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Impact of Threat Level, Task Instruction, and Individual Characteristics on Cold Pressor Pain and Fear among Children and Their Parents.
Pain Pract. 2016 07; 16(6):657-68.PP

Abstract

The cold pressor task (CPT) is increasingly used to induce experimental pain in children, but the specific methodology of the CPT is quite variable across pediatric studies. This study examined how subtle variations in CPT methodology (eg. provision of low- or high-threat information regarding the task; provision or omission of maximum immersion time) may influence children's and parents' perceptions of the pain experience. Forty-eight children (8 to 14 years) and their parents were randomly assigned to receive information about the CPT that varied on 2 dimensions, prior to completing the task: (i) threat level: high-threat (task described as very painful, high pain expressions depicted) or low-threat (standard CPT instructions provided, low pain expressions depicted); (ii) ceiling: informed (provided maximum immersion time) or uninformed (information about maximum immersion time omitted). Parents and children in the high-threat condition expected greater child pain, and these children reported higher perceived threat of pain and state pain catastrophizing. For children in the low-threat condition, an informed ceiling was associated with less state pain catastrophizing during the CPT. Pain intensity, tolerance, and fear during the CPT did not differ by experimental group, but were predicted by child characteristics. Findings suggest that provision of threatening information may impact anticipatory outcomes, but experienced pain was better explained by individual child variables.

Authors+Show Affiliations

Departments of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada. Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada.Center for Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, Washington, U.S.A.Departments of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada. Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada.Department of Psychology and Centre for Pain Research, National University of Ireland, Galway, Ireland.Victoria Hospital, London Health Sciences Centre, London, Ontario, Canada.Departments of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada. Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada. Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26011606

Citation

Boerner, Katelynn E., et al. "Impact of Threat Level, Task Instruction, and Individual Characteristics On Cold Pressor Pain and Fear Among Children and Their Parents." Pain Practice : the Official Journal of World Institute of Pain, vol. 16, no. 6, 2016, pp. 657-68.
Boerner KE, Noel M, Birnie KA, et al. Impact of Threat Level, Task Instruction, and Individual Characteristics on Cold Pressor Pain and Fear among Children and Their Parents. Pain Pract. 2016;16(6):657-68.
Boerner, K. E., Noel, M., Birnie, K. A., Caes, L., Petter, M., & Chambers, C. T. (2016). Impact of Threat Level, Task Instruction, and Individual Characteristics on Cold Pressor Pain and Fear among Children and Their Parents. Pain Practice : the Official Journal of World Institute of Pain, 16(6), 657-68. https://doi.org/10.1111/papr.12306
Boerner KE, et al. Impact of Threat Level, Task Instruction, and Individual Characteristics On Cold Pressor Pain and Fear Among Children and Their Parents. Pain Pract. 2016;16(6):657-68. PubMed PMID: 26011606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Threat Level, Task Instruction, and Individual Characteristics on Cold Pressor Pain and Fear among Children and Their Parents. AU - Boerner,Katelynn E, AU - Noel,Melanie, AU - Birnie,Kathryn A, AU - Caes,Line, AU - Petter,Mark, AU - Chambers,Christine T, Y1 - 2015/05/26/ PY - 2015/01/08/received PY - 2015/02/10/accepted PY - 2015/5/27/entrez PY - 2015/5/27/pubmed PY - 2017/2/15/medline KW - children KW - cold pressor task KW - experimental methods KW - fear KW - parents KW - pediatric pain KW - threat SP - 657 EP - 68 JF - Pain practice : the official journal of World Institute of Pain JO - Pain Pract VL - 16 IS - 6 N2 - The cold pressor task (CPT) is increasingly used to induce experimental pain in children, but the specific methodology of the CPT is quite variable across pediatric studies. This study examined how subtle variations in CPT methodology (eg. provision of low- or high-threat information regarding the task; provision or omission of maximum immersion time) may influence children's and parents' perceptions of the pain experience. Forty-eight children (8 to 14 years) and their parents were randomly assigned to receive information about the CPT that varied on 2 dimensions, prior to completing the task: (i) threat level: high-threat (task described as very painful, high pain expressions depicted) or low-threat (standard CPT instructions provided, low pain expressions depicted); (ii) ceiling: informed (provided maximum immersion time) or uninformed (information about maximum immersion time omitted). Parents and children in the high-threat condition expected greater child pain, and these children reported higher perceived threat of pain and state pain catastrophizing. For children in the low-threat condition, an informed ceiling was associated with less state pain catastrophizing during the CPT. Pain intensity, tolerance, and fear during the CPT did not differ by experimental group, but were predicted by child characteristics. Findings suggest that provision of threatening information may impact anticipatory outcomes, but experienced pain was better explained by individual child variables. SN - 1533-2500 UR - https://www.unboundmedicine.com/medline/citation/26011606/Impact_of_Threat_Level_Task_Instruction_and_Individual_Characteristics_on_Cold_Pressor_Pain_and_Fear_among_Children_and_Their_Parents_ L2 - https://doi.org/10.1111/papr.12306 DB - PRIME DP - Unbound Medicine ER -