Parental narrative style moderates the relation between pain-related attention and memory biases in youth with chronic pain

ABSTRACT

Negatively biased pain memories robustly predict maladaptive pain outcomes in children. Both attention bias to pain and parental narrative style have been linked with the development of these negative biases, with previous studies indicating that how parents talk to their child about the pain might buffer the influence of children's attention bias to pain on the development of such negatively biased pain memories. This study investigated the moderating role of parental narrative style in the relation between pain-related attention and memory biases in a pediatric chronic pain sample who underwent a cold pressor task. Participants were 85 youth-parent dyads who reminisced about youth's painful event. Eye-tracking technology was used to assess youth's attention bias to pain information, whereas youth's pain-related memories were elicited 1 month later through telephone interview. Results indicated that a parental narrative style using less repetitive yes-no questions, more emotion words, and less fear words buffered the influence of high levels of youth's attention bias to pain in the development of negatively biased pain memories. Opposite effects were observed for youth with low levels of attention bias to pain. Current findings corroborate earlier results on parental reminiscing in the context of pain (memories) but stress the importance of matching narrative style with child characteristics, such as child attention bias to pain, in the development of negatively biased pain memories. Future avenues for parent-child reminiscing and clinical implications for pediatric chronic pain are discussed.

Pain memory in children: a systematic review and meta-analysis with a meta-regression

ABSTRACT

The aim of this systematic review and meta-analysis was to analyze the accuracy of memory of pain and the variables that may influence it in children with acute, experimental, and chronic pain. We conducted a search in electronic databases from inception to February 11, 2022. Twelve observational studies and 3 randomized controlled studies were included in the study. The main outcome measure was the accuracy of the memory of the pain intensity (experienced/recalled). To compare the outcomes reported by the studies, we calculated the standardized mean difference (SMD) over time for the continuous variables. The overall meta-analysis showed a small effect size in favor of an overestimation of experienced pain intensity (SMD = 0.28). Subanalyzing per pain context, there was a small effect size in favor of overestimation in the clinical context (SMD = 0.33), but there was no evidence of any change in the accuracy of memory of pain in the experimental context (SMD = 0.07). The mean age of the participants and the proportion of girls significantly predicted the accuracy of the memory of pain. The period since the experienced pain measurement, the intensity of expected and recalled fear, trait anxiety, and anxiety sensitivity did not significantly predict the accuracy of the memory of pain. Children showed an overestimation in pain memory between the experienced and recalled intensity of acute pain, especially in a clinical context. Furthermore, only gender and age were predictors of the accuracy of pain memory. These results highlight the relevance of pain memory to medical practice and future research.

The convergence of naturalistic paradigms and cognitive neuroscience methods to investigate memory and its development

Studies that involve lab-based stimuli (e.g., words, pictures) are fundamental in the memory literature. At the same time, there is growing acknowledgment that memory processes assessed in the lab may not be analogous to how memory operates in the real world. Naturalistic paradigms can bridge this gap and over the decades a growing proportion of memory research has involved more naturalistic events. However, there is significant variation in the types of naturalistic studies used to study memory and its development, each with various advantages and limitations. Further, there are notable gaps in how often different types of naturalistic approaches have been combined with cognitive neuroscience methods (e.g., fMRI, EEG) to elucidate the neural processes and substrates involved in memory encoding and retrieval in the real world. Here we summarize and discuss what we identify as progressively more naturalistic methodologies used in the memory literature (movie, virtual reality, staged-events inside and outside of the lab, photo-taking, and naturally occurring event studies). Our goal is to describe each approach's benefits (e.g., naturalistic quality, feasibility), limitations (e.g., viability of neuroimaging method for event encoding versus event retrieval), and discuss possible future directions with each approach. We focus on child studies, when available, but also highlight past adult studies. Although there is a growing body of child memory research, naturalistic approaches combined with cognitive neuroscience methodologies in this domain remain sparse. Overall, this viewpoint article reviews how we can study memory through the lens of developmental cognitive neuroscience, while utilizing naturalistic and real-world events.

