Preoperative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgery experience (e.g., agitation, crying, spontaneous urination, and the need for physical restraint during anesthetic induction). Preoperative anxiety has also been associated with the display of a number of maladaptive behaviors postsurgery, including postoperative pain, sleeping disturbances, parent-child conflict, and separation anxiety. For these reasons, researchers have sought out interventions to treat or prevent childhood preoperative anxiety and possibly decrease the development of negative behaviors postsurgery. Such interventions include sedative premedication, parental presence during anesthetic induction, behavioral preparation programs, music therapy, and acupuncture. The present article reviews the existing research on the various modes of intervention for preoperative anxiety in children. Clinical implications and future directions are discussed.

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Although widely used, there have been few investigations of the factorial validity of the short-form McGill Pain Questionnaire (SF-MPQ; Melzack, 1987). Confirmatory factor analysis was performed on item responses to the SF-MPQ obtained from 188 patients with chronic back pain. Consistent with the original structure proposed by Melzack (1987), results indicated that the SF-MPQ is best represented by a two-factor solution. However, these findings are contrary to results obtained by Burckhardt and Bjelle (1994) who, using their Swedish version of the SF-MPQ, obtained a three-factor solution. Potential explanations for the disparity between the results of the two studies are explored and recommendations for continuing clinical and research applications are offered.

These results indicate that the association between pain and PTSD symptoms, previously observed in primarily male samples, is generalisable to females. Clinical implications and possible mechanisms of association are discussed.

Recent factor analytic investigations of post-traumatic stress disorder in military veterans suggest that symptoms are best described by either a hierarchical 2-factor model or a 4-factor inter-correlated model. Other recent evidence suggests that post-traumatic stress disorder and chronic pain are intricately related; however, the nature of this relationship is not well understood. Factor analysis provides one method for clarifying this relationship. In study 1, we compared competing models of post-traumatic stress disorder symptom structure in a sample of 400 male United Nations peacekeepers using confirmatory factor analysis. Results indicated that both the hierarchical 2-factor and the 4-factor inter-correlated models provided good fit to the data. In study 2, the reliability of these models was assessed in 427 male United Nations peacekeepers with chronic back pain and 341 without. Group comparisons of the confirmatory factor analysis results revealed that the structure of the hierarchical 2-factor and 4-factor inter-correlated models both provided good fit to the data in both the chronic back pain and the group without. However, the structure of the models for the group with chronic back pain group differed in significant ways from that of the group without chronic back pain. Post-traumatic stress disorder symptoms in military veterans can be adequately conceptualized using either a hierarchical 2-factor or 4-factor inter-correlated model. Chronic pain has a minimal influence on overall factor structure. The hierarchical 2-factor model, while parsimonious, does not provide the degree of symptom detail provided by the 4-factor inter-correlated model. Implications for conceptualization of post-traumatic stress disorder symptoms for patients with chronic back pain and significant post-traumatic stress disorder symptomatology are discussed.

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The course of severe anxiety surrounding health issues is unknown. The available literature suggests that adults who are overly anxious about health issues often interpret or misinterpret their bodily signs and symptoms to be indicative of a serious illness. The construct of health anxiety has not been examined in children and, to date, there has not been an instrument developed for this purpose. The Illness Attitude Scales is one of the most commonly used instruments for evaluating fears, beliefs, and attitudes that are associated with hypochondriasis and abnormal illness behaviour in adults. We sought to adapt the Illness Attitude Scales for use with children ages 8-15 years. The adapted Illness Attitude Scales was renamed the Childhood Illness Attitude Scales. Revisions to the adult version consisted of simplification of language, revision of Likert scale (i.e. 5-point to 3-point scale), and the addition of 7 questions to evaluate the role parents/guardians play in facilitating medical attention or treatment. Correlations between Childhood Illness Attitude Scales total scores and other self-report measures were supportive of the construct-related validity of the Childhood Illness Attitude Scales and suggested that it is a useful measure of health anxiety in school-age children. Practical and theoretical implications of the present results are discussed.