Dyadic analysis of siblings' relationship quality, behavioural responses, and pain experiences during experimental pain.

Research on family factors in paediatric pain has primarily focused on parents; the role of siblings has been largely ignored. This study examined whether sibling relationship quality was related to siblings' behaviours during experimental pain, and whether the behaviours of an observing sibling were related to children's pain outcomes. Ninety-two sibling dyads between 8 and 12 years old completed both observational and questionnaire measures of sibling relationship quality. Children took turns completing the cold-pressor task (CPT) in a counterbalanced order with their sibling present. Pain outcomes (intensity, fear, and tolerance) were recorded for each sibling, and the behaviour of the observing and participating siblings during the CPT were coded as attending, nonattending, and coping/encouragement. Structural equation modelling, using the actor-partner interdependence model, was conducted to analyse the dyadic data. While participating in the CPT with their sibling present, greater levels of warmth and positivity in the sibling relationship were related to children engaging in more nonattending behaviours and less attending behaviours. Greater levels of attending behaviours by the observing child was related to the sibling having a lower pain tolerance, and greater levels of coping/encouragement behaviours by the observing child was related to the sibling reporting greater pain intensity and fear during the CPT. Children with warmer/positive sibling relationships were more likely to respond to acute pain by shifting the focus away from their pain experience (eg, through distraction) when a sibling was present. Pain-focused behaviours by an observing sibling are related to greater child pain and fear during experimental pain.

Adult judgments of children's pain and fear during venipuncture: The impact of adult and child sex.

BACKGROUND: Low levels of agreement between caregiver and child reports of acute pain are well documented. AIMS: This study builds on prior research through exploring factors that may contribute to low caregiver-child concordance. Specifically, the study examined the influence of adult and child sex on adult judgments of children's pain and fear during venipuncture and examined whether trait parental pain catastrophizing, empathy, and anxiety predicted judgment accuracy. METHODS: Using a judgment study paradigm, 160 participants (82 women) viewed 20 10-s video clips of children (10 boys, 10 girls) undergoing venipuncture and rated each child's pain and fear. Adults' ratings were compared to the children's own ratings. Adults completed measures of trait parental pain catastrophizing, dispositional empathy, and trait anxiety. RESULTS: Adults accurately judged boys' pain and fear significantly more often than that of girls. Further, adults underestimated and overestimated girls' pain and overestimated girls' fear significantly more frequently than that of boys. No effects of adult sex or adult by child sex interactions emerged. Parental pain catastrophizing significantly predicted underestimation of girls' pain, with adults who engaged in more catastrophizing being less likely to underestimate girls' pain. The variables did not predict adult judgment of child pain for women and men separately and did not predict adult judgment of child fear when examined by adult sex, child sex, or both combined. CONCLUSIONS: Child sex influences adult pain and fear judgments, with girls being more vulnerable to inaccurate assessment than boys. Higher levels of parental pain catastrophizing may buffer against adults' propensities to underestimate girls' pain.

Contexte: Le faible niveau de concordance entre la douleur aiguë rapportée par le prestataire de soins et celle rapportée par l'enfant est bien documentée.But: Cette étude s'appuie sur des études antérieures pour examiner les facteurs qui peuvent contribuer à la faible concordance prestataire de soins-enfant. Plus particulièrement, cette étude portait sur l'influence du sexe de l'adulte et celui de l'enfant sur les jugements que portent les adultes sur la douleur et la peur de l'enfant pendant une ponction veineuse et examine si la catastrophisation de la douleur par le parent, l'empathie et l'anxiété prédisaient l'exactitude de ces jugements.Méthodes: À l'aide d'un paradigme pour l'étude des jugements, 160 participants (82 femmes) ont visionné 20 clips vidéo de 10 secondes présentant des enfants (10 garçons, 10 filles) au moment d'une ponction veineuse, et ont attribué une note à la douleur et à la peur ressentie par l'enfant. Les notes attribuées par les adultes ont été comparées à celels attribuées par les enfants eux-mêmes. Les adultes se sont soumis à la mesure de la catastrophisation de la douleur en tant que trait parental, de leur tendance à l'empathie et de l'anxiété chronique.Résultats: La adultes ont jugé avec exactitude la douleur et la peur ressenties par les garçons significativement plus souvent que celles ressenties par les filles. De plus, les adultes ont sous-estimé et surestimé la douleur des filles, et surestimé la peur des filles significativment plus fréquemment que celle des garçons.. Aucun effet du sexe de l'adulte ni aucune interaction entre le sexe de l'adulte et celui de l'enfant n'a été observé. La catrastrophisation de la douleur par le parent prédisait significativement la sous-estimation de la douleur ressentie par les filles, alors que les adultes qui catastrophisaient davantage étaient moins susceptibles de sous-estimer la douleur des filles. Les variables ne prédisaient pas le jugement de la douleur des enfants par les adultes pour les femmes et les hommes séparément, et ne prédisaient pas le jugement de la peur de l'enfant par les adultes lorsqu'examiné par sexe de l'adulte, sexe de l'enfant ou une combinaison des deux.Conclusions: Le sexe de l'enfant influence le jugement de l'adulte sur la peur et la douleur, les filles étant plus vulnérables aux jugements inexacts que les garçons. Des niveaux plus élevés de catastrophisation de la douleur par le parent pourraient amortir la propension des adultes à sous-estimer la douleur ressentie par les filles.

Affiliation affects generosity in young children: The roles of minimal group membership and shared interests.