A Randomized Controlled Trial of a Parent-Led Memory-Reframing Intervention to Reduce Distress and Pain Associated with Vaccine Injections in Young Children

Children remember their memories of pain long after the painful experience is over. Those memories predict higher levels of future pain intensity. Young children's memories can be reframed to be less distressing. Parents and the way they reminisce about past events with their children play a key role in the formation of pain memories. A novel parent-led memory-reframing intervention changed children's memories of post-surgical pain to be less distressing. The intervention efficacy in the context of vaccine injections is unclear. This registered randomized controlled trial (NCT05217563) aimed to fill this gap. Seventy-four children aged 4.49 years (SD = 1.05) and scheduled to obtain two COVID-19 vaccine injections and one of their parents were randomized to receive: (1) standard care; (2) standard care and memory-reframing information; and (3) standard care and memory-reframing information with verbal instructions. Children reported their pain after vaccine injections. One week after the first vaccination, children reported memory of pain. Parents reported their use of memory-reframing strategies and intervention feasibility and acceptability. The intervention did not result in significant differences in children's recalled or future pain. Parents rated the intervention as acceptable and feasible.

Let's (Not) Talk About Pain: Mothers' and Fathers' Beliefs Regarding Reminiscing About Past Pain

Children's memories for past pain set the stage for their future pain experiences. Parent-child reminiscing about pain plays a key role in shaping children's pain memories. Parental beliefs about the functions of reminiscing are associated with parental reminiscing behaviors. To date, no studies have investigated parental beliefs regarding the functions of reminiscing about past pain or the associations between parental beliefs and reminiscing about past pain. This study aimed to fill these gaps. One-hundred and seven parents (52% fathers) of young children were asked about their beliefs regarding reminiscing about past pain. Interview data were first analyzed using inductive reflexive thematic analysis. A coding scheme was created based on the generated themes to quantitatively characterize parental beliefs. Parents also reminisced with their children about unique past events involving pain. Parent-child reminiscing narratives were coded to capture parent reminiscing behaviors. Inductive reflexive thematic analysis generated three major themes representing parental beliefs regarding reminiscing about past pain: “reminiscing to process past pain,” “reminiscing as a learning tool,” and “avoiding reminiscing about past pain.” Parents who endorsed avoiding reminiscing used fewer optimal reminiscing elements (i.e., open-ended questions) when reminiscing about past painful experiences with children. Parents who endorsed reminiscing to process past pain used more emotion-laden language when reminiscing about past pain. Mothers and fathers of boys and girls endorsed the reminiscing functions to a similar degree. Parents of older, vs. younger, children endorsed reminiscing to process past pain to a greater degree. Developmental considerations and clinical implications of the findings are discussed.

Reframe the Pain: A Randomized Controlled Trial of a Parent-Led Memory-Reframing Intervention

Negatively-biased pain memories (ie, recalling more pain as compared to earlier reports) are a robust predictor of future pain experiences. This randomized controlled trial examined the efficacy of a memory-reframing intervention to reframe children's pain memories. Sixty-five children (54% girls, M_age=5.35 years) underwent a tonsillectomy and reported their levels of post-surgical pain intensity and pain-related fear. 2 weeks post-surgery, children and 1 of their parents were randomized to the memory-reframing intervention or control group. Following control/intervention instructions, parents and children reminisced about the past surgery as they normally would (control) or using the memory-reframing strategies (intervention). Children recalled their post-surgical pain intensity and pain-related fear one week later. Parents reported the intervention's acceptability. Recruitment statistics were used to assess feasibility. Controlling for initial pain intensity ratings and using the Faces Pain Scale Revised, children in the intervention group reported more accurate/positively-biased memories for day 1 post-surgery pain intensity (M = 2.60/10; 95% CI, 1.62 to 3.68), compared to children in the control group (M = 4.11/10; 95% CI, 3.12 to 5.03), η_p² = .07, p = .040. The intervention was acceptable and feasible. Optimal parent-child reminiscing about a past pain experience resulted in children remembering their pain more accurately/positively. Clinicaltrials.gov:NCT03538730. PERSPECTIVE: This article presents results of the first randomized controlled trial examining the efficacy of parent-led memory-reframing intervention to change children's memories for pain. Children of parents who were taught and engaged in optimal reminiscing about a past surgery experience remembered their pain intensity more accurately/positively.

