The impact of parental gender, catastrophizing, and situational threat upon parental behaviour to child pain: a vignette study

Background: This study examined which parents report to be solicitous or discouraging in response to their child's pain, and when they do so. Methods: Using a vignette methodology, mothers (n = 472) and fathers (n = 271) imagined their child in pain situations varying in duration (1 day or several weeks) and cause of pain (known or unknown biomedical cause). Results: In general, fathers demonstrated similar tendencies toward solicitousness than mothers, but reported to engage more in discouraging behaviours. In line with expectations, parents who catastrophized about their child's pain reported a higher inclination to engage in solicitous behaviours. Only for fathers, high catastrophizing was also related to a higher report of discouraging behaviours. However, the effects of catastrophizing differed across situations varying in duration and cause of pain. Specifically, the effect of parental catastrophizing upon self-reported solicitous behaviours was particularly strong when imagining their child in pain with unknown biomedical cause. Further, high catastrophizing in fathers only translated in a higher inclination for discouraging responses when imagining their child in pain of short duration. Conclusions: The findings of the current study highlight the importance of parental catastrophizing in explaining parental behavioural tendencies in response to their child in pain. Further, reported behaviours were found to vary across pain situations, attesting to the importance of studying parental behaviour 'in context'

Learning about pain through observation: the role of pain-related fear

Observational learning may contribute to development and maintenance of pain-related beliefs and behaviors. The current study examined whether observation of video primes could impact appraisals of potential back stressing activities, and whether this relationship was moderated by individual differences in pain-related fear. Participants viewed a video prime in which back-stressing activity was associated with pain and injury. Both before and after viewing the prime, participants provided pain and harm ratings of standardized movements drawn from the Photograph of Daily Activities Scale (PHODA). Results indicated that observational learning occurred for participants with high levels of pain-related fear but not for low fear participants. Specifically, following prime exposure, high fear participants showed elevated pain appraisals of activity images whereas low fear participants did not. High fear participants appraised the PHODA-M images as significantly more harmful regardless of prime exposure. The findings highlight individual moderators of observational learning in the context of pain

Child's and parent's catastrophizing about pain is associated with procedural fear in children: a study in children with diabetes and their mothers

The contribution of the child's and parents' catastrophizing about pain was explored in explaining procedural pain and fear in children. Procedural fear and pain were investigated in 44 children with Type I diabetes undergoing a finger prick. The relationships between parents' catastrophizing and parents' own fear and estimates of their child's pain were also investigated. The children and their mothers completed questionnaires prior to a routine consultation with the diabetes physician. Children completed a situation-specific measure of the Pain Catastrophizing Scale for Children (PCS-C) and provided ratings of their experienced pain and fear on a 0-10 numerical rating scale (NRS). Parents completed a situation-specific measure of the Pain Catastrophizing Scale For Parents (PCS-P) and provided estimates of their child's pain and their own experienced fear on a 0-10 NRS. Analyses indicated that higher catastrophizing by children was associated with more fear and pain during the finger prick. Scores for parents' catastrophizing about their children's pain were positively related to parents' scores for their own fear, estimates of their children's pain, and child-reported fear, but not the amount of pain reported by the child. The findings attest to the importance of assessing for and targeting child and parents' catastrophizing about pain. Addressing catastrophizing and related fears and concerns of both parents and children may be necessary to assure appropriate self-management. Further investigation of the mechanisms relating catastrophizing to deleterious outcomes is warranted

Impact of parental catastrophizing and contextual threat on parents' emotional and behavioral responses to their child's pain

Limited research has addressed processes underlying parents' empathic responses to their child's pain. The present study investigated the effects of parental catastrophizing, threatening information about the child's pain, and child pain expression upon parental emotional and behavioral responses to their child's pain. A total of 56 school children participated in a heat pain task consisting of 48 trials while being observed by 1 of their parents. Trials were preceded by a blue or yellow circle, signaling possible pain stimulation (i.e., pain signal) or no pain stimulation (i.e., safety signal). Parents received either neutral or threatening information regarding the heat stimulus. Parents' negative emotional responses when anticipating their child's pain were assessed using psychophysiological measures - i.e., fear-potentiated startle and corrugator EMG activity. Parental behavioral response to their child's pain (i.e., pain attending talk) was assessed during a 3-minute parent-child interaction that followed the pain task. The Child Facial Coding System (CFCS) was used to assess children's facial pain expression during the pain task. Results indicated that receiving threatening information was associated with a stronger parental corrugator EMG activity during pain signals in comparison with safety signals. The same pattern was found for parental fear-potentiated startle reflex, particularly when the child's facial pain expression was high. In addition, parents who reported high levels of catastrophizing thought about their child's pain engaged, in comparison with low-catastrophizing parents, in more pain-attending talk when they received threatening information. The findings are discussed in the context of affective-motivational theories of pain. © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved