelernter, J., Kranzler, H. & Cubells, J. Genetics of two mu opioid receptor gene (OPRM1) exon I polymorphisms: population studies, and allele frequencies in alcohol-and drug-dependent subjects. Mol. Psychiatry 4, 476–483 (1999).

    CAS  PubMed  Google Scholar 

  13. Williams, D. R. & Mohammed, S. A. Discrimination and racial disparities in health: evidence and needed research. J. Behav. Med. 32, 20–47 (2009).

    PubMed  Google Scholar 

  14. Williams, D. R. Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann. N.Y. Acad. Sci. 896, 173–188 (1999).

    CAS  PubMed  Google Scholar 

  15. Hatch, S. L. & Dohrenwend, B. P. Distribution of traumatic and other stressful life events by race/ethnicity, gender, SES and age: a review of the research. Am. J. Commun. Psychol. 40, 313–332 (2007).

    Google Scholar 

  16. Campbell, C. M., Edwards, R. R. & Fillingim, R. B. Ethnic differences in responses to multiple experimental pain stimuli. PAIN 113, 20–26 (2005).

    PubMed  Google Scholar 

  17. Cano, A., Mayo, A. & Ventimiglia, M. Coping, pain severity, interference, and disability: the potential mediating and moderating roles of race and education. J. Pain 7, 459–468 (2006).

    PubMed  PubMed Central  Google Scholar 

  18. Burgess, D. J. et al. The effect of perceived racial discrimination on bodily pain among older African American men. Pain Med. 10, 1341–1352 (2009).

    PubMed  Google Scholar 

  19. Edwards, R. R. The association of perceived discrimination with low back pain. J. Behav. Med. 31, 379–389 (2008).

    PubMed  Google Scholar 

  20. Goodin, B. R. et al. Perceived racial discrimination, but not mistrust of medical researchers, predicts the heat pain tolerance of African Americans with symptomatic knee osteoarthritis. Health Psychol. 32, 1117–1126 (2013).

    PubMed  PubMed Central  Google Scholar 

  21. Mathur, V. et al. Discrimination in health care settings is associated with greater clinical and laboratory pain in sickle cell disease. J. Pain 15, S37 (2014).

    Google Scholar 

  22. Apkarian, A. V., Bushnell, M. C., Treede, R. D. & Zubieta, J. K. Human brain mechanisms of pain perception and regulation in health and disease. Eur. J. Pain 9, 463–463 (2005).

    PubMed  Google Scholar 

  23. Wager, T. D. et al. An fMRI-based neurologic signature of physical pain. N. Engl. J. Med. 368, 1388–1397 (2013).

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Sokol-Hessner, P., Camerer, C. F. & Phelps, E. A. Emotion regulation reduces loss aversion and decreases amygdala responses to losses. Soc. Cognit. Affect. Neurosci. 8, 341–350 (2013).

    Google Scholar 

  25. Hutcherson, C. A., Plassmann, H., Gross, J. J. & Rangel, A. Cognitive regulation during decision making shifts behavioral control between ventromedial and dorsolateral prefrontal value systems. J. Neurosci. 32, 13543–13554 (2012).

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Borsook, D., Upadhyay, J., Chudler, E. H. & Becerra, L. A key role of the basal ganglia in pain and analgesia – insights gained through human functional imaging. Mol. Pain 6, 1–17 (2010).

    Google Scholar 

  27. Baliki, M. N., Geha, P. Y., Fields, H. L. & Apkarian, A. V. Predicting value of pain and analgesia: nucleus accumbens response to noxious stimuli changes in the presence of chronic pain. Neuron 66, 149–160 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Baliki, M. N. et al. Corticostriatal functional connectivity predicts transition to chronic back pain. Nat. Neurosci. 15, 1117–1119 (2012).

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Dias-Ferreira, E. et al. Chronic stress causes frontostriatal reorganization and affects decision-making. Science 325, 621–625 (2009).