Father- and Mother-Child Reminiscing About Past Pain and Young Children's Cognitive Skills

Objective Painful experiences are common, distressing, and salient in childhood. Parent-child reminiscing about past painful experiences is an untapped opportunity to process pain-related distress and, similar to reminiscing about other distressing experiences, promotes children's broader development. Previous research has documented the role of parent-child reminiscing about past pain in children's pain-related cognitions (i.e., memories for pain), but no study to date has examined the association between parent-child reminiscing about past painful experiences and children's broader cognitive skills. Design and Methods One hundred and ten typically developing four-year-old children and one of their parents reminisced about a past painful autobiographical event. Children then completed two tasks from the NIH Toolbox Cognitive Battery, the Flanker Inhibitory Control & Attention Test and the Picture Sequence Memory Test, to measure their executive function and episodic memory, respectively. Results Results indicated that the relation between parental reminiscing style and children's executive function was moderated by child sex, such that less frequent parental use of yes-no repetition questions was associated with boys' but not girls', greater performance on the executive function task. Children displayed greater episodic memory performance when their parents reminisced using more explanations. Conclusions The current study demonstrates the key role of parent-child reminiscing about pain in children's broader development and supports the merging of developmental and pediatric psychology fields. Future longitudinal research should examine the directionality of the relation between parent-child reminiscing about past pain and children's developmental outcomes.

Parent-child attachment security is associated with preschoolers' memory accuracy for emotional life events through sensitive parental reminiscing

There is considerable controversy regarding the accuracy and suggestibility of children's autobiographical memory for emotionally salient life events. Attachment perspectives of autobiographical memory development identify the attachment security of parent-child dyads and parents' emotional support and coherence during reminiscing with their children as critical mechanisms underlying children's memory accuracy and suggestibility. In the current investigation, 72 preschool-aged children (M = 4.01 years, SD = 0.85; 44 female) reminisced with their parents about times they felt happy, sad, scared, and angry. Children were then independently interviewed about these experiences by an unfamiliar researcher using free recall, specific questions (i.e., questions about factual details), and misleading questions (i.e., questions suggesting false details). Parents completed an assessment of their children's attachment security within the parent-child relationship. Results revealed significant indirect effects of parent-child attachment security on children's memory accuracy through parental sensitive guidance during reminiscing when cognitive (i.e., intelligence) and behavioral (i.e., temperament, behavior problems) covariates were statistically controlled. Parent-child attachment security was positively associated with parental sensitive guidance during reminiscing, which, in turn, was positively associated with the accuracy of children's independent reports. The findings support attachment perspectives of autobiographical memory by identifying emotionally sensitive and coherent reminiscing as a parenting behavior that explains in part associations between parent-child attachment security and children's independent memory accuracy for emotional life events.

Communication between parents and well-siblings in the context of living with a child with a life-threatening or life-limiting condition

Effective parent-child communication may serve to buffer the potential negative impacts of stressful situations on a child. Children who have a brother or sister with a life-threatening or life-limiting medical condition may turn to their parents for help with comprehending the situation, to help maintain their own ability to function across various life areas or to receive emotional support. There is a need for more investigation into the nature and importance of parent-child communication in the context of living with a seriously ill brother or sister. The current paper presents a framework of parent-sibling communication in the context of living with a seriously unwell child, distinguishing the focus of communication (illness-related vs. non-illness-related) and the purpose of communication (information-provision vs. emotional support). Such a framework offers a holistic approach to exploring some of the challenges of communication between parents and well-siblings. The state of current knowledge regarding the focus and purpose of communication between parents and well-siblings is reviewed, and implications for research and possible clinical applications discussed.

