Different factors appear to be associated with pain in each cultural group. Italian patients' response to pain was best predicted by the length of time they had the pain. The level of reported psychological distress was most important for explaining the pain of Jewish patients because a high level of distress was strongly associated with an emotionally expressive pain response and with interference in daily functioning. Finally, for Puerto Rican patients, high psychological distress, strong 'friendship solidarity', and dependency on other Puerto Ricans when sick and suffering chronic pain were all associated with an emotionally expressive pain response and significant disruption in daily activities attributable to pain. Overall this research suggests that while cultural groups may report similar responses to pain, different factors influence their responses.
Different cultures present different settings and conditions for the expression of pain.
Nonetheless, we should not expect all Irish, or all Italians or all Blacks to be equally influenced by intracultural factors. Lipton and Marbach's research does, however, help us to understand how, within different cultural groups, individuals are influenced by particular psychosocial processes. A very practical clinical example of this would be that not all cultures are equally willing to use 'pain killing' medication. In addition to this, some Chinese people also have a belief that pain killers cause sweating and that this loss of body fluid will induce weakness. People of particular faiths may accept pain as their due.