Development and validation of the pain response inventory for children.

Abstract

The Pain Response Inventory (PRI) was developed as a multidimensional instrument to assess children's coping responses to recurrent pain. The PRI assesses 3 broad coping factors-Active, Passive, and Accommodative-each with subscales representing specific strategies for coping with pain. Confirmatory factor analysis was used to derive and cross-validate the factor structure of the PRI in 3 different samples of children and adolescents: school children, abdominal pain patients, and former abdominal pain patients. The subscales were found to be internally consistent and reasonably stable. Validity of the subscales was assessed by examining the relations of particular coping strategies to various outcome indicators, including functional disability, somatization symptoms, and depressive symptoms. Results indicated that different types of health outcome were predicted by different patterns of PRI coping strategies, thus supporting the utility of a multidimensional approach to the assessment of coping responses to pain.With the formulation of the gate-control theory of pain (Melzack & Wall, 1965), it became generally recognized that the experience of pain is not a purely sensory phenomenon related to tissue damage. Rather, it is also influenced by cognitive, behavioral, and emotional factors. This model suggests that effective pain management cannot rely solely on interventions directed at the source of tissue damage but also must include interventions designed to modify psychosocial factors that affect nociceptive processing (McGrath & Hillier, 1996). This multidimensional model of pain has been the impetus for the rapid growth in behavioral science research on pain in the past two decades.Cognitive and behavioral responses to pain, often studied under the rubric of "coping with pain," are of particular interest because they may be amenable to change through interventions by health professionals. Moreover, such coping responses may significantly lessen pain and associated disability and thereby complement and even decrease the need for more invasive pharmacological or surgical interventions. Studies of adult pain patients suggest that certain coping strategies (typically ' 'passive'' strategies, such as taking to bed, restricting one's activities, or

Brief hypnotherapeutic–behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: a randomized controlled trial

“…Because of the different answer formats of the five pain ratings, the variables were z-standardized and added up to provide a balanced index of AP. Previous studies [55] have shown adequate internal consistency of the API (α =.80-93), which could be confirmed in our sample (α=.87).…”

“…Because of the different scaling of the three pain ratings, the index of AP is calculated from standardized z values. This procedure considers various symptom patterns (e.g., scarce but intensive AP or frequent but weak AP) and is similar to the API [55]. In many studies, a 50 % symptom improvement is considered to be a reasonable definition of a treatment responder [8], but we applied a more conservative categorization, which was also used in a previous trial addressing childhood FGIDs [48,49].…”

“…Parents were asked to rate their children's AP with the parental form of the five-item abdominal pain index (API) [55]. The API assessed the frequency of AP within the last 2 weeks on a 6-point scale from "not at all" to "every day."…”

“…The duration of AP was scored as: 0 = no pain, 1 = a few minutes, 2 = about half an hour, 3 = about an hour, 4 = between 1 and 2 h, 5 = 3 or 4 h, 7 = most of the day and 8 = all day (it never completely stops). The classification of pain duration was taken over from the widely used abdominal pain index (API) [55].…”

A closer look at co‐rumination: Gender, coping, peer functioning and internalizing/externalizing problems

“…Prominent theoretical models (Ayers, Sandler, West, & Roosa, 1996;Walker, Smith, Garber, & Van Slyke, 1997) of coping highlight key dimensions of voluntary coping, including coping efforts that: are enacted to exert control over the stressor or one's reaction to it; represent a child/adolescent's attempts to adapt to the stressful experience; and involve disengaging from the stressor and/or one's emotional response Running head: A CLOSER LOOK AT CO-RUMINATION 9 to the stressor (Compas et al 2001). The current project adopted the five-factor Responses to Stress Model (Connor-Smith et al, 2000).…”