Parent-Child Reminiscing about Past Pain as a Preparatory Technique in the Context of Children's Pain: A Narrative Review and Call for Future Research

Pain permeates childhood and remains inadequately and/or inconsistently managed. Existing research and clinical practice guidelines have largely focused on factors influencing the immediate experience of pain. The need for and benefits of preparing children for future pain (e.g., painful procedures) has been well established. Despite being a robust predictor of future pain and distress, memories of past painful experiences remain overlooked in pediatric pain management. Just as autobiographical memories prepare us for the future, children’s memories for past pain can be harnessed to prepare children for future painful experiences. Children’s pain memories are malleable and can be reframed to be less distressing, thus reducing anticipatory distress and promoting self-efficacy. Parents are powerful agents of change in the context of pediatric pain and valuable historians of children’s past painful experiences. They can alter children’s pain memories to be less distressing simply by talking, or reminiscing, about past pain. This narrative review summarizes existing research on parent–child reminiscing in the context of acute and chronic pediatric pain and argues for incorporation of parent–child reminiscing elements into preparatory interventions for painful procedures.

Struggling to breathe: a qualitative study of children's wellbeing during lockdown in Spain

OBJECTIVE

COVID-19 has spread throughout the world, including Europe. In order to halt the spread of the pandemic by maintaining social distancing, all children in Spain have been completely confined to their homes, and from March 13th to April 26th they were forbidden from going outdoors at any time. The aim of this research was gather the voices of children in lockdown during the COVID-19 pandemic in Spain in order to examine how they are coping with this health crisis. Design: A sample of 250 Children from a region of Spain aged 3-12 years (mean 7.14) were openly asked about their lockdown activities, needs, and feelings. Main Outcome Measures: Responses were analyzed using Iramuteq software for lexical analysis. Results: Children reported having mixed emotions in lockdown; whilst they are happy and relaxed with their families, they also feel fear, nervousness, worry, loneliness, sadness, boredom, and anger. At a physical level, Children noted it was difficult to be deprived of fresh air for weeks, which also makes them primarily sedentary, and they missed outdoor exercise. Socially, they missed peers and caregivers. Conclusion: This study provides evidence about the need to safeguard children's wellbeing during the COVID-19 crisis.

The Effects of a Functional Three-dimensional (3D) Printed Knee Joint Simulator in Improving Anatomical Spatial Knowledge

In recent decades, three-dimensional (3D) printing as an emerging technology, has been utilized for imparting human anatomy knowledge. However, most 3D printed models are rigid anatomical replicas that are unable to represent dynamic spatial relationships between different anatomical structures. In this study, the data obtained from a computed tomography (CT) scan of a normal knee joint were used to design and fabricate a functional knee joint simulator for anatomical education. Utility of the 3D printed simulator was evaluated in comparison with traditional didactic learning in first-year medical students (n = 35), so as to understand how the functional 3D simulator could assist in their learning of human anatomy. The outcome measure was a quiz comprising 11 multiple choice questions based on locking and unlocking of the knee joint. Students in the simulation group (mean score = 85.03%, ±SD 10.13%) performed significantly better than those in the didactic learning group, P < 0.05 (mean score = 70.71%, ±SD 15.13%), which was substantiated by large effect size, as shown by a Cohen's d value of 1.14. In terms of learning outcome, female students who used 3D printed simulators as learning aids achieved greater improvement in their quiz scores as compared to male students in the same group. However, after correcting for the modality of instruction, the sex of the students did not have a significant influence on the learning outcome. This randomized study has demonstrated that the 3D printed simulator is beneficial for anatomical education and can help in enriching students' learning experience.

