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Mathmann P, Konerding U, Deuster D, Neumann K. The Influence of Age, Gender, Health-Related Behaviors, and Other Factors on Occupationally Relevant Health Complaints of Singers. J Voice 2024; 38:170-180. [PMID: 34583882 DOI: 10.1016/j.jvoice.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Professional singers' careers are usually associated with health-relevant factors that they themselves may or may not be able to influence. We have therefore investigated the effect of modifiable health-related behaviors and non-modifiable factors on singers' occupational health. METHODS In an explorative, questionnaire-based study, self-reported, occupationally relevant health complaints and behaviors, along with singer-specific characteristics, were surveyed from 349 professional singers and voice teachers (116 men, 233 women; age 18-73 years) and the influence of age, gender, duration of daily and lifelong singing, voice category, and health-related behaviors (smoking, alcohol consumption, physical activity) on occupationally relevant health complaints were analyzed using bi- and multivariate statistical methods. RESULTS Singers reported less risky alcohol consumption (5.4% versus ≈15%) and smoking (15.5% versus 29.7%) than the general population, and too little physical activity was described in two thirds of both populations. After controlling for multiple testing, no effect was found for these behaviors, the time spent singing daily, gender, or voice categories on singers' complaints. Health complaints were significantly fewer for males (P < .001) and older women and were reported more frequently for higher-pitched male voices, a trend not found in females. CONCLUSION Singers seem to smoke and drink less than members of the general population. These factors did not affect their complaints. Female singers described more work-related health complaints than males, a finding that corresponds to women in the general population. Older singers reported fewer complaints than younger singers, possibly because of selection effects or older singers acquiring strategies to avoid health-damaging behavior.
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Affiliation(s)
- Philipp Mathmann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, University of Münster,Münster, Germany.
| | - Uwe Konerding
- Trimberg Research Academy, University of Bamberg,Bamberg, Germany; Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Dirk Deuster
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, University of Münster,Münster, Germany
| | - Katrin Neumann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, University of Münster,Münster, Germany
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2
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Anderson NC, Zhou Y, Humphris G. How are emotional distress and reassurance expressed in medical consultations for people with long-term conditions who were unable to receive curative treatment? A pilot observational study with huntington's disease and prostate cancer. Pilot Feasibility Stud 2021; 7:119. [PMID: 34082819 PMCID: PMC8176610 DOI: 10.1186/s40814-021-00833-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
Objective It is unclear whether how people with long-term conditions express distress, and how clinicians respond, influences perceptions of consultation outcomes. The pilot study examined emotional distress and reassurance in consultations with people whose long-term conditions (at the time of consultations) were treated using active surveillance or symptom management (as no curative treatment was suitable). Methods An observational pilot study was conducted involving consultations between people with long-term conditions and their respective clinician. Consultations between three clinicians (two Huntington’s Disease; one Prostate Cancer) and 22 people with long-term conditions (11 Huntington’s Disease; 11 Prostate Cancer) were audio-recorded. Participants also completed an expanded Consultation and Relational Empathy (CARE) Measure. Two researchers coded sessions using Verona Coding Definitions of Emotional Sequences (VR-CoDES/VR-CoDES-P). Code frequencies were calculated, t tests performed between conditions, and Pearson’s correlations performed for associations between CARE responses and clinician utterances. Results People with long-term conditions expressed emotional distress on average 4.45 times per session, averaging 1.09 Concern and 3.36 Cue utterances. Clinicians responded with more explicit (2.59) and space-providing (3.36), than non-explicit (1.86) and space-reducing (1.09), responses per session. Clinicians expressed spontaneous reassurance on average 5.18 times per session, averaging 3.77 Cognitive and 1.5 Affective reassurance utterances. Huntington’s Disease consultations featured significantly more 'Cues', 'Concerns' and 'Overall' 'Emotional Distress', and 'Cognitive' and 'Overall' ‘Reassurance'. Conclusion Emotional distress was expressed more using hints than explicit concern utterances. Clinicians predominantly explicitly explored distress rather than providing information/advice and provided advice using spontaneous cognitive reassurance. People with Huntington’s Disease expressed more concerns and received more reassurance, indicating different needs between conditions. Future research is required to explore emotional distress and reassurance in a larger sample of participants and long-term condition types, and how the practical implications of these findings may be used to enhance outcomes of consultations. Trial registration N/A. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00833-z.
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Affiliation(s)
- Niall C Anderson
- School of Medicine, University of St Andrews, St. Andrews, KY16 9TF, UK.
| | - Yuefang Zhou
- School of Medicine, University of St Andrews, St. Andrews, KY16 9TF, UK
| | - Gerry Humphris
- School of Medicine, University of St Andrews, St. Andrews, KY16 9TF, UK
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Yeung VWL, Geers AL. Prior Pain Exposure and Mere Possession of a Placebo Analgesic Predict Placebo Analgesia: Findings From a Randomized, Double-Blinded, Controlled Trial. THE JOURNAL OF PAIN 2020; 22:415-431. [PMID: 33127585 DOI: 10.1016/j.jpain.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/25/2022]
Abstract
A recent study found that merely possessing a placebo analgesic reduces pain. The current study tested for a possible moderator of this effect. Specifically, does the mere possession of a placebo analgesic affect pain for individuals with and without immediate prior experience with the pain task? Healthy participants (N = 127) were randomized to prior pain (PP) condition or without prior pain (No-PP) condition. In the PP condition, participants first did a preliminary trial of a cold pressor test (CPT) to induce direct experience with this pain stimulus. Then they were randomized to possess an inert cream described as either an analgesic cream or an anti-itch cream (pain-irrelevant control object). Participants then completed the main CPT. In the No-PP condition, participants underwent identical procedures and randomization except that they did not do a preliminary CPT, thus having no immediate prior CPT pain experience. We found a significant prior pain experience and possession status interaction effect on placebo analgesia. Participants in the No-PP condition showed evidence of lower pain when they merely possessed an analgesic cream than an anti-itch cream. Such mere possession effect was not found in the PP condition. The impact of expectancy and emotion on the underlying process are discussed. PERSPECTIVE: This article presents a novel finding that prior pain exposure and mere possession of a placebo analgesic predicted placebo analgesia. It offers a novel perspective on the time course of placebo effect. It provides practical implications on potential pain intervention for clinicians and paradigm design for researchers of placebo study.