Young children's willingness to share with others is selective, and is affected by their level of affiliation with the recipients of their generosity. We explored affiliation's impact on sharing behavior with two experiments comparing the effects of two distinct affiliative cues-minimal group membership and shared interests. Children (4- to 6-year-olds) completed a resource allocation task, making forced-choice decisions as to how to distribute stickers between themselves and others. In Experiment 1, the sharing partners were minimal in- and out-group members; in Experiment 2, they differed in their opinion of the participants' interests. Both experiments' manipulations affected feelings of affiliation, as indicated by children's stated friendship preferences and perceptions of similarity. More notably, both minimal group membership and interests affected sharing behavior. Children made fewer generous allocations toward out-group members than toward in-group members. Similarly, children made fewer generous allocations when recipients disliked their interests than when recipients shared those interests or when their opinions were unknown. Across experiments, the recipient manipulations' effects on generosity were similar in their pattern and magnitude despite fundamental differences between the two affiliative cues. These findings highlight the broad impact of affiliation on young children's sharing behavior.

A Comparison of Maternal versus Paternal Nonverbal Behavior During Child Pain.

Parental behavior plays a significant role in children's pain response. Prior research has found generally no differences between mothers' and fathers' verbal behavior during child pain. This study compared mothers' and fathers' nonverbal behavior during child pain. Nonverbal behavior of mothers (n = 39) and fathers (n = 39) of 39 children (20 boys) aged 8 to 12 years who participated in the cold pressor task (counterbalanced once with each parent) was coded. A range of nonverbal behaviors were coded, including distraction, physical proximity, physical comfort/reassurance, procedure-related attending behavior, and fidgeting. The most common behaviors parents engaged in were fidgeting, procedure-related attending behaviors, and physical proximity. Results indicated that the types of nonverbal behavior parents engage in did not differ between mothers and fathers. However, children of mothers who engaged in more physical comfort/reassurance reported higher levels of pain intensity, and children of mothers who engaged in more procedure-related attending behaviors had lower pain tolerance. Further, both mothers and fathers who engaged in higher levels of verbal nonattending behaviors also engaged in lower levels of nonverbal procedure-related attending behaviors. These findings further support the importance of considering the influence of mothers and fathers in children's pain, and provide novel insights into the role of nonverbal behavior.

A scoping review on the study of siblings in pediatric pain.

Background: Sibling relationships are longstanding across an individual's life and are influential in children's development. The study of siblings in pediatric pain is, although in early stages, a growing field. Aims: This scoping review sought to summarize and map the type of research available examining siblings and pediatric pain to identify gaps and directions for future research. Methods: Studies were identified based on a search of PubMed, CINAHL, PsycInfo, Embase, and Web of Science (up to November 2016). We extracted data about study methods, the sample, outcome assessment, and the influence/relationships investigated. Results: Thirty-five studies were included. Most studies used quantitative methods (n = 28), and participants typically included children (i.e., aged 6-12; n = 24) and adolescents (i.e., aged 13-18; n = 18). The majority of studies examined siblings in the context of chronic and disease-related pain (n = 30). Though quantitative studies primarily focused on the genetic influence of pain conditions (n = 18), qualitative and mixed-methods studies typically focused on exploring the impact of siblings with and without pain on one another (n = 2) and the impact of pain on the broader dyadic relationship/functioning (n = 4). Conclusions: Sibling research in pediatric pain has been primarily focused on the biological/physical components of pain, using quantitative approaches. Conducting more studies using qualitative or mixed-methods designs, incorporating multiple assessment measures (e.g., observational, self-report) and multiple perspectives (e.g., siblings, health professionals), may provide an opportunity to gain richer and more comprehensive information regarding the experience of siblings.

Contexte: Les relations entre membres d'une même fratrie durent toute la vie et influencent le développement des enfants. Bien qu'elle soit encore à ses débuts, l'étude des fratries dans le domaine de la douleur pédiatrique est un domaine en pleine croissance.But: Cette revue exploratoire avait pour but de cartographier et de résumer le type d'études sur les fratries et la douleur pédiatrique actuellement disponibles, afin de répertorier les lacunes existantes et définir les orientations possibles pour les études à venir.Méthodes: Les études ont été répertoriées par le truchement d'une recherche sur PubMed, CINAHL, PsycInfo, Embase et Web of Science (jusqu'en novembre 2016). Nous en avons tiré des données sur les méthodes, l'échantillon, l'évaluation des résultats et l'influence ou les relations à l'étude.Résultats: Trente-cinq études ont été retenues. La majorité de ces études utilisaient des méthodes quantitatives (n = 28) et les participants étaient généralement des enfants (i.e. âgés de 6 à 12 ans; n = 24) et des adolescents (i.e. âgés de 14 à 18 ans; n = 18). La plupart de ces études portaient sur les frères et soeurs dans le contexte de la douleur chronique liée à une maladie (n = 30). Tandis que les études quantitatives portaient généralement sur la dimension génétique de la douleur, (n = 18), les études qualitatives et les études mixtes portaient généralement sur l'effet des frères et sœurs avec douleur et sans douleur l'un sur l'autre (n = 2) ainsi que sur l'effet de la douleur sur la relation au sein d'une dyade ou le fonctionnement de celle-ci (n = 4).Conclusions: La recherche sur les fratries dans le domaine de la douleur pédiatrique met surtout l'accent sur les composantes biologiques/physiques de la douleur, à l'aide d'approches quantitatives. La conduite d'études ayant recours à des devis qualitatifs ou mixtes et intégrant de multiples mesures d'évaluation (i.e. observationnelles, auto-rapportées) et de multiples perspectives (ex. : membres d'une même fratrie, professionnels de la santé) pourrait être une occasion d'obtenir de l'information plus riche et plus exhaustive en ce qui concerne l'expérience des fratries.