Long-term autobiographical memory across middle childhood: patterns, predictors, and implications for conceptualizations of childhood amnesia

We examined recall of events by children 4-11 years to inform patterns of retention of autobiographical memories as well as factors that predict their survival. 101 children participated in a 4-year prospective study. At study inception, children were 4, 6, and 8 years. They were tested annually for three more years for a total of four waves of data collection. At each wave, we obtained narrative reports of recent (all waves) and distant (Waves 2-4) events, resulting in virtually continuous sampling of memories formed by 4- to 11-year-olds and recalled after 1-3-year delays. We also measured children's language, and domain-general and memory-specific cognitive skills. Multi-level modelling revealed age-related increases in the likelihood of survival of memories over the delays. Critically, the rate of increase in retention of individual memories was the same across the cohorts. In addition to age, thematic coherence of original memory reports predicted memory survivability. Other factors were not predictive. The dense sampling and prospective tracking of memories across the 4-11-year age period permitted an especially strong test for continuity versus discontinuity in autobiographical memory across the second half of the first decade of life. The data are strongly indicative of continuity and gradual change.

Caregiver–adolescent co-reminiscing and adolescents’ individual recollections of a devastating tornado: Associations with enduring posttraumatic stress symptoms

Although disaster-related posttraumatic stress symptoms (PTSS) typically decrease in intensity over time, some youth continue to report elevated levels of PTSS many years after the disaster. The current study examines two processes that may help to explain the link between disaster exposure and enduring PTSS: caregiver emotion socialization and youth recollection qualities. One hundred and twenty-two youth (ages 12 to 17) and their female caregivers who experienced an EF-4 tornado co-reminisced about the event, and adolescents provided independent recollections between 3 and 4 years after the tornado. Adolescent individual transcripts were coded for coherence and negative personal impact, qualities that have been found to contribute to meaning making. Parent–adolescent conversations were coded for caregiver egocentrism, a construct derived from the emotion socialization literature to reflect the extent to which the caregiver centered the conversation on her own emotions and experiences. Egocentrism predicted higher youth PTSS, and this association was mediated by the coherence of adolescents’ narratives. The association between coherence and PTSS was stronger for youth who focused more on the negative personal impacts of the tornado event during their recollections. Results suggest that enduring tornado-related PTSS may be influenced in part by the interplay of caregiver emotion socialization practices and youth recollection qualities.

Predictors of age-related and individual variability in autobiographical memory in childhood

Development of autobiographical memory is as a gradual process beginning in early childhood and continuing through late adolescence. Substantial attention has been paid to early childhood when first personal memories are formed; less attention has been focused on the flourishing of memories from the late preschool years onward. We addressed this void with a three-year cohort-sequential study of age-related changes in the length, completeness, and coherence of autobiographical narratives by children 4-10 years. We also examined the unique and combined variance in autobiographical narrative explained by children's own language, maternal narrative style, domain-general cognitive abilities, non-autobiographical story recall, and memory-specific skills. There was substantial growth in autobiographical narrative skill across the 4-10-year period. Non-autobiographical story recall was a strong concurrent and cross-lagged predictor for all autobiographical narrative measures. Memory-specific and domain-general cognitive abilities systematically predicted narrative completeness and coherence but not length. Children's language and maternal narrative style did not contribute additional variance when these predictors were considered. The findings highlight that age-related changes in autobiographical memory are the results of combined contributions of a variety of domain-general and domain-specific predictors.

Remembering pain after surgery: a longitudinal examination of the role of pain catastrophizing in children's and parents' recall

Children's memories for pain play a powerful role in their pain experiences. Parents' memories may also influence children's pain experiences, by influencing parent-child interactions about pain and children's cognitions and behaviors. Pain catastrophizing of children and parents has been implicated as a factor underlying memory biases; however, this has not been empirically examined. The current longitudinal study is the first to examine the role of pain catastrophizing of children and parents in the development of their pain memories after surgery. Participants were 49 youth (32 girls) aged 10 to 18 years undergoing major surgery and their parents. One week before surgery, children and parents completed measures of pain catastrophizing. Two weeks after surgery (the acute recovery period), children and parents completed measures of child pain intensity and affect. Two to 4 months after surgery, children's and parents' memories of child pain intensity and affect were elicited. Hierarchical linear regression models revealed that over and above covariates, parent catastrophizing about their child's pain (magnification, rumination) accounted for a significant portion of variance in children's affective and parents' sensory pain memories. Although parent catastrophizing had a direct effect on pain memories, mediation analyses revealed that child catastrophizing (helplessness) indirectly influenced children's and parents' pain memories through the child's postoperative pain experience. Findings highlight that aspects of catastrophic thinking about child pain before surgery are linked to distressing pain memories several months later. Although both child and parent catastrophizing influence pain memory development, parent catastrophizing is most influential to both children's and parents' evolving cognitions about child pain.