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Affiliation(s)
| | - Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, Ohio
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Wai-Lan Yeung V, Geers AL, Colloca L. Merely Possessing a Placebo Analgesic Improves Analgesia Similar to Using the Placebo Analgesic. Ann Behav Med 2020; 54:637-652. [PMID: 32227161 DOI: 10.1093/abm/kaaa007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Placebo analgesia studies generally reported that the actual use of a placebo analgesic reduces pain. Yeung, Geers, and Kam found that the mere possession (without use) of a placebo analgesic also reduces pain. PURPOSE We investigated the relative effectiveness of using versus possessing a placebo analgesic on pain outcomes. METHODS In Study 1a, 120 healthy adults were randomized to either the experimental (EXP) conditions (EXP1: used a placebo analgesic cream, EXP2: possessed a placebo analgesic cream) or control (CO) conditions (CO1: possessed a sham cream, CO2: no cream). All participants underwent a cold pressor test (CPT). Study 1b further delineated the effect of possession from the effect of use. Sixty healthy adults were randomized to either the placebo-possession condition (merely possessed a placebo analgesic cream) or the placebo-possession-use condition (possessed and used a placebo analgesic cream). All participants did a CPT. RESULTS In Study 1a, as expected, a placebo effect was found-participants who used a placebo analgesic cream showed better pain outcomes than the two CO groups. Surprisingly, participants who merely possessed a placebo analgesic cream performed equally well as those who actually used it. In Study 1b, participants in the two conditions did not differ in most pain outcomes. Participants who possessed and used a placebo analgesic cream only showed slightly more reduction in pain intensity compared to participants who merely possessed the placebo analgesic cream. CONCLUSIONS Our results suggest that merely possessing a placebo analgesic could enhance pain outcomes similar to that of applying the placebo analgesic.
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Affiliation(s)
| | - Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Luana Colloca
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA.,Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, MD, USA.,Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
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5
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Frygner-Holm S, Åsenlöf P, Ljungman G, Söderlund A. Physical therapists' experiences of learning and delivering a complex behavioral medicine intervention to adolescents with pain. Physiother Theory Pract 2019; 37:583-593. [PMID: 31305232 DOI: 10.1080/09593985.2019.1639232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The objective was to study physical therapists' (PTs') experiences of learning and delivering a complex intervention, a tailored behavioral medicine treatment (BMT) targeting adolescents with pain in primary care.Method: An explorative study with qualitative approach, using content analysis. Three primary care PTs delivering the treatments in a randomized controlled study were interviewed regarding their views on the BMT.Results: The participating PTs considered learning about and delivering the BMT as challenging but rewarding. The biopsychosocial approach, tailoring of the treatment and dialogues with parents were identified as key aspects of the BMT program. The process of formulating a functional behavioral analysis was perceived as strenuous. The supervision of the PTs throughout the study was regarded as crucial and necessary for learning about and providing tailored BMT.Conclusion: Learning about and delivering BMT targeting adolescents with persistent pain is fruitful but laborious and demanding according to three PTs experienced with treatment of pediatric pain in primary care. Extensive education and long periods of supervision seem to be crucial for success and safe delivery according to protocol.
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Affiliation(s)
| | | | - Gustaf Ljungman
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden
| | - Anne Söderlund
- School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Stahlschmidt L, Hübner-Möhler B, Dogan M, Wager J. Pain Self-Efficacy Measures for Children and Adolescents: A Systematic Review. J Pediatr Psychol 2019; 44:530-541. [DOI: 10.1093/jpepsy/jsz002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/19/2018] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lorin Stahlschmidt
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital Datteln
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine
| | - Bettina Hübner-Möhler
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital Datteln
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine
| | - Meltem Dogan
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital Datteln
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine
| | - Julia Wager
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital Datteln
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine
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Kassab M, Hamadneh S, Nuseir K, ALmomani B, Hamadneh J. Factors Associated With Infant Pain Severity Undergoing Immunization Injections. J Pediatr Nurs 2018; 42:e85-e90. [PMID: 29681431 DOI: 10.1016/j.pedn.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 03/30/2018] [Accepted: 04/01/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Factors influencing infants' behavioral and vocal (cry) response to painful stimuli are explored to improve pain management plans for infants undergoing immunizations. DESIGN AND METHODS An observational study design was used. Pain responses of 60 to 75 days-old infants (44% male vs 56% female) undergoing two-month immunization injections were videotaped and coded using the Modified Behavioral Pain Scale (MBPS), and duration of total crying time during injection was recorded. The influences of five factors (gender, caregiver attendance, previous experience of nociception (circumcision), mode of delivery), and weight (birth and current) were examined at baseline, during and post-immunization. RESULTS Higher birth weight was the most significant factor that reduced pain responses during (p = 0.001) and post-immunization (p = 0.03). A higher birth weight reduced full lung crying (p = 0.04), which reflects crying during injection as compared to total crying time. Vaginal delivery had a significant effect on behavioral pain responses of infants only post-immunization (p = 0.006). Parent's presence in the immunization room significantly reduced total crying time (p = 0.03). Uncircumcised male infants had a significant reduction in behavioral pain responses during immunization (p = 0.01) compared to circumcised infants. CONCLUSIONS The literature well supports the acknowledgement of early pain experience and its psychological consequences. Knowing and controlling for each of mentioned factors early in life during every painful procedure could improve coping mechanisms of infants for any painful procedures later in life. PRACTICE IMPLICATIONS Control of certain factors during early life experiences can modify pain of immunization.
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Affiliation(s)
- Manal Kassab
- Department of Maternal and child health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; University of Technology, Sydney (UTS), Sydney, Australia.
| | - Shereen Hamadneh
- Department of Maternal and Child Health, Faculty of Nursing, Al-albayt University, Mafraq, Jordan
| | - Khawla Nuseir
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Basima ALmomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Jehan Hamadneh
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Jordan University of Science and technology (JUST), Irbid, Jordan
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Walco GA, Krane EJ, Schmader KE, Weiner DK. Applying a Lifespan Developmental Perspective to Chronic Pain: Pediatrics to Geriatrics. THE JOURNAL OF PAIN 2017; 17:T108-17. [PMID: 27586828 DOI: 10.1016/j.jpain.2015.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 10/23/2015] [Accepted: 11/16/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED An ideal taxonomy of chronic pain would be applicable to people of all ages. Developmental sciences focus on lifespan developmental approaches, and view the trajectory of processes in the life course from birth to death. In this article we provide a review of lifespan developmental models, describe normal developmental processes that affect pain processing, and identify deviations from those processes that lead to stable individual differences of clinical interest, specifically the development of chronic pain syndromes. The goals of this review were 1) to unify what are currently separate purviews of "pediatric pain," "adult pain," and "geriatric pain," and 2) to generate models so that specific elements of the chronic pain taxonomy might include important developmental considerations. PERSPECTIVE A lifespan developmental model is applied to the forthcoming Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy to ascertain the degree to which general "adult" descriptions apply to pediatric and geriatric populations, or if age- or development-related considerations need to be invoked.
