F06 - Pain and Gender Psychosocial(836) Heat pain sensitivity: Influences of ethnicity and genderF Rahim-Williams, D Herrera, K Virtusio, C Campbell, B Hastie, J Riley, III,R Fillingim; University of Florida, Gainesville, FLThe aim of this study was to examine heat pain sensitivity in males andfemales from three ethnic groups, African Americans, Hispanic Ameri-cans and non-Hispanic whites, and to determine whether intensity andunpleasantness ratings for suprathreshold heat stimuli differed acrosssex and ethnic group. Participants included sixty-nine African American(43 F, 26 M), sixty-one Hispanic (35 F, 26 M) and eighty-four non-Hispanicwhite (37 F, 47 M) participants who provided ratings of pain intensityand unpleasantness of 5-second thermal stimuli at 45, 47, 49, and 51degrees Celsius. Analyses of the entire group revealed significant sexdifferences and ethnic group differences for both intensity and unpleas-antness, such that men and non-Hispanic whites reported the lowestheat pain intensity and unpleasantness ratings. When ethnic group dif-ferences were examined separately by sex, ethnic differences were sig-nificant only among men, due to white men having significantly lowerratings than both African American and Hispanic men, but no suchgroup differences emerged for women. This is in contrast to our previ-ous findings regarding heat pain threshold and tolerance, where therewere no ethnic group differences for threshold and ethnic differencesfor tolerance were comparable across sex. These findings suggest thatdepending on the pain measure examined, ethnic differences may varyby gender, highlighting the importance of considering both variableswhen conducting studies of experimental pain response.

(837) Health disparities among race-ethnic and gender differ-ences in self-care

R Harris, J Riley, III; University of Florida School of Dentistry, Gainesville, FLEthnic disparities in pain have recently gained increasing attention;however, very little is known about how differences in self-initiated carecontribute to pain-related race-ethnic and gender disparities. The pur-pose of this study was to investigate ethnic differences in pain reducingself-initiated behaviors across race-ethnicity for males and females. An-other aim was to evaluate both between group and within group dif-ferences in the use of pain medication and commonly practiced painself-care as they relate to culture using both level of acculturation andlinguistic factors among healthy Hispanic, non-Hispanic Whites, andnon-Hispanic Black adults reporting oral or arthritic pain. The race-eth-nic differences in the total number of self-care behaviors used differedacross ethnic groups for oral pain (oral sores, tooth pain, and TMD) andarthritic pain. The results of the study confirmed our hypotheses thatrace-ethnic and gender differences are strong predictors of self-carebehavior. Black females were more active in self-treating their orofacialpain and Black males were very active for jaw joint/face pain. In general,females were more active in self-care for pain than males. However, anunexpected finding was that gender and race-ethnicity were strongpredictors for alcohol use. These findings suggest potentially importantrace-ethnic and gender differences in patterns and predictors of self-care behaviors.

F07 - Pain and Illness Behavior(838) Incorporating the patient’s perspective into treatment:

Unique subgroups in fibromyalgiaE O’Brien, R McCulloch, A Hassinger, J Craggs, R Staud, M Robinson; Universityof Florida, Gainesville, FLFibromyalgia is a prevalent and costly health problem associated with wide-spread pain, emotional distress, and decreased quality of life. Fibromyalgiapatients and their healthcare providers often report frustration and dissatis-faction with treatment attempts. Patient-centered models of healthcare maybe particularly applicable to treatments for fibromyalgia. This study examinedfibromyalgia patients’ self-reported criteria about which areas they consid-ered to be important to address during treatment. Participants included 305fibromyalgia patients (281 females and 24 males) who completed self-reportmeasures on pain, mood, sleep, somatic focus, and level of functioning. Par-ticipants also completed the Patient Centered Outcomes (PCO) Questionnaire,which assesses four domains relevant to chronic pain populations: pain, fa-tigue, distress, and interference in daily activities. A hierarchical agglomera-tive cluster analysis was performed using patients’ PCO ratings for the impor-tance of addressing each of the four domains during treatment. A two-clustersolution emerged: a “Low-Distress-Focused” cluster, identified by markedlylow importance ratings for distress but moderate to high importance ratingsfor the other three domains; and a “Multifocused” cluster, identified by thehigh importance ratings endorsed across all four PCO domains. Significantdifferences in pain ratings, negative mood, somatic focus, and disability mea-sures were noted between the clusters. Also, while the 2 clusters differed onthe degree of distress reduction required to consider treatment successful,success criteria for the 2 clusters were similar for 3 of the 4 PCO domains.Across clusters, significant reductions were required across multiple domains(pain, fatigue, distress, and interference) in order to consider treatment suc-cessful, with reductions of 56-63% across domains considered clinically mean-ingful. This study highlights the use of a patient-centered perspective foridentifying unique subgroups within what is often considered a homogenouschronic pain population. Identification of such subgroups may lead to moreeffective treatment matching, as well as greater treatment satisfaction forpatients.

(839) Cross-site comparison of lateralization of chronic painD Giddon, Y Kim, C Peeters-Asdourian, N Anderson; Harvard University, Bos-ton, MABased on previous findings of left lateralization of somatoform disor-ders and the role of the right hemisphere in processing negative emo-tions, the objective of this study was to demonstrate in two HarvardMedical School-affiliated hospitals that left-lateralized (L) chronic pain/complaints would occur more frequently, be of greater intensity andduration and require more health care interventions than right-lateral-ized (R) pain. The initial patient intake form was obtained for 481 ran-domly-selected male and female chronic pain patients from the BethIsrael Deaconess Medical Center (BIDMC). Patient behaviors (number ofvisits, telephone contacts, missed appointments, etc.) were recorded. Inaddition to demographic information, intensity, duration ( sixmonths), and location of pain were noted for comparison with similardata from 454 patients from the Brigham and Women’s Hospital.1 Nosignificant differences were found between BIDMC and BWH patients ingender, weight, height, body mass index, or age. BWH patients reportedsignificantly higher pain intensity scores (p�.001), more alcohol con-sumption (p�.001), medical problems and interventions (p�.001) thanBIDMC patients. For females only, BIDMC L pain patients had signifi-cantly higher pain scores (p�.05); and for males and females combined,fewer indications of organic bases for pain than R patients (p�.03). TheBIDMC and two hospitals combined had more patients with L than Rchronic pain; based on the a priori prediction of left lateralization,p�.062 or .031 one-tail for BIDMC and p�.123 or .061 one-tail for BWHplus BIDMC. In conclusion, further evidence has been provided for dif-ferences in frequency/intensity and pain-related behavior between pa-tients with L and R chronic pain. (Prasanna, Annals Behav Med, 2004).

S60 Abstracts