When Parents Know Little about What Happened: Parent-guided Conversations, Stress, and Young Children's Eyewitness Memory

This study examined how 4- to 7-year-olds' memories for a stressor were influenced by conversations with a parent who had little knowledge of the target event, and the stress children experienced before, during, and after the event. Children (N = 43) watched a mildly stressful video before talking about it with a parent. Parents were asked to focus on either the children's feelings or the content of the video itself. A researcher interviewed the children about their memory following the conversation. Behavioral and physiological measures of children's stress were collected at multiple stages. Children recalled more inaccurate information with the parent than with the interviewer. Younger age and parent insecure attachment were associated with poorer memory. Manipulation of parents' emotion orientation did not predict memory, but individual differences in the talk did, although in different ways from what would be expected from research on conversations about shared events. Less stress (according to self-reported happiness and observed negative affect) before and after, but not during, the stressor was linked with better memory. Implications for children's memory in legal settings are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Developmental Changes in Memory-Related Linguistic Skills and Their Relationship to Episodic Recall in Children

This longitudinal study of nine children examined two issues concerning infantile amnesia: the time at which memories for events experienced before the age of 3–4 years disappear from consciousness and whether this timing of memory loss is related to the development of specific aspects of episodic and autobiographical memory. This study followed children from infancy to early childhood and examined the central role of three verbal–cognitive milestones related to autobiographical memory: the age at which children begin to report autobiographical memories using the past tense (Milestone 1); the age at which they begin to verbally acknowledge past events (Milestone 2); and the age at which they begin to spontaneously use memory-related verbs (Milestone 3). As expected, memories of events that occurred before 3–4 years of age were affected by infantile amnesia. Achievement of these milestones followed almost the same developmental progression: Milestone 1 (1 year; 10 months (1;10) to 3 years; 4 months (3;4)) was followed by Milestones 2 (3;1 to 4;0) and 3 (3;5 to 4;4). Milestone 2 was typically related to the onset of infantile amnesia, whereas Milestone 1 occurred during the period for which the children became amnesic as they aged. These data suggest that linguistic meta-cognitive awareness of personal memory is the key feature in infantile amnesia.

Drawing helps children to talk about their presenting problems during a mental health assessment

When children require mental health services, clinicians need to conduct assessments that are developmentally sensitive and that include the child's point of view. Drawing is a popular tool that is commonly used in clinical settings. Research on drawing in experimental settings has confirmed that the opportunity to draw while talking increases the amount of verbal information that children report during an interview. The present research examined whether drawing also facilitates children's self reports during a mental health assessment. A total of 33 5-12-year-old children were asked either to draw and tell about their presenting problem or to tell only. Children who drew and told provided twice as much verbal information as children who told only. Further, interviewers in the draw and tell condition used a greater number of minimal responses than did interviewers in the tell only condition. These data have important implications for clinical practice.

How Children Report True and Fabricated Stressful and Non-Stressful Events

As children can be victims or witnesses to crimes and may be required to testify about their experiences in court, the ability to differentiate between children's true and fabricated accounts of victimization is an important issue. This study used automated linguistic analysis software to detect linguistic patterns in order to differentiate between children's true and false stressful bullying reports and reports of non-stressful events. Results revealed that children displayed different linguistic patterns when reporting true and false stressful and non-stressful stories, with non-stressful stories being more accurately discriminated based on linguistic patterns. Results suggest that it is difficult to discriminate accurately and consistently between children's true and false stories of victimization.