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Affiliation(s)
- Gary A Walco
- Departments of Anesthesiology and Pain Medicine, Pediatrics, and Psychiatry, University of Washington School of Medicine, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington.
| | - Elliot J Krane
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California; Stanford Children's Health, Palo Alto, California
| | - Kenneth E Schmader
- Department of Medicine, Duke University Medical Center, Durham, North Carolina; GRECC, Durham VA Medical Center, Durham, North Carolina
| | - Debra K Weiner
- VA Pittsburgh Geriatric Research, Education and Clinical Center, Pittsburgh, Pennsylvania; Departments of Medicine, Psychiatry, and Anesthesiology, Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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van Ganzewinkel CJJLM, Been JV, Verbeek I, van der Loo TB, van der Pal SM, Kramer BW, Andriessen P. Pain threshold, tolerance and intensity in adolescents born very preterm or with low birth weight. Early Hum Dev 2017; 110:31-38. [PMID: 28499135 DOI: 10.1016/j.earlhumdev.2017.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Data on long-term consequences of neonatal pain is limited. AIM To assess whether perinatal factors, later pain experience and pain coping strategies are associated with altered pain threshold, pain tolerance and pain intensity in adolescents born preterm. STUDY DESIGN Observational, longitudinal study (Project on Preterm and SGA-infants, POPS-19). SUBJECTS We analyzed data of 412 adolescents at the age of 19years, who were born at a gestational age<32weeks or with a birth weight<1500g. OUTCOME MEASURES Participants performed a standardized cold pressor test to assess pain threshold, tolerance and intensity. Furthermore, they completed a pain coping questionnaire (PCQ). RESULTS In univariate analysis, female gender and necrotizing enterocolitis (NEC) were associated with lower pain tolerance, indicated by reaching the ceiling time of 180s in ice water (females 19% vs males 29%, NEC 7% vs no NEC 25%). Female gender was associated with higher pain intensity (mean difference 0.58; 95%CI 0.21; 0.95) and lower pain threshold (log rank test p 0.007). In a multivariate Cox regression analyses, emotion focused avoidance pain coping style was significantly associated with lower pain threshold (hazard ratio HR 1.38; 95%CI 1.02; 1.87) and pain tolerance (HR 1.72; 95%CI 1.21; 2.42). NEC was significantly associated with lower pain threshold (HR 1.47; 95%CI 1.01; 2.14) and pain tolerance (HR 1.63; 95%CI 1.09; 2.41). CONCLUSION In adolescence, maladaptive pain coping strategy was associated with lower pain threshold, pain tolerance and higher pain intensity. NEC was associated with altered pain response in adolescents born preterm.
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Affiliation(s)
| | - Jasper V Been
- Division of Neonatology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Obstetrics and Gynaecology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, Netherlands
| | - Inge Verbeek
- Department of Pediatrics, Division of Neonatology, Máxima Medical Centre, De Run 4600, 5504 MB Veldhoven, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Tera Boelen van der Loo
- TNO Quality of Life, Prevention and Health, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
| | - Sylvia M van der Pal
- TNO Quality of Life, Prevention and Health, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
| | - Boris W Kramer
- Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
| | - Peter Andriessen
- Department of Pediatrics, Division of Neonatology, Máxima Medical Centre, De Run 4600, 5504 MB Veldhoven, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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LEE PERLHAN, YEH YICHUN, HSIAO RAYC, YEN CHENGFANG, HU HUEIFAN. Pain-related quality of life related to mental health and sociodemographic indicators in adolescents. ARCH CLIN PSYCHIAT 2017. [DOI: 10.1590/0101-60830000000122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- PERL HAN LEE
- Kaohsiung Medical University Hospital, Taiwan; Kaohsiung Medical University, Taiwan
| | - YI-CHUN YEH
- Kaohsiung Medical University Hospital, Taiwan; Kaohsiung Medical University, Taiwan
| | - RAY C. HSIAO
- University of Washington, United States; Children’s Hospital, United States
| | - CHENG-FANG YEN
- Kaohsiung Medical University Hospital, Taiwan; Kaohsiung Medical University, Taiwan
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Melchior M, Poisbeau P, Gaumond I, Marchand S. Insights into the mechanisms and the emergence of sex-differences in pain. Neuroscience 2016; 338:63-80. [DOI: 10.1016/j.neuroscience.2016.05.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 12/19/2022]
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Marche TA, Briere JL, von Baeyer CL. Children's Forgetting of Pain-Related Memories. J Pediatr Psychol 2015; 41:220-31. [PMID: 26666267 DOI: 10.1093/jpepsy/jsv111] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/23/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Given that forgetting negative experiences can help children cope with these experiences, we examined their ability to forget negative aspects of painful events. METHODS 86 children aged 7-15 years participated in a retrieval-induced forgetting task whereby they repeatedly retrieved positive details of a physically painful experience, and an experimental pain task (cold-pressor task). RESULTS Repeatedly retrieving positive details of a prior pain experience produced forgetting of the negative aspects of that experience. Pain-related self-efficacy predicted retrieval-induced forgetting; children with a poorer belief in their ability to cope with pain experienced less forgetting. Children who had a more difficult time forgetting prior negative experiences were more anxious about the pain task and reported higher pain thresholds. CONCLUSIONS Understanding children's memory for painful experiences may help improve their pain management and coping ability.
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Affiliation(s)
- Tammy A Marche
- Department of Psychology, Arts, and Science, University of Saskatchewan
| | - Jennifer L Briere
- Department of Psychology, Arts, and Science, University of Saskatchewan
| | - Carl L von Baeyer
- Department of Psychology, Arts, and Science, University of Saskatchewan
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13
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Zhou Y, Humphris GM. Reassurance and distress behavior in preschool children undergoing dental preventive care procedures in a community setting: a multilevel observational study. Ann Behav Med 2015; 48:100-11. [PMID: 24311016 DOI: 10.1007/s12160-013-9566-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The effect of reassurance in managing distress among children who receive procedures of a less aversive nature has not been fully investigated. PURPOSE This study aimed to investigate the relationship between reassurance by dental staff and distress behavior of preschool children receiving preventive procedures in a community setting. METHODS Nurse-child interactions (n = 270) during fluoride varnish application were video recorded and coded. Multilevel logistic regression modeled the probability of the occurrence of child distress behavior as a function of reassurance provision, controlling for child-level and nurse-level variables. RESULTS Child distress behavior was positively related to nurse verbal reassurance but negatively linked to the time that this reassurance occurred. Both child initial anxiety and nurse nonprocedural training increased the probability of observable distress behavior. CONCLUSIONS The use of verbal reassurance to promote reception of mild invasive procedures was counterindicated, especially when offered early in the intervention ( ClinicalTrials.gov number: NCT00881790).
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Affiliation(s)
- Yuefang Zhou
- School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, Scotland, UK,
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14
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Pain severity and pain catastrophizing predict functional disability in youth with inflammatory bowel disease. J Crohns Colitis 2014; 8:1118-24. [PMID: 24630487 DOI: 10.1016/j.crohns.2014.02.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 02/05/2014] [Accepted: 02/14/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Abdominal pain is commonly reported by youth with IBD. In a significant subset of youth, pain severity and pain catastrophizing (i.e., unhelpful thoughts related to the pain) may contribute to more negative outcomes and greater impairment in functioning. This study aimed to examine relationships of pain severity and pain catastrophizing with functional disability among a sample of youth with inflammatory bowel disease (IBD). METHODS Seventy-five youth aged 11 to 18 years completed ratings of abdominal pain severity, pain catastrophizing, and functional disability using validated measures. Disease activity was rated by treating physicians. RESULTS Over half of participants reported abdominal pain in the past two weeks, and pain was present among those with and without clinical disease activity. Nearly one-third of youth reported mild to moderate functional disability. After controlling for gender, pain severity accounted for 15% of the variance in patient functional disability. Moreover, pain catastrophizing contributed significant variance to the prediction of functional disability (approximately 7%) beyond the role of pain severity. CONCLUSIONS Greater attention to the role of pain catastrophizing in contributing to functional disability in youth with IBD may be important given that pain-related cognitions are modifiable via intervention.
