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The impact of maternal behaviour on children's pain experiences : subtitle an experimental analysis Chambers, Christine Therese

Abstract

Pain is a common experience for children, but there can be tremendous variability in pain expression from one child to another. Clinical lore and psychological theory have highlighted the important role parents may play in socializing children's pain behaviours. For example, certain parental behaviours (e.g., reassurance, criticism) have been linked with increases in child distress, while other behaviours (e.g., humour, suggestions on how to cope) have been linked with decreases in child distress. To date, however, the majority of research examining the relationship between parental behaviours and children's pain experiences has been correlational and conclusions regarding causality have been limited. The purpose of the present study was to provide an experimental investigation of the impact of maternal behaviour on children's pain experiences. Participants were 120 children (60 boys, 60 girls) between the ages of 8 and 12 years and their mothers who were recruited from the community. Mothers were trained to interact with their children in one of three randomly assigned ways during a lab-induced cold pressor pain paradigm: 1) a pain-promoting interaction, consisting of reassurance, empathy, apologies, giving control to the child, and criticism; 2) a pain-reducing interaction, consisting o f non-procedural talk, humour, and suggestions on how to cope; or 3) a no training control group. The content of the maternal training conditions was based on the previous correlational literature indicating links between certain kinds of parental behaviours and child distress. Children's pain experiences were assessed using self-report measures of intensity and affect, behavioural coding of facial expressivity, pain tolerance, and heart rate responsiveness during the cold pressor. Results indicated that maternal interaction type had the expected effects on girls' self-reported ratings of pain intensity; when controlling for the effects of age, girls whose mothers had interacted with them in the pain-promoting manner reported more pain than girls whose mothers were in the control group, who in turn reported more pain than girls whose mothers had interacted with them in the pain-reducing manner. This effect was not significant for boys. Maternal interaction type had no effect on children's facial expressivity, ratings of pain affect, pain tolerance, or heart rate responsiveness during the cold pressor. Age was significantly related to children's ratings on the self-report measures; younger children reported lower levels of pain intensity and affect than older children. There were no gender differences on the majority of the pain measures, with the exception of facial expressivity, where boys evidenced higher scores than girls. These results indicate that maternal behaviour can have a direct impact on girls' subjective reports of pain and provide evidence of the importance of social learning factors in influencing children's pain experiences. Future research is needed to extend this research to samples of children experiencing chronic pain, as well as explore the possible role of child characteristics (e.g., coping skills) as moderators of maternal interaction effects.

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