Facilitating Maltreated Children's Use of Emotional Language

This study examined the effects of rapport (emotional, National Institute of Child Health and Human Development [NICHD]) and prompt type (what-next, cued-action, cued-emotion, what-think) on one hundred forty-two 4-9-year-old maltreated children's spontaneous and prompted emotional language. Children in the emotional-rapport condition narrated the last time they felt good and the last time they felt bad on the playground. Children in the NICHD-rapport condition narrated their last birthday party and what happened yesterday. Following rapport, all children were presented a series of story stems about positive and negative situations. Emotional-rapport minimally affected children's use of emotional language. Cued-emotion prompts were most productive in eliciting emotional language. Overall, there were few effects because of age. Children often produced less emotional language when describing negative events, particularly with respect to their spontaneous utterances, suggesting reluctance. These differences largely disappeared when children were asked additional questions, particularly cued-emotion questions. The results offer support for cued-emotion prompts as a means of increasing maltreated children's use of emotional language.

Individual differences in preschoolers' emotion content memory: the role of emotion knowledge

This study examined the relation between preschool children's emotion knowledge and their ability to recall emotionally salient information. In total, 42 participants (ages 35-65months) viewed a brief video in which a child played with different toys and expressed one of four basic emotions (happy, sad, angry, or afraid) or a neutral expression in each of 10 vignettes. Children were tested on memory accuracy from the vignettes, and their emotion knowledge was also measured. Results indicated that preschoolers' emotion knowledge was significantly related to memory accuracy for emotion information above and beyond the effect of age or receptive language skills. Tests of a mediation model revealed that emotion knowledge fully mediated the effect of age (or general developmental level) on memory accuracy.

'I was just screeching!': comparing child and parent derived measures of distress

Two studies explored relationships between children's (2-13 years old) descriptions of how much they had cried and two other ways of assessing children's distress during injuries and subsequent hospital treatment, one parent-generated and the other child-generated. In the first study, 201 2- to 13-year-old children's descriptions of crying were compared with parental ratings of child distress, and in the second, these two measures plus a Faces Pain Scale were compared for 71 2- to 6-year-olds. Children's self-descriptions of crying were highly similar to parental ratings at all ages, but the Faces Pain Scale had less similarity to other measures, especially for younger preschoolers. Findings suggest that children's self-descriptions of emotional reactions may be a useful tool for assessing children's distress for real-world events with no adult witnesses.

Pain is not over when the needle ends: a review and preliminary model of acute pain memory development in childhood

SUMMARY Over the past several decades, the field of pediatric pain has made impressive advances in our understanding of the pain experience of the developing child, as well as the devastating impact of inadequately managed pain early in life. It is now well recognized that, from infancy, children are capable of developing implicit memories of pain that can influence their subsequent reactions to pain. The present review provides a synthesis of selected studies that made a significant impact on this field of inquiry, with particular emphasis on recent clinical and laboratory-based experimental research examining children’s explicit autobiographical memories for acute pain. Research has begun to move towards improving the precision with which children at risk for developing negatively estimated pain memories can be identified, given the adverse influence these memories can have on subsequent pain experiences. As such, several fear- and anxiety-related child and parent variables implicated in this process are discussed, and avenues for future research and clinical intervention are identified throughout. Finally, a preliminary empirically and theoretically derived model of acute pain memory development in childhood is presented to parsimoniously summarize the evidence accumulated to date and guide future investigation in this area.

Children's memories for events relating to treatment for eye cancer: Influence of age at loss of eye

Treatment for retinoblastoma frequently involves removal of at least one eye in the first 5 years. Variation in age of treatment leads to the assumption that children's later verbal accessibility of early traumatic memories may vary, with some children having less opportunity to make sense of their condition. Video recordings were made of 17 children who had undergone enucleation either before 24 months (n = 8) or after 24 months (n = 9) involved in "hospital play'' using props designed to elicit talk about "eyes." The hypothesis that a larger number of verbalizations about medical procedures would occur in children enucleated after 24 months than before 24 months was supported. Children enucleated after 24 months engaged in significantly more talk about enucleation and/or examination under anesthetic whereas none of the children enucleated in infancy talked about these medical events. The outcome supports the view that there is a transition around 24 months in the extent to which children can have verbal access to previous traumatic memories. The design of interventions needs to take into account that children enucleated in infancy have less opportunity for later verbal access to early memories of traumatic events than those treated later, leading to possible misconceptions about their own condition.