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Boerner KE, Birnie KA, Caes L, Schinkel M, Chambers CT. Sex differences in experimental pain among healthy children: A systematic review and meta-analysis. Pain 2014; 155:983-993. [DOI: 10.1016/j.pain.2014.01.031] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/19/2013] [Accepted: 01/30/2014] [Indexed: 01/12/2023]
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Wilson AC, Moss A, Palermo TM, Fales JL. Parent pain and catastrophizing are associated with pain, somatic symptoms, and pain-related disability among early adolescents. J Pediatr Psychol 2013; 39:418-26. [PMID: 24369365 DOI: 10.1093/jpepsy/jst094] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To examine associations between parental history of pain and catastrophizing and their adolescent's pain, somatic symptoms, catastrophizing, and disability. METHODS Participants included 178 youths aged 11-14 years recruited through public schools. Adolescents completed measures assessing pain characteristics, somatic symptoms, and pain catastrophizing. Parents reported on their own pain, and catastrophizing about their adolescent's pain. RESULTS About one quarter of the adolescents and two thirds of parents reported having pain. Parent pain was associated with adolescent pain, somatic symptoms, and pain catastrophizing. Parent catastrophizing was a significant predictor of adolescent somatic symptoms and pain-related disability, beyond the contribution of parent pain. Adolescent catastrophizing mediated the association between parent catastrophizing and adolescent pain-related disability. CONCLUSIONS Parent history of pain and pain-related cognitions may contribute to adolescent risk for chronic pain.
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Affiliation(s)
- Anna C Wilson
- PhD, Institute on Development & Disability, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailstop CDRC, Portland, OR 97239, USA.
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Pubertal status moderates the association between mother and child laboratory pain tolerance. Pain Res Manag 2013; 19:23-9. [PMID: 24367794 DOI: 10.1155/2014/390368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND There is limited information regarding the relationship between parent and child responses to laboratory pain induction in the absence of experimental manipulation. OBJECTIVES To assess the association between responses to cold and pressure pain tasks in 133 nonclinical mothers and children (mean age 13.0 years; 70 girls), and the moderating effects of child sex and pubertal status on these mother-child relationships. METHODS Mothers and children independently completed the cold and pressure pain tasks. Multiple linear regression analyses examined the association between mothers' and children's laboratory pain responses. The moderating effects of child sex and pubertal status were tested in the linear models by examining the interaction among mother laboratory pain responses, and child sex and pubertal status. RESULTS Mothers' cold pain anticipatory anxiety and pressure pain intensity were associated with children's pressure pain anticipatory anxiety. Mothers' pressure pain tolerance was associated with children's pain tolerance for both the cold and pressure pain tasks. Mothers' cold pain tolerance was associated with children's pressure pain tolerance. Pubertal status moderated two of the three significant mother-child pain tolerance relationships, such that the associations held for early pubertal but not for late pubertal children. Sex did not moderate mother-child pain associations. CONCLUSIONS The results indicate that mother-child pain relationships are centred primarily on pain avoidance behaviour, particularly among prepubertal children. These findings may inform interventions focused on pain behaviours, with a particular emphasis on mothers of prepubertal children, to reduce acute pain responses in their children.
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Wilson AC, Holley AL, Palermo TM. Applications of laboratory pain methodologies in research with children and adolescents: emerging research trends. Pain 2013; 154:1166-1169. [PMID: 23707308 DOI: 10.1016/j.pain.2013.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 03/27/2013] [Accepted: 04/05/2013] [Indexed: 12/29/2022]
Affiliation(s)
- Anna C Wilson
- Institute on Development and Disability, Division of Psychology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Mailstop CDRC, Portland, OR 97239, USA Seattle Children's Research Institute, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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Conditioned pain modulation in children and adolescents: effects of sex and age. THE JOURNAL OF PAIN 2013; 14:558-67. [PMID: 23541066 DOI: 10.1016/j.jpain.2013.01.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 11/21/2022]
Abstract
UNLABELLED Conditioned pain modulation (CPM) refers to the diminution of perceived pain intensity for a test stimulus following application of a conditioning stimulus to a remote area of the body, and is thought to reflect the descending inhibition of nociceptive signals. Studying CPM in children may inform interventions to enhance central pain inhibition within a developmental framework. We assessed CPM in 133 healthy children (mean age = 13 years; 52.6% girls) and tested the effects of sex and age. Participants were exposed to 4 trials of a pressure test stimulus before, during, and after the application of a cold water conditioning stimulus. CPM was documented by a reduction in pressure pain ratings during cold water administration. Older children (12-17 years) exhibited greater CPM than younger children (8-11 years). No sex differences in CPM were found. Lower heart rate variability at baseline and after pain induction was associated with less CPM, controlling for child age. The findings of greater CPM in the older age cohort suggest a developmental improvement in central pain inhibitory mechanisms. The results highlight the need to examine developmental and contributory factors in central pain inhibitory mechanisms in children to guide effective, age appropriate pain interventions. PERSPECTIVE In this healthy sample, younger children exhibited less CPM than did older adolescents, suggesting a developmental improvement in CPM. Cardiac vagal tone was associated with CPM across age. The current findings may inform the development of targeted, developmentally appropriate pain interventions for children.
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The effects of coping style on virtual reality enhanced videogame distraction in children undergoing cold pressor pain. J Behav Med 2012. [DOI: 10.1007/s10865-012-9479-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pagé MG, Stinson J, Campbell F, Isaac L, Katz J. Pain-related psychological correlates of pediatric acute post-surgical pain. J Pain Res 2012. [PMID: 23204864 PMCID: PMC3508661 DOI: 10.2147/jpr.s36614] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Post-surgical pain is prevalent in children, yet is significantly understudied. The goals of this study were to examine gender differences in pain outcomes and pain-related psychological constructs postoperatively and to identify pain-related psychological correlates of acute post-surgical pain (APSP) and predictors of functional disability 2 weeks after hospital discharge. Methods Eighty-three children aged 8–18 (mean 13.8 ± 2.4) years who underwent major orthopedic or general surgery completed pain and pain-related psychological measures 48–72 hours and 2 weeks after surgery. Results Girls reported higher levels of acute postoperative anxiety and pain unpleasantness compared with boys. In addition, pain anxiety was significantly associated with APSP intensity and functional disability 2 weeks after discharge, whereas pain catastrophizing was associated with APSP unpleasantness. Conclusion These results highlight the important role played by pain-related psychological factors in the experience of pediatric APSP by children and adolescents.
