"The Pain Experience in the Eastern and Western World: Locus of Control among Chronic Pain Patients in the US and India"
The experience of pain among chronic pain patients is influenced by psychological, affective, and cultural information as well as physical pain. In particular, patients' Locus of Control (LOC) determines the extent to which they believe that they have control over the pain in their lives and thus affects the intensity of their perceived pain experience. Research shows an internal LOC, in which the patient believes that he or she has control over his or her own pain, is idealized more in the Western world. An external LOC, in which pain is predetermined and due to either chance or "powerful others" such as doctors, is more prevalent and admired in the East. In the current study, a Differential Item Functioning (DIF) analysis was conducted on questions in the Multidimensional Health Locus of Control (MHLC) among samples of chronic pain adults in the United States (N=77) and in Vellore, India (N=69). American chronic pain patients were more likely to endorse Internal LOC items that contained an element of blame for their pain, such as "Whatever goes wrong with my pain is my own fault" and "I deserve the credit when my condition improves and the blame when it gets worse." Indian patients endorsed Chance LOC items significantly more strongly than Americans, supporting research that an external LOC is more common in the East. Interestingly, Indian patients were also significantly more likely to endorse items that indicated doctors played a larger role in their pain than Americans. This statistic was anecdotally supported by qualitative interviews, in which one Indian patient noted, "Doctors are revered next to God here." The starkly diverse elements of control over Indian and American patients' pain may account for different pain experiences and measurement disparities in their self-rated pain intensity.
Supported by a Harrison Award and Psi Chi grant.