    CAS  PubMed  Google Scholar 

  30. May, A. Neuroimaging: visualising the brain in pain. Neurol. Sci. 28 (Suppl. 2), S101–S107 (2007).

    PubMed  Google Scholar 

  31. Woo, C. W. et al. Quantifying cerebral contributions to pain beyond nociception. Nat. Commun. 8, 1–14 (2017).

    CAS  Google Scholar 

  32. Chang, L. J., Gianaros, P. J., Manuck, S. B., Krishnan, A. & Wager, T. D. A sensitive and specific neural signature for picture-induced negative affect. PLoS Biol. 13, e1002180 (2015).

    PubMed  PubMed Central  Google Scholar 

  33. Krishnan, A. et al. Somatic and vicarious pain are represented by dissociable multivariate brain patterns. eLife 5, 1–42 (2016).

    Google Scholar 

  34. Kross, E., Berman, M. G., Mischel, W., Smith, E. E. & Wager, T. D. Social rejection shares somatosensory representations with physical pain. Proc. Natl Acad. Sci. USA 108, 6270–6275 (2011).

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Craig, A. D., Krout, K. & Andrew, D. Quantitative response characteristics of thermoreceptive and nociceptive lamina I spinothalamic neurons in the cat. J. Neurophysiol. 86, 1459–1480 (2001).

    CAS  PubMed  Google Scholar 

  36. Taylor, A. B., MacKinnon, D. P. & Tein, J.-Y. Tests of the three-path mediated effect. Organ. Res. Methods 11, 241–269 (2008).

    Google Scholar 

  37. Woo, C.-W., Roy, M., Buhle, J. T. & Wager, T. D. Distinct brain systems mediate the effects of nociceptive input and self-regulation on pain. PLoS Biol. 13, e1002036 (2015).

    PubMed  PubMed Central  Google Scholar 

  38. Leknes, S. et al. The importance of context: when relative relief renders pain pleasant. PAIN 154, 402–410 (2013).

    PubMed  PubMed Central  Google Scholar 

  39. Goyal, M. K., Kuppermann, N., Cleary, S. D., Teach, S. J. & Chamberlain, J. M. Racial disparities in pain management of children with appendicitis in emergency departments. JAMA Pediatrics 169, 996–1002 (2015).

    PubMed  PubMed Central  Google Scholar 

  40. Staton, L. J. et al. When race matters: disagreement in pain perception between patients and their physicians in primary care. J. Nat. Med. Assoc. 99, 532–538 (2007).

    Google Scholar 

  41. Todd, K. H., Deaton, C., D’Adamo, A. P. & Goe, L. Ethnicity and analgesic practice. Ann. Emergency Med. 35, 11–16 (2000).

    CAS  Google Scholar 

  42. Baliki, M. N. et al. Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J. Neurosci. 26, 12165–12173 (2006).

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Apkarian, A. V., Hashmi, J. A. & Baliki, M. N. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. PAIN 152, S49–S64 (2011).

    PubMed  Google Scholar 

  44. López-Solà, M. et al. Towards a neurophysiological signature for fibromyalgia. PAIN 158, 34–47 (2017).

    PubMed  PubMed Central  Google Scholar 

  45. Kutch, J. J. et al. Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study. PAIN 158, 1979–1991 (2017).

    PubMed  PubMed Central  Google Scholar 

  46. Kornelsen, J. et al. Default mode network functional connectivity altered in failed back surgery syndrome. J. Pain 14, 483–491 (2013).

    PubMed  Google Scholar 

  47. Mays, V. M., Cochran, S. D. & Barnes, N. W. Race, race-based discrimination, and health outcomes among African Americans. Annu. Rev. Psychol. 58, 201–225 (2007).

    PubMed  PubMed Central  Google Scholar 

  48. Bennett, G. G. et al. Stress, coping, and health outcomes among African-Americans: a review of the John Henryism hypothesis. Psychol. Health 19, 369–383 (2004).

    Google Scholar 

  49. Clark, R., Anderson, N. B., Clark, V. R. & Williams, D. R. Racism as a stressor for African Americans: a biopsychosocial model. Am. Psychol. 54, 808–816 (1999).

    Google Scholar 

  50. Williams, D. R. Race, socioeconomic status, and health the added effects of racism and discrimination. Ann. N.Y. Acad. Sci. 896, 173–188 (1999).

    CAS  PubMed  Google Scholar 

  51. McEwen, B. S. Stress adaptation, and disease: allostasis and allostatic load. Ann. N.Y. Acad. Sci. 840, 33–44 (1998).