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Affiliation(s)
- M Gabrielle Pagé
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
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22
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Schmitz AK, Vierhaus M, Lohaus A. Pain tolerance in children and adolescents: Sex differences and psychosocial influences on pain threshold and endurance. Eur J Pain 2012; 17:124-31. [DOI: 10.1002/j.1532-2149.2012.00169.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2012] [Indexed: 11/12/2022]
Affiliation(s)
- A-K. Schmitz
- Department of Psychology; University of Bielefeld; Bielefeld; Germany
| | - M. Vierhaus
- Department of Psychology; University of Bielefeld; Bielefeld; Germany
| | - A. Lohaus
- Department of Psychology; University of Bielefeld; Bielefeld; Germany
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Rollman GB, Abdel-Shaheed J, Gillespie JM, Jones KS. Does past pain influence current pain: biological and psychosocial models of sex differences. Eur J Pain 2012; 8:427-33. [PMID: 15324774 DOI: 10.1016/j.ejpain.2004.03.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2003] [Accepted: 01/30/2004] [Indexed: 12/30/2022]
Abstract
Previous studies have generally indicated sizeable sex differences for both laboratory pain reactivity and clinical pain reports. Numerous biological and psychosocial models have been invoked to account for these findings, but the laboratory and clinical findings have generally been examined in isolation. This paper reviews data which show a relationship between past clinical pain experiences and current responses to experimentally induced pain. Individuals with a greater pain history tend to show lower pain tolerance. Since women often have high pain experience levels and lower pain tolerance, one might ask whether the two factors are related. We review several models, based upon concepts of neonatal differences in pain reactivity, hypervigilance following early pain experiences, and concepts of peripheral and central sensitization or plasticity which might help to bridge the gap between clinical and experimental findings.
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Affiliation(s)
- Gary B Rollman
- Department of Psychology, University of Western Ontario, London, Ont., Canada N6A 5C2.
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24
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Huguet A, Miró J, Nieto R. The factor structure and factorial invariance of the Pain-Coping Questionnaire across age: Evidence from community-based samples of children and adults. Eur J Pain 2012; 13:879-89. [DOI: 10.1016/j.ejpain.2008.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Revised: 09/08/2008] [Accepted: 10/16/2008] [Indexed: 10/21/2022]
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Reliability and validity of the Child Pain Anxiety Symptoms Scale (CPASS) in a clinical sample of children and adolescents with acute postsurgical pain. Pain 2011; 152:1958-1965. [DOI: 10.1016/j.pain.2011.02.053] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/11/2011] [Accepted: 02/28/2011] [Indexed: 11/24/2022]
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Campbell CM, Bounds SC, Simango MB, Witmer KR, Campbell JN, Edwards RR, Haythornthwaite JA, Smith MT. Self-reported sleep duration associated with distraction analgesia, hyperemia, and secondary hyperalgesia in the heat-capsaicin nociceptive model. Eur J Pain 2010; 15:561-7. [PMID: 21194997 DOI: 10.1016/j.ejpain.2010.11.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 11/15/2010] [Accepted: 11/29/2010] [Indexed: 01/20/2023]
Abstract
Although sleep deprivation is known to heighten pain sensitivity, the mechanisms by which sleep modifies nociception are largely unknown. Few studies of sleep-pain interactions have utilized quantitative sensory testing models that implicate specific underlying physiologic mechanisms. One possibility, which is beginning to receive attention, is that differences in sleep may alter the analgesic effects of distraction. We utilized the heat-capsaicin nociceptive model to examine whether self-reported habitual sleep duration is associated with distraction analgesia, the degree of secondary hyperalgesia and skin flare, markers implicating both central and peripheral processes that heighten pain. Twenty-eight healthy participants completed three experimental sessions in a randomized within subjects design. In the pain only condition, pain was induced for approximately 70-min via application of heat and capsaicin to the dorsum of the non-dominant hand. Verbal pain ratings were obtained at regular intervals. In the distraction condition, identical procedures were followed, but during heat-capsaicin pain, subjects played a series of video games. The third session involved assessing performance on the video games (no capsaicin). Participants indicated their normal self-reported habitual sleep duration over the past month. Individuals who slept less than 6.5 h/night in the month prior to the study experienced significantly less behavioral analgesia, increased skin flare and augmented secondary hyperalgesia. These findings suggest that reduced sleep time is associated with diminished analgesic benefits from distraction and/or individuals obtaining less sleep have a reduced ability to disengage from pain-related sensations. The secondary hyperalgesia finding may implicate central involvement, whereas enhanced skin flare response suggests that sleep duration may also impact peripheral inflammatory mechanisms.
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Affiliation(s)
- Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
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Vierhaus M, Lohaus A, Schmitz AK. Sex, gender, coping, and self-efficacy: mediation of sex differences in pain perception in children and adolescents. Eur J Pain 2010; 15:621.e1-8. [PMID: 21147542 DOI: 10.1016/j.ejpain.2010.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 10/27/2010] [Accepted: 11/09/2010] [Indexed: 01/21/2023]
Abstract
Sex differences in pain perception have been reported in an expanding literature based on adult samples in epidemiological as well as laboratory studies. Especially with respect to the latter, studies with children and adolescents do not consistently show that females report higher pain ratings and display lower pain tolerance than males. The first aim of the presented studies is to comparably examine sex differences in children and adolescents based on experimental and questionnaire approach indices of pain perception. The second aim is to examine the contribution of three prominent psychosocial factors (gender-role expectations, coping with pain, and pain self-efficacy) to these sex differences. In Study 1, a total of 118 children and adolescents from grades 5 to 9 were tested with the Cold Pressor Task (CPT) and a Pain Perception Questionnaire. In Study 2, 148 participants additionally reported on their gender-role expectations, coping with pain, and pain self-efficacy. Although the results reveal only medium-sized correlations between the CPT and the questionnaire measures, both measures indicate substantial sex differences in pain perception in both studies. In Study 2, sex differences are also present for masculinity, femininity, catastrophizing as well as pain self-efficacy. However, while the relation between sex and the CPT rating is partially mediated by pain self-efficacy, catastrophizing partially mediates the relation between sex and the questionnaire based pain ratings. The results of both studies are discussed with respect to the difference between experimental assessments of pain perception and assessments by questionnaire in children and adolescents.
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Affiliation(s)
- Marc Vierhaus
- Department of Psychology, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany.
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Dahlquist LM, Weiss KE, Law EF, Sil S, Herbert LJ, Horn SB, Wohlheiter K, Ackerman CS. Effects of videogame distraction and a virtual reality type head-mounted display helmet on cold pressor pain in young elementary school-aged children. J Pediatr Psychol 2010; 35:617-25. [PMID: 19786489 PMCID: PMC2889252 DOI: 10.1093/jpepsy/jsp082] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 08/07/2009] [Accepted: 08/17/2009] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study examined the effects of videogame distraction and a virtual reality (VR) type head-mounted display helmet for children undergoing cold pressor pain. METHODS Fifty children between the ages of 6 and 10 years underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered via a VR helmet or without a VR helmet in counterbalanced order. RESULTS As expected, children demonstrated significant improvements in pain threshold and pain tolerance during both distraction conditions. However, the two distraction conditions did not differ in effectiveness. CONCLUSIONS Using the VR helmet did not result in improved pain tolerance over and above the effects of interactive videogame distraction without VR technology. Clinical implications and possible developmental differences in elementary school-aged children's ability to use VR technology are discussed.
