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Sex differences in response to experimental pain are commonly reported in systematic reviews in the adult literature. The objective of the present research was to conduct a systematic review and meta-analysis of sex differences in healthy children's responses to experimental pain (e.g., cold pressor, heat pain, pressure pain) and, where possible, to conduct analyses separately for children and adolescents. A search was conducted of electronic databases for published papers in English of empirical research using experimental pain tasks to examine pain-related outcomes in healthy boys and girls between 0 and 18 years of age. Eighty articles were eligible for inclusion and were coded to extract information relevant to sex differences. The systematic review indicated that, across different experimental pain tasks, the majority of studies reported no significant differences between boys and girls on painrelated outcomes. However, the meta-analysis of available combined data found that girls reported significantly higher pain intensity compared to boys in studies where the mean age of participants was greater than 12 years. Additionally, a meta-analysis of heat pain found that boys had significiantly higher tolerance than girls overall, and boys had significantly higher heat pain threshold than girls in studies where the mean age of participants was 12 years or younger. These findings suggest that developmental stage may be relevant for understanding sex differences in pain . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 SEX DIFFERENCES IN EXPERIMENTAL PAIN IN CHILDREN AbstractSex differences in response to experimental pain are commonly reported in systematic reviews in the adult literature. The objective of the present research was to conduct a systematic review and meta-analysis of sex differences in healthy children's responses to experimental pain (e.g., cold pressor, heat pain, pressure pain) and, where possible, to conduct analyses separately for children and adolescents. A search was conducted of electronic databases for published papers in English of empirical research using experimental pain tasks to examine pain-related outcomes in healthy boys and girls between 0 and 18 years of age. Eighty articles were eligible for inclusion and were coded to extract information relevant to sex differences. The systematic review indicated that, across different experimental pain tasks, the majority of studies reported no significant differences between boys and girls on pain-related outcomes. However, the meta-analysis of available combined data found that girls reported significantly higher pain intensity compared to boys in studies where the mean age of participants was greater than 12 years. Additionally, a meta-analysis of heat pain found that boys had significiantly higher tolerance than girls overall, and...

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2 SUMMARYUsing categorical and bibliometric meta-trend analysis methods, this article provides a comprehensive overview of published peer-reviewed research articles on pediatric pain from 1975-2010. ABSTRACTThe field of pediatric pain research began in the mid-1970's and has undergone significant growth and development in recent years as evidenced by the variety of books, conferences, and journals on the topic as well as the number of disciplines engaged in work in this area.Using categorical and bibliometric meta-trend analysis, the current study offers a synthesis of research on pediatric pain published between 1975 and 2010 in peer-reviewed journals.Abstracts from 4256 articles, retrieved from Web of Science, were coded across four categories: article type, article topic, type and age of participants, and pain stimulus. The affiliation of the first author and number of citations were also gathered. The results suggest a significant increase in the number of publications over the time period investigated, with 96% of the included articles published since 1990 and most research being multi-authored publications in pain-focused journals. First authors were most often from the United States, and affiliated with a medical department. The majority of studies were original research articles; the most frequent topics were pain characterization (39.86%), pain intervention (37.49%), and pain assessment (25.00%). Clinical samples were most frequent, with participants most often characterized as children (6-12 years) or adolescents (13-18 years) experiencing chronic or acute pain. The findings provide a comprehensive overview of contributions in the field of pediatric pain research over 35 years and offers recommendations for future research in the area.3

Pain catastrophizing has emerged as one of the most robust predictors of child pain outcomes.Although assessments of state (i.e., situation-specific) pain catastrophizing in children and parents are often used, their psychometric properties are unknown. This study aimed to assess factor structure, reliability and predictive validity of state versions of Pain Catastrophizing Scales for children (PCS-C State) and parents (PCS-P State) relative to corresponding trait versions for child and parental pain-related outcomes. Data were pooled from 8 experimental pain studies wherein child and/or parent state catastrophizing (measured immediately before application of a pain stimulus) and trait catastrophizing were assessed in community-based samples of children aged 8-18 years (N=689) and their parents (N=888) in Dutch or English.Exploratory factor analyses were conducted to examine the underlying factor structure of the PCS-P/PCS-C State, revealing a single factor solution that explained 55.53% of the variance for children and 49.72% for parents. Hierarchical linear regression analyses were used to examine relative influence of state versus trait catastrophizing on child and parent painrelated outcomes. Child and parent state catastrophizing were significantly associated with child pain intensity, child state anxiety and parental distress. State catastrophizing scores showed stronger associations than trait scores for most outcomes.Perspective: This article presents the psychometric properties of state pain catastrophizing measures for children and parents. Findings underscore the importance of assessing state pain catastrophizing about acute pain experiences in parents and children, and provide a basis for robust and valid measurement of state pain catastrophizing about child pain.

Behavioral sleep problems are highly prevalent among young and school-aged children. Despite strong evidence for effective interventions, few children receive evidence-based care. In this study, 124 Canadian health professionals answered open-ended questions regarding barriers and facilitators of their provision of evidence-based behavioral sleep-related care, and responses were analyzed for content. Responses represented issues at an individual practice level, as well as broader systemic issues. The most frequently reported barrier and facilitator related to knowledge, training, and education. Other barriers included lack of time and institutional support, and facilitators included supportive sleep attitudes and beliefs. This study may inform the design of education programs for health professionals, and provides support for broader systems-level initiatives targeted at increasing evidence-based practice.

Introduction Provoked vestibulodynia (PVD) is a common vulvovaginal pain condition associated with negative psychological and sexual consequences for affected women and their sexual partners. Greater pain acceptance has been found to be associated with better functional and psychological outcomes in individuals with chronic pain, and acceptance-based strategies are being increasingly incorporated into treatment protocols. The present study is a novel investigation of pain acceptance in PVD couples. Aim The aim was to examine the associations between acceptance of vulvovaginal pain and women's pain during intercourse, as well as the psychological and sexual adjustment of both women with PVD and their partners. Methods Sixty-one couples (Mage for women = 27.95 years, SD = 5.87; Mage for men = 30.48 years, SD = 6.70) in which the woman was diagnosed with PVD completed the Chronic Pain Acceptance Questionnaire, in reference to women's vulvovaginal pain. Women also rated their pain during intercourse, and couples completed measures of anxiety, depression, sexual function, and sexual satisfaction. Main Outcome Measures Dependent measures were (i) women's self-reported pain during intercourse on a numerical rating scale; (ii) State-Trait Anxiety Inventory trait subscale; (iii) Beck Depression Inventory-II; (iv) Derogatis Interview for Sexual Functioning; and (v) Global Measure of Sexual Satisfaction Scale. Results Women's greater pain acceptance was associated with their lower self-reported pain during intercourse, controlling for partner's pain acceptance. Greater pain acceptance among women was associated with their own lower anxiety and depression, greater sexual functioning, as well as their own and their partner's greater sexual satisfaction, controlling for the partner's pain acceptance. Additionally, greater pain acceptance among male partners was associated with their own lower depression. Conclusions Findings suggest that psychological interventions for PVD should target increasing couples' vulvovaginal pain acceptance in order to improve women's pain and the sexual and psychological functioning of both members of the couple.

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