    CAS  PubMed  Google Scholar 

  52. Zeiders, K. H., Doane, L. D. & Roosa, M. W. Perceived discrimination and diurnal cortisol: examining relations among Mexican American adolescents. Hormones Behav. 61, 541–548 (2012).

    CAS  Google Scholar 

  53. McCallum, T., Sorocco, K. H. & Fritsch, T. Mental health and diurnal salivary cortisol patterns among African American and European American female dementia family caregivers. Am. J. Geriatr. Psychiatry 14, 684–693 (2006).

    CAS  PubMed  Google Scholar 

  54. Kapuku, G. K., Treiber, F. A. & Davis, H. C. Relationships among socioeconomic status, stress-induced changes in cortisol, and blood pressure in African American males. Ann. Behav. Med. 24, 320–325 (2002).

    PubMed  Google Scholar 

  55. Lee, D. B. et al. Psychological pathways from racial discrimination to cortisol in African American males and females. J. Behav. Med. 41, 208–220 (2018).

    PubMed  Google Scholar 

  56. Lampe, A. et al. Chronic pain syndromes and their relation to childhood abuse and stressful life events. J. Psychosom. Res. 54, 361–367 (2003).

    PubMed  Google Scholar 

  57. Brascher, A. K., Becker, S., Hoeppli, M. E. & Schweinhardt, P. Different brain circuitries mediating controllable and uncontrollable pain. J. Neurosci. 36, 5013–5025 (2016).

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Lee, J. et al. Encoding of self-referential pain catastrophizing in the posterior cingulate cortex in fibromyalgia. Arthritis Rheumatol. 70, 1308–1318 (2018).

    PubMed  PubMed Central  Google Scholar 

  59. Wager, T. D., Atlas, L. Y., Leotti, L. A. & Rilling, J. K. Predicting individual differences in placebo analgesia: contributions of brain activity during anticipation and pain experience. J. Neurosci. 31, 439–452 (2011).

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Williams, D. R. & Rucker, T. D. Understanding and addressing racial disparities in health care. Health Care Finan. Rev. 21, 75–90 (2000).

    CAS  Google Scholar 

  61. Woodrow, K. M., Friedman, G. D., Siegelaub, A. B. & Collen, M. F. Pain tolerance: differences according to age, sex and race. Psychosom. Med. 34, 548–556 (1972).

    CAS  PubMed  Google Scholar 

  62. Edwards, C. L., Fillingim, R. B. & Keefe, F. Race, ethnicity and pain. PAIN 94, 133–137 (2001).

    PubMed  Google Scholar 

  63. U.S. Census Bureau. Population Profile of the United States: Dynamic Version. 1–9 (US Census Bureau, 2005).

  64. Zunhammer, M., Bingel, U. & Wager, T. D. Placebo effects on the neurologic pain signature: a meta-analysis of individual participant functional magnetic resonance imaging data. JAMA Neurol. 75, 1321–1330 (2018).

    PubMed  PubMed Central  Google Scholar 

  65. Ma, Y. et al. Serotonin transporter polymorphism alters citalopram effects on human pain responses to physical pain. Neuroimage 135, 186–196 (2016).

    CAS  PubMed  Google Scholar 

  66. Han, S. Understanding cultural differences in human behavior: a cultural neuroscience approach. Curr. Opin. Behav. Sci. 3, 68–72 (2015).

    Google Scholar 

  67. Han, S. in Brain Mapping: An Encyclopedic Reference Vol. 3 (ed. Toga, A. W.) 217–220 (Elsevier, 2015).

  68. Losin, E. A. R. Culture, brain, and health: introduction to the special issue. Cult. Brain 5, 1–3 (2017).

    Google Scholar 

  69. Rahim-Williams, F. B. et al. Ethnic identity predicts experimental pain sensitivity in African Americans and Hispanics. PAIN 129, 177–184 (2007).

    PubMed  PubMed Central  Google Scholar 

  70. Portenoy, R. K., Ugarte, C., Fuller, I. & Haas, G. Population-based survey of pain in the United States: differences among white, African American, and Hispanic subjects. J. Pain 5, 317–328 (2004).