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Affiliation(s)
- Lynnda M Dahlquist
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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Hechler T, Kosfelder J, Vocks S, Mönninger T, Blankenburg M, Dobe M, Gerlach AL, Denecke H, Zernikow B. Changes in Pain-Related Coping Strategies and Their Importance for Treatment Outcome Following Multimodal Inpatient Treatment: Does Sex Matter? THE JOURNAL OF PAIN 2010; 11:472-83. [DOI: 10.1016/j.jpain.2009.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 08/13/2009] [Accepted: 09/19/2009] [Indexed: 10/19/2022]
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Catastrophizing delays the analgesic effect of distraction. Pain 2010; 149:202-207. [PMID: 20188470 DOI: 10.1016/j.pain.2009.11.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Revised: 10/09/2009] [Accepted: 11/10/2009] [Indexed: 11/23/2022]
Abstract
Behavioral analgesic techniques such as distraction reduce pain in both clinical and experimental settings. Individuals differ in the magnitude of distraction-induced analgesia, and additional study is needed to identify the factors that influence the pain relieving effects of distraction. Catastrophizing, a set of negative emotional and cognitive processes, is widely recognized to be associated with increased reports of pain. We sought to evaluate the relationship between catastrophizing and distraction analgesia. Healthy participants completed three sessions in a randomized order. In one session (Pain Alone), pain was induced by topical application of a 10% capsaicin cream and simultaneous administration of a tonic heat stimulus. In another session (Pain+Distraction), identical capsaicin+heat application procedures were followed, but subjects played video games that required a high level of attention. During both sessions, verbal ratings of pain were obtained and participants rated their degree of catastrophizing. During the other session (Distraction Alone) subjects played the video games in the absence of any pain stimulus. Pain was rated significantly lower during the distraction session compared to the "Pain Alone" session. In addition, high catastrophizers rated pain significantly higher regardless of whether the subjects were distracted. Catastrophizing did not influence the overall degree of distraction analgesia; however, early in the session high catastrophizers had little distraction analgesia, though later in the session low and high catastrophizers rated pain similarly. These results suggest that both distraction and catastrophizing have substantial effects on experimental pain in normal subjects and these variables interact as a function of time.
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Reference values for quantitative sensory testing in children and adolescents: developmental and gender differences of somatosensory perception. Pain 2010; 149:76-88. [PMID: 20138430 DOI: 10.1016/j.pain.2010.01.011] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 01/05/2010] [Accepted: 01/13/2010] [Indexed: 12/28/2022]
Abstract
The Quantitative Sensory Testing (QST) protocol of the German research network on neuropathic pain (DFNS) encompassing all somatosensory modalities assesses the functioning of different nerve fibers and of central pathways. The aim of our study was: (1) to explore, whether this QST protocol is feasible for children, (2) to detect distribution properties of QST data and the impact of body site, age and gender and (3) to establish reference values for QST in children and adolescents. The QST protocol of the DFNS with modification of instructions and pain rating was used in 176 children aged 6.12-16.12years for six body sites. QST was feasible for children over 5years of age. ANOVAs revealed developmental, gender and body site differences of somatosensory functions similar to adults. The face was more sensitive than the hand and/or foot. Younger children (6-8years) were generally less sensitive to all thermal and mechanical detection stimuli but more sensitive to all pain stimuli than older (9-12years) children, whereas there were little differences between older children and adolescents (13-17years). Girls were more sensitive to thermal detection and pain stimuli, but not to mechanical detection and pain stimuli. Reference values differ from adults, but distribution properties (range, variance, and side differences) were similar and plausible for statistical factors. Our results demonstrate that the full QST protocol is feasible and valid for children over 5years of age with their own reference values.
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Langer SL, Romano JM, Levy RL, Walker LS, Whitehead WE. Catastrophizing and Parental Response to Child Symptom Complaints. CHILDRENS HEALTH CARE 2009; 38:169-184. [PMID: 21423794 DOI: 10.1080/02739610903038750] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study investigated whether catastrophic thinking about pain by children with functional abdominal pain or by their parents is associated with health outcomes in the child. Subjects were 132 parent-child dyads. Child catastrophizing predicted child depression, anxiety and functional disability. Parents' catastrophizing cognitions about their own pain predicted self-reported protective responses to their children's abdominal pain (responding in ways that encourage illness behavior). Protectiveness, in turn, predicted child functional disability. All findings held despite controlling for child age, gender, and symptom severity. These results suggest that catastrophic cognitions play an important role in how children and parents cope and respond to functional abdominal pain, and may have implications for assessment and treatment in the clinical setting.
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Dahlbeck DT, Lightsey OR. Generalized Self-Efficacy, Coping, and Self-Esteem as Predictors of Psychological Adjustment Among Children With Disabilities or Chronic Illnesses. CHILDRENS HEALTH CARE 2008. [DOI: 10.1080/02739610802437509] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Keenan K, Hipwell AE, Hinze AE, Babinski DE. The association of pain and depression in preadolescent girls: moderation by race and pubertal stage. J Pediatr Psychol 2008; 34:727-37. [PMID: 18948381 DOI: 10.1093/jpepsy/jsn111] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To test whether an association between pain response and depression in females is present during preadolescence using a controlled pain stimulus and a clinically relevant assessment of depressive symptoms. METHOD In a sample of 232 girls, pain threshold and tolerance were assessed at age 10 years using the cold pressor task, and a diagnostic interview was used to assess depression symptoms at 10 and 11 years of age. RESULTS Response to pain at age 10 was associated with depressive symptoms at ages 10 and 11; race and pubertal stage moderated the association. Pain response and depression were more strongly associated among girls who had reached advanced stages of pubertal development and among European American girls. CONCLUSIONS The results add to the existing literature on the co-occurrence of depression and pain by demonstrating modest but consistent concurrent and prospective associations between response to pain and depression among girls during preadolescence.
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Affiliation(s)
- Kate Keenan
- Department of Psychiatry, University of Chicago, Chicago, IL 60637, USA.
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35
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Trapanotto M, Pozziani G, Perissinotto E, Barbieri S, Zacchello F, Benini F. The Cold Pressor Test for the Pediatric Population: Refinement of Procedures, Development of Norms, and Study of Psychological Variables. J Pediatr Psychol 2008; 34:749-59. [DOI: 10.1093/jpepsy/jsn107] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dahlquist LM, Weiss KE, Clendaniel LD, Law EF, Ackerman CS, McKenna KD. Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children. J Pediatr Psychol 2008; 34:574-84. [PMID: 18367495 DOI: 10.1093/jpepsy/jsn023] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To test whether a head-mounted display helmet enhances the effectiveness of videogame distraction for children experiencing cold pressor pain. METHOD Forty-one children, aged 6-14 years, underwent one or two baseline cold pressor trials followed by two distraction trials in which they played the same videogame with and without the helmet in counterbalanced order. Pain threshold (elapsed time until the child reported pain) and pain tolerance (total time the child kept the hand submerged in the cold water) were measured for each cold pressor trial. RESULTS Both distraction conditions resulted in improved pain tolerance relative to baseline. Older children appeared to experience additional benefits from using the helmet, whereas younger children benefited equally from both conditions. The findings suggest that virtual reality technology can enhance the effects of distraction for some children. Research is needed to identify the characteristics of children for whom this technology is best suited.