The nature of trauma memories in acute stress disorder in children and adolescents

BACKGROUND

There is increasing theoretical, clinical and research evidence for the role of trauma memory in the aetiology of acute pathological stress responses in adults. However, research into the phenomenology of trauma memories in young people is currently scarce.

METHODS

This study compared the nature of trauma narratives to narratives of unpleasant non-traumatic events in young people (aged 8-17) who sought emergency medical attention following an assault or road traffic accident. Data were collected within 2-4 weeks of the index event. Symptom severity was assessed by child self-report and face-to-face diagnostic interviews. Comparisons of narrative indices were made between those children with acute stress disorder (ASD) and those without ASD.

RESULTS

Among participants (n = 50), those with ASD (38%) had significantly elevated levels of disorganisation in their trauma narrative, compared both to trauma-exposed controls and to their unpleasant comparative narrative. This effect was not accounted for by age. Regardless of ASD diagnostic status, trauma narratives had significantly higher sensory content and significantly lower positive emotion content compared to the unpleasant comparative narrative. These effects were not significant when age was included as a covariate. Acute symptom severity was significantly predicted by the level of disorganisation in the trauma narrative and the child's cognitive appraisals of the event.

CONCLUSIONS

These data provide the first empirical evidence that disorganisation is not only directly linked to symptom severity, but also specific to the trauma memory. In addition, it provides support for the adaptation of adult cognitive models to acute pathological stress reactions in children and adolescents.

Autobiographical memory development from an attachment perspective: the special role of negative events

The authors propose a novel model of autobiographical memory development that features the fundamental role of attachment orientations and negative life events. In the model, it is proposed that early autobiographical memory derives in part from the need to express and remember negative experiences, a need that has adaptive value, and that attachment orientations create individual differences in children's recollections of negative experiences. Specifically, the role of attachment in the processing of negative information is discussed in regard to the mnemonic stages of encoding, storage, and retrieval. This model sheds light on several areas of contradictory data in the memory development literature, such as concerning earliest memories and children's and adults' memory/suggestibility for stressful events.

Mapping the Future of Reminiscence: A Conceptual Guide for Research and Practice

Nearly 50 years after Butler’s seminal 1963 contribution, the field of reminiscence and life review is entering a more mature stage. Isolated examples of increasingly sophisticated studies have recently emerged that can serve as a sound, cumulative data base. However, the field lacks an overarching conceptual model describing emerging trends, neglected domains, and key linkages among component parts. In the present article, the authors selectively, yet critically, review prior limitations and promising developments and then describe a comprehensive, multifaceted conceptual model that can guide future research and practice. The authors initially situate their model within a particular theoretical orientation (i.e., life-span psychology). They then describe a heuristic model that identifies and discusses triggers, modes, contexts, moderators, functions, and outcomes. Finally, the authors illustrate how these interactive factors influence both theoretical and applied areas.

Parental influences on earliest memories

Recently, independent lines of research have indirectly supported the notion that social variables, especially parent-child relationships, have a significant impact on adults' memories of their early life. In order to directly assess this Italian students were asked to recall as many memories involving parents as they could from before the age of 6 in a 3-minute timed recall task (i.e., memory fluency). They also filled out assessments about parental involvement in their lives as well as the quality of their relationships with their mothers and fathers. We found that, for males, the more involved the parents and the warmer the relationships between sons and both their mothers and their fathers, the more early memories, the more positive early memories, and the more episodic memories men recalled. For women, the warmer the relationship with their mothers, the earlier their earliest memory. Results are discussed in terms of gendered parent-child interactions as well as McAdam's emergent life-story theory.