    PubMed  Google Scholar 

  71. Shavers, V. L., Bakos, A. & Sheppard, V. B. Race, ethnicity, and pain among the U.S. adult population. J. Health Care Poor Underserv. 21, 177–220 (2010).

    Google Scholar 

  72. Barratt, W. The Barratt Simplified Measure of Social Status (BSMSS): Measuring SES http://socialclassoncampus.blogspot.com/2012/06/barratt-simplified-measure-of-social.html (2006).

  73. Gray, M. J., Litz, B. T., Hsu, J. L. & Lombardo, T. W. Psychometric properties of the life events checklist. Assessment 11, 330–341 (2004).

    PubMed  Google Scholar 

  74. Williams, D. R., Yan, Y., Jackson, J. S. & Anderson, N. B. Racial differences in physical and mental health: socio-economic status, stress and discrimination. J. Health Psychol. 2, 335–351 (1997).

    CAS  PubMed  Google Scholar 

  75. Melzack, R. The McGill Pain Questionnaire: major properties and scoring methods. PAIN 1, 277–299 (1975).

    PubMed  Google Scholar 

  76. Freynhagen, R., Baron, R., Gockel, U. & Tolle, T. R. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr. Med. Res. Opin. 22, 1911–1920 (2006).

    PubMed  Google Scholar 

  77. Watson, D., Clark, L. A. & Tellegen, A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J. Personal. Soc. Psychol. 54, 1063–1070 (1988).

    CAS  Google Scholar 

  78. Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P. R. & Jacobs, G. A. Test Manual for the State Trait Anxiety Inventory (Consulting Psychologists Press, 1983).

  79. Meyer, T. J., Miller, M. L., Metzger, R. L. & Borkovec, T. D. Development and validation of the Penn State Worry Questionnaire. Behav. Res. Ther. 28, 487–495 (1990).

    CAS  PubMed  Google Scholar 

  80. Edwards, L. C., Pearce, S. A., Turner-Stokes, L. & Jones, A. The Pain Beliefs Questionnaire: an investigation of beliefs in the causes and consequences of pain. PAIN 51, 267–272 (1992).

    PubMed  Google Scholar 

  81. McNeil, D. W. & Rainwater, A. J. 3rd Development of the Fear of Pain Questionnaire—III. J. Behav. Med. 21, 389–410 (1998).

    CAS  PubMed  Google Scholar 

  82. Kohn, P. M. Sensation-seeking, augmenting-reducing, and strength of the nervous system. Motivation, Emotion, and Personality: Proc. XXIII International Congress of Psychology 167–173 (Elsevier, 1985).

  83. Sullivan, M. J., Bishop, S. R. & Pivik, J. The Pain Catastrophizing Scale: development and validation. Psychol. Assess. 7, 524–532 (1995).

    Google Scholar 

  84. Street, R. L., O’Malley, K. J., Cooper, L. A. & Haidet, P. Understanding concordance in patient–physician relationships: personal and ethnic dimensions of shared identity. Ann. Fam. Med. 6, 198–205 (2008).

    PubMed  PubMed Central  Google Scholar 

  85. Hall, M. A. et al. Measuring patients trust in their primary care providers. Med. Care Res. Rev. 59, 293–318 (2002).

    PubMed  Google Scholar 

  86. Bartoshuk, L. M., Fast, K. & Snyder, D. J. Differences in our sensory worlds: invalid comparisons with labeled scales. Curr. Dir. Psychol. Sci. 14, 122–125 (2005).

    Google Scholar 

  87. Price, D. D., Mcgrath, P. A., Rafii, A. & Buckingham, B. The validation of visual analog scales as ratio scale measures for chronic and experimental pain. PAIN 17, 45–56 (1983).

    PubMed  Google Scholar 

  88. Reuter, C. & Oehler, M. Psychoacoustics of chalkboard squeaking. J. Acoust. Soc. Am. 130, 2545–2545 (2011).

    Google Scholar 

  89. Bradley, M. M. & Lang, P. J. The International Affective Digitized Sounds (IADS-2): Affective Ratings of Sounds and Instruction Manual (Univ. of Florida, 2007).

  90. R Core Team. R: A Language and Environment for Statistical Computing (R Foundation for Statistical Computing, 2014).

  91. Lindquist, M. A., Spicer, J., Asllani, I. & Wager, T. D. Estimating and testing variance components in a multi-level GLM. Neuroimage 59, 490–501 (2012).