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Affiliation(s)
- Lynnda M Dahlquist
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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Lu Q, Tsao JCI, Myers CD, Kim SC, Zeltzer LK. Coping predictors of children's laboratory-induced pain tolerance, intensity, and unpleasantness. THE JOURNAL OF PAIN 2007; 8:708-17. [PMID: 17611165 DOI: 10.1016/j.jpain.2007.04.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Revised: 03/23/2007] [Accepted: 04/30/2007] [Indexed: 11/17/2022]
Abstract
UNLABELLED This study examined coping predictors of laboratory-induced pain tolerance, intensity, and unpleasantness among 244 healthy children and adolescents (50.8% female; mean age, 12.73 +/- 2.98 years; range, 8-18 years). Participants were exposed to separate 4-trial blocks of pressure and thermal (heat) pain stimuli, as well as 1 trial of cold pain stimuli. Strategies for coping with pain were measured using the Pain Coping Questionnaire (PCQ). Linear regression analyses were conducted to examine the associations between the 8 PCQ subscales and pain responses (pain tolerance, intensity, and unpleasantness) to all 3 pain tasks, controlling for age and sex. We found that internalizing/catastrophizing predicted higher pain intensity across the 3 pain tasks and higher cold pain unpleasantness; seeking emotional support predicted lower pressure pain tolerance; positive self-statements predicted lower pressure pain intensity and lower cold pain intensity and unpleasantness; and behavioral distraction predicted higher pressure pain tolerance and lower heat pain unpleasantness. These results suggest that in healthy children, internalizing/catastrophizing, and seeking emotional support may be conceptualized as pain-prone coping strategies, and positive self-statements and behavioral distraction as pain-resistant coping strategies within the context of laboratory pain. PERSPECTIVE These results support investigation of interventions with children that aim to reduce acute pain responses by modifying coping to reduce seeking of emotional support and catastrophizing and enhance the use of positive self statements and behavioral distraction.
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Affiliation(s)
- Qian Lu
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90024, USA.
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Abstract
The purpose of this study was to assess sleep, daytime sleepiness, and behavior problems in children suffering from headaches and in controls, with a special focus on the role of gender. A clinical group of 28 children with persistent headache complaints and a control group of 108 healthy children were included. Sleep was assessed by actigraphy and diaries. Behavior problems were assessed by parental reports. In comparison with the control group, the sleep quality of the clinical group was poorer and they complained more about excessive daytime sleepiness. Children suffering from headache showed higher levels of internalizing behavior problems. Gender was found to be a moderating factor for the relationships between headache and sleep. Compared with control girls, girls suffering from headaches had poorer sleep quality, whereas the opposite was true for the boys. The results highlight the importance of assessing sleep, daytime sleepiness, and psychologic adjustment in children complaining about headaches as an integral part of their routine assessment.
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Keogh E, Eccleston C. Sex differences in adolescent chronic pain and pain-related coping. Pain 2006; 123:275-284. [PMID: 16644131 DOI: 10.1016/j.pain.2006.03.004] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Revised: 03/01/2006] [Accepted: 03/06/2006] [Indexed: 10/24/2022]
Abstract
Sex differences exist in pain and the strategies used to cope with pain. Although it is has been proposed that such differences become apparent around puberty, somewhat surprisingly very little research has specifically investigated sex as a moderator of pain within adolescents. The primary aim of the current study was to investigate sex differences in pain and coping within a group of 46 male and 115 female adolescent chronic pain sufferers. All were aged between 11 and 19 years and had been referred to the Pain Management Unit at the Royal National Hospital for Rheumatic Diseases, United Kingdom. Patients completed a battery of measures including pain experiences and a pain coping questionnaire. No sex differences were found in pain chronicity, although males and females did differ in self-reported pain experiences (females reported higher pain). Sex differences were also found in coping behaviours. Females used more social support, positive statements and internalizing/catastrophizing, whereas males reported engaging in more behavioural distraction. Of these strategies internalizing/catastrophizing was found to mediate the relationship between sex and pain. This suggests that not only do sex differences exist in the pain experiences and pain-coping strategies of adolescents with chronic pain, but that internalizing/catastrophizing may be an important mechanism in understanding such differences. More research examining potential sex differences in children and adolescents is recommended.
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Affiliation(s)
- Edmund Keogh
- Pain Management Unit, Department of Psychology, University of Bath, Bath BA2 7AY, UK Royal National Hospital for Rheumatic Diseases, NHS Trust, Bath, UK
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Bursch B, Tsao JCI, Meldrum M, Zeltzer LK. Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions). Pain 2006; 125:35-42. [PMID: 16740360 PMCID: PMC2394279 DOI: 10.1016/j.pain.2006.04.026] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2005] [Revised: 03/15/2006] [Accepted: 04/10/2006] [Indexed: 11/18/2022]
Abstract
Despite frequent targeting of health beliefs in pediatric chronic pain treatment interventions, there are currently no reliable and valid self-efficacy measures for children with chronic pain and their parents. The current study examined the psychometric properties of parent and child versions of a self-efficacy measure related to the child functioning normally when in pain. Pediatric pain patients, 9-18 years of age, and a caregiver completed questionnaires before an initial tertiary care clinic appointment. The 67 patients in our sample had an average of 1.7 pain locations, including abdominal pain (43.3%), headaches (50.7%), body pain (25.4%), back pain (23.9%), limb pain (20.9%), and/or chest pain (9.0%). Reliability for the new measures was excellent; the Cronbach's alpha was .89 for the 7 child items and .90 for the 7 parent items. Strong evidence for construct validity was also obtained as 23 of the 27 hypothesized correlations were confirmed. As predicted, parent and child ratings of increased self-efficacy for the child functioning normally when in pain were significantly correlated with each other, and to parent reports of fewer problems functioning due to physical or emotional problems; parent reports of fewer somatic, behavioral or emotional symptoms; parent reports of increased self-esteem, and unrelated to child pain, age and gender. Additionally, child ratings of increased self-efficacy were significantly correlated with child reports of increased self-esteem and fewer somatic symptoms. Replication with a larger sample size, more complex modeling, and prospective studies are indicated.
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Affiliation(s)
- Brenda Bursch
- Department of Psychiatry and Biobehavioral Sciences, Division of Child Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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McCarthy AM, Kleiber C. A conceptual model of factors influencing children's responses to a painful procedure when parents are distraction coaches. J Pediatr Nurs 2006; 21:88-98. [PMID: 16545669 DOI: 10.1016/j.pedn.2005.06.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this article is to present a model of factors that may influence a child's response to a painful procedure when parents are distraction coaches during the procedure. Nonpharmacological interventions, in particular, distraction, and parents as coaches for their children during procedures are discussed. A conceptual model is presented that illustrates the multiple factors and their possible relationships. A selected review of studies is provided that supports the inclusion of these factors in the model. The model and literature review focus on three major areas: characteristics of the child, characteristics of the parent, and procedural variables. The model presented is currently being tested in a large multisite study on the use of distraction during intravenous line insertion.