    PubMed  Google Scholar 

  92. Greenspan, J. D. et al. Studying sex and gender differences in pain and analgesia: a consensus report. PAIN 132, S26–S45 (2007).

    PubMed  PubMed Central  Google Scholar 

  93. Baron, R. M. & Kenny, D. A. The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J. Personal. Soc. Psychol. 51, 1173–1182 (1986).

    CAS  Google Scholar 

  94. Wager, T. D. et al. Brain mediators of cardiovascular responses to social threat: part I: reciprocal dorsal and ventral sub-regions of the medial prefrontal cortex and heart-rate reactivity. Neuroimage 47, 821–835 (2009).

    PubMed  Google Scholar 

  95. Atlas, L. Y., Bolger, N., Lindquist, M. A. & Wager, T. D. Brain mediators of predictive cue effects on perceived pain. J. Neurosci. 30, 12964–12977 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  96. Wager, T. D., Davidson, M. L., Hughes, B. L., Lindquist, M. A. & Ochsner, K. N. Prefrontal-subcortical pathways mediating successful emotion regulation. Neuron 59, 1037–1050 (2008).

    CAS  PubMed  PubMed Central  Google Scholar 

  97. Wager, T. D., Keller, M. C., Lacey, S. C. & Jonides, J. Increased sensitivity in neuroimaging analyses using robust regression. Neuroimage 26, 99–113 (2005).

    PubMed  Google Scholar 

  98. Koyama, T., McHaffie, J. G., Laurienti, P. J. & Coghill, R. C. The single-epoch fMRI design: validation of a simplified paradigm for the collection of subjective ratings. Neuroimage 19, 976–987 (2003).

    PubMed  Google Scholar 

  99. Rissman, J., Gazzaley, A. & D’Esposito, M. Measuring functional connectivity during distinct stages of a cognitive task. Neuroimage 23, 752–763 (2004).

    PubMed  Google Scholar 

  100. Rouder, J. N., Speckman, P. L., Sun, D., Morey, R. D. & Iverson, G. Bayesian t-tests for accepting and rejecting the null hypothesis. Psychonom. Bull. Rev. 16, 225–237 (2009).

    Google Scholar 

  101. Lee, M. D. & Wagenmakers, E.-J. Bayesian Cognitive Modeling: A Practical Course (Cambridge Univ. Press, 2013).

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Acknowledgements

This work was supported by the National Institutes of Health (grant nos. 2R01MH076136 and R01DA035484 to T.D.W. and 5K01DA045735 to E.A.R.L.) and start-up funds from the University of Miami College of Arts and Sciences (to E.A.R.L.). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We thank the IBG and J. Hewitt and S. A. Rhea for their help and support in recruiting from the IBG participant pools. We thank E. Delk for her help with data analysis and A. Ledbetter and D. Ryan for their help with recruitment and data collection.

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E.A.R.L. and T.D.W. designed the study. E.A.R.L., J.R.A-H. and H.E. collected the data. E.A.R.L., C-W.W., T.D.W. and N.A.M. analysed the data. E.A.R.L. wrote the manuscript and E.A.R.L and C-W.W. created the figures, both with substantial input from the other authors.

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Correspondence to Elizabeth A. Reynolds Losin or Tor D. Wager.

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Extended data

Extended Data Fig. 1 Average continuous pain intensity ratings for the three stimulus intensity levels by heat condition.

Error bands are between-participant standard error.

Extended Data Fig. 2 Path diagrams and statistics for three-path, multi-level mediation analysis between painful stimulus intensity, connectivity between the vmPFC and NAc clusters from the GLM, and trial-by-trial pain rating across all participants.

Connectivity between the vmPFC and NAc regions from the GLM exhibited a trend (p <0.1) towards mediating the relationship between painful stimulus intensity and pain rating. Path coefficients are listed for each path with standard errors in parentheses.

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Losin, E.A.R., Woo, CW., Medina, N.A. et al. Neural and sociocultural mediators of ethnic differences in pain. Nat Hum Behav 4, 517–530 (2020). https://doi.org/10.1038/s41562-020-0819-8

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