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Lu Q, Zeltzer LK, Tsao JCI, Kim SC, Turk N, Naliboff BD. Heart rate mediation of sex differences in pain tolerance in children. Pain 2005; 118:185-93. [PMID: 16213093 DOI: 10.1016/j.pain.2005.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2005] [Revised: 06/16/2005] [Accepted: 08/08/2005] [Indexed: 11/15/2022]
Abstract
Despite evidence supporting the existence of important sex-related differences in pain, the mechanisms underpinning such differences are not well understood. The aim of this study is to examine the relationship between sex and pubertal differences in autonomic arousal and pain tolerance to laboratory pain stimuli in healthy children. We tested the following specific hypotheses: (1) females would have greater autonomic arousal and less pain tolerance than males, and (2) this sex difference in pain tolerance would be mediated by autonomic arousal. Participants were 244 healthy children (50.8% female, mean age 12.73+/-2.98 years, range 8-18 years). Separate 4-trial blocks of cutaneous pressure and thermal pain stimuli were presented in counterbalanced order. Heart rate (HR) was recorded during 2-3 min periods preceding each block and a 1-min period between trials. Results indicated lower tolerance in females for cutaneous pressure, but not thermal pain, compared to males. In addition, pre-trial HR was greater for females than males. Mediation analyses suggested that sex differences in pressure pain tolerance were accounted for by sex differences in pre-trial HR. There were also significant effects for puberty, but these did not vary by sex. Overall, early pubertal children had greater pre-trial HR and less pain tolerance than those in late puberty for both cutaneous pressure and thermal pain across sex. These results suggest that autonomic arousal may be a mediator of sex-related differences in pain responses in children.
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Affiliation(s)
- Qian Lu
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, and Veterans Administration Greater Los Angeles Healthcare System, Bldg. 115, Rm. 223, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
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Vervoort T, Goubert L, Eccleston C, Bijttebier P, Crombez G. Catastrophic thinking about pain is independently associated with pain severity, disability, and somatic complaints in school children and children with chronic pain. J Pediatr Psychol 2005; 31:674-83. [PMID: 16093515 DOI: 10.1093/jpepsy/jsj059] [Citation(s) in RCA: 165] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate the value of pain catastrophizing in explaining pain, disability, and somatic complaints, beyond negative affectivity (NA). METHOD Two cross-sectional studies, one in a sample of school children (n = 193) and a second in a clinical sample of children with recurrent or chronic pain (n = 43), were conducted. In both studies, measures of pain catastrophizing and NA were examined for their ability to explain pain, disability, and somatic complaints. RESULTS In both studies, pain catastrophizing significantly accounted for the variance of pain, disability, and somatic complaints, beyond the effects of age, sex, and NA. Furthermore, pain catastrophizing significantly mediated the relationship between NA and somatic complaints in both studies and between NA and functional disability in study 1. CONCLUSIONS Results suggest the importance of assessing for pain catastrophizing in children. Pain catastrophizing is further discussed in terms of communicating distress to significant others.
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Affiliation(s)
- Tine Vervoort
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000, Ghent, Belgium.
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Reid GJ, McGrath PJ, Lang BA. Parent-child interactions among children with juvenile fibromyalgia, arthritis, and healthy controls. Pain 2005; 113:201-10. [PMID: 15621381 DOI: 10.1016/j.pain.2004.10.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2004] [Revised: 10/08/2004] [Accepted: 10/18/2004] [Indexed: 11/25/2022]
Abstract
Parent-child interactions during pain-inducing exercise tasks among children (11-17 years old) with fibromyalgia, juvenile rheumatoid arthritis, and pain-free controls were examined and the contribution of parent-child interactions to disability was tested. Fifteen children in each of the three diagnostic groups and their parents completed 5-min exercise tasks and completed questionnaire measures of disability (Functional Disability Inventory) and coping (Pain Coping Questionnaire). There were few group differences in parent-child interactions. After controlling for children's ratings of pain evoked by the exercise, group differences in interactions during exercise tasks were no longer significant. Sequential analyses, controlling for group and exercise task, revealed that when parents made statements discouraging coping following children's negative verbalizations about the task or pain, children were less likely to be on task, compared to when parents made statements encouraging coping or when parents made any other statements. Children's general pain coping strategies were not related to parent-child interactions. Parent-child interactions were generally not related to disability. Across the groups, more pain and less time on task during the exercises were related to Functional Disability Inventory scores and more school absences. Parent-child interaction patterns influence children's adaptation to pain during experimental tasks. Parents' discouragement of coping in response to their children's negative statements related to the pain or the pain-evoking task are counter productive to children's ability to maintain activity in a mildly painful situation.
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Affiliation(s)
- Graham J Reid
- Psychology, IWK Health Centre and Dalhousie University, Halifax, NS, Canada.
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Logan DE, Rose JB. Gender differences in post-operative pain and patient controlled analgesia use among adolescent surgical patients. Pain 2004; 109:481-487. [PMID: 15157709 DOI: 10.1016/j.pain.2004.02.026] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2003] [Revised: 02/12/2004] [Accepted: 02/23/2004] [Indexed: 10/26/2022]
Abstract
The aim of this study was to explore gender differences in anticipatory emotional distress, coping strategies, post-operative pain perception, and patient-controlled analgesia (PCA) use among adolescent surgical patients. One hundred and two 12-18-year-old adolescents undergoing surgeries with overnight hospital stay were recruited. Participants completed pre-operative measures of anxiety and anticipated pain. Post-operatively, they reported on coping skills, post-operative anxiety, and pain. Data on PCA use were recorded from medical records. Girls reported higher levels of pre-operative state anxiety and anticipated more pain. After surgery, girls and boys differed on their lowest daily pain ratings and average daily pain ratings, with girls reporting more pain in both cases. Reports of highest daily pain were similar across genders. Gender was found to moderate the relationship between anticipatory distress and post-operative pain, such that higher anticipatory distress before surgery predicted more post-operative pain for girls, but not for boys. Patterns of PCA use did not vary by gender on post-operative days 0 or 1. Findings suggest that adolescent boys' and girls' pain experiences are different in several important respects, although somewhat less divergent than has been reported in samples of adult males and females. Results have implications for the development of targeted intervention strategies to help adolescents cope effectively with acute post-operative pain.
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Affiliation(s)
- Deirdre E Logan
- The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Abstract
This review discusses the recent literature on pain conditions in children that should be of interest to rheumatologists. The focus of the review is therefore on musculoskeletal pains in children, particularly chronic or recurrent musculoskeletal pain. Articles that have a broader focus on pain are discussed when these are likely to be of general interest to rheumatologists. Chronic or recurrent pain in childhood is common and can be caused by a wide variety of conditions, several of which are discussed here. The importance of being able to measure pain in children has been emphasized repeatedly in the recent literature. With increased understanding of how to evaluate pain in children has come the recognition that pain in children is multifactorial and that even when there are obvious "organic" causes of the pain (such as arthritis), psychosocial factors are critical in how pain is perceived, and they influence the extent to which pain leads to dysfunction. There is also increasing evidence that cognitive-behavioral therapies are effective in managing chronic pain in children. The frequency of back pain in children is increasingly recognized, and the role of children's work and play, carrying heavy backpacks, and sitting for long periods of time at computers in causing back pain is of interest. The studies reviewed here add to an increasingly rich and informative literature on musculoskeletal and other chronic pain in children, and they help emphasize the importance of proper evaluation and management of pain in children.
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Affiliation(s)
- Pete Malleson
- Division of Pediatric Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada.
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