Do abused young children feel less pain?

Drouineau, Marie-Hélène; Guenego, Elise; Sebille, Véronique; Vrignaud, Bénédicte; Balençon, M.; Blanchais, Thomas; Levieux, Karine; Vabres, N.; Picherot, G.; Guen, C. Gras-Le

doi:10.1016/j.chiabu.2017.02.002

Cited by 13 publications

(20 citation statements)

References 30 publications

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“…Of these samples, six (75%) were children who were maltreated by a parent or caregiver (Katz & Tener, 2021a, 2021bKatz et al, 2020;Lev-Wiesel et al, 2014;Simon et al, 2018;Tsur et al, 2021Tsur et al, , 2022 and two (25%) were of children evaluated due to allegations or concerns of abuse by parents, caregivers, family members, or family friends (Drouineau et al, 2017;Taylor & Higginbotham, 2020). Three (37.5%) of the eight children's samples studied sexual abuse (Katz et al, 2020;Taylor & Higginbotham, 2020;Tsur et al, 2022), three (37.5%) studied physical abuse (Katz & Tener, 2021a, 2021bSimon et al, 2018;Tsur et al, 2021), one (12.5%) did not specify the type of the maltreatment (Drouineau et al, 2017), and one studied multiple types of abuse (physical, sexual, emotional, neglect, and witnessing domestic violence; Lev-Wiesel et al, 2014). The remaining three (27.27%) samples were of adults who retrospectively reported childhood sexual abuse (Carballo-Diéguez & Dolezal, 1995;Dolezal & Carballo-Diéguez, 2002;Sigurdardottir & Halldorsdottir, 2013).…”

Section: Sample Characteristics and Types Of Maltreatmentmentioning

confidence: 99%

“…Of the manuscripts included in the review, only three (27.27%) aimed to assess experiences of peritraumatic pain in CM (Drouineau et al, 2017). Two of these manuscripts examined pain from the perspectives of children conveyed in forensic interviews following parental physical or sexual abuse (Tsur et al, 2021(Tsur et al, , 2022.…”

Section: Bottom-up Versus Top-down Focus On Peritraumatic Painmentioning

confidence: 99%

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Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review

Tsur,

Talmon,

Shemesh

2023

Trauma, Violence, & Abuse

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Extensive research has been conducted on the link between trauma, child maltreatment (CM), and chronic pain. Although the risk of suffering from chronic pain among CM survivors has been established, much less is known about the experience of pain during CM incidents or whether such peritraumatic pain sensations are associated with later chronic pain. This scoping review was conducted to synthesize the existing literature on pain during and a short time following CM (i.e., peritraumatic pain). Utilizing the preferred reporting items for systematic reviews and meta-analyses guidelines, the current review included 11 manuscripts, which met the following criteria: (a) refer to physical pain experienced during or a short time after CM, (b) were published in peer-reviewed journals, and (c) were written in English. The review demonstrated that most of the included studies were not intentionally focused on peritraumatic pain, the majority used qualitative research methods, and all were cross-sectional. Furthermore, although validated questionnaires are available, most of the studies did not utilize such measures. Those that intentionally reported pain demonstrated its high intensity and prevalence in CM incidents, indicating that pain is inherently embedded in the experience of maltreatment. The findings spotlight an underdeveloped research realm on a phenomenon that may hold significant empirical, clinical, and legal implications. Research endeavors should initiate interdisciplinary bodies of knowledge to establish well-validated research methodologies that properly quantify peritraumatic pain in trauma and CM.

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Section: Sample Characteristics and Types Of Maltreatmentmentioning

confidence: 99%

Section: Bottom-up Versus Top-down Focus On Peritraumatic Painmentioning

confidence: 99%

Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review

Tsur,

Talmon,

Shemesh

2023

Trauma, Violence, & Abuse

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“…Indeed, the final diagnosis of child physical abuse relies on a combination of social and clinical evaluations and medical tests (42), so the detection of additional skeletal injuries by BS may have limited impact when cutaneous, neurological, or ophthalmologic findings suggesting physical abuse have already been detected. However, the additional skeletal injuries detected by BS may confirm the diagnosis of abuse in doubtful cases, and their location brings additional information to adapt treatment (43) and evaluate the potential mechanisms involved in the inflicted injury (20,42).…”

Section: Limitationsmentioning

confidence: 99%

Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children

et al. 2020

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Background: Timely diagnosis of child physical abuse is of paramount importance. The added value of bone scintigraphy (BS) after a negative radiological skeletal survey (RSS) in children with suspected physical abuse has never been evaluated. Objective: The objective of this study was to assess the extent to which BS could improve the detection rate of skeletal injury in children with suspected physical abuse with an initial negative RSS. Methods: We used discharge codes to retrospectively identify children evaluated for suspected physical abuse in a university hospital (Nantes, France). We included all consecutive children younger than 3 years old who underwent both RSS and BS, with an interval of ≤96 h between tests, from 2013 to 2019. BS and RSS results were interpreted independently during the study period. We specifically analyzed BS results for children with a negative RSS to assess the value of BS as an add-on test. Results: Among the 268 children ≤3 years old with suspected physical abuse who underwent RSS, 140 (52%) also underwent BS within 96 h and were included in the analysis. The median age was 6 months old (interquartile range: 3-8). The detection rate of ≥1 skeletal injury with RSS alone was 49% (n = 69/140, 95% CI: 41-58%) vs. 58% (n = 81/140, 50-66%) with RSS followed by add-on BS, for an absolute increase in the detection rate of 9% points (95% CI: 4-14%). The number of children with a negative RSS who would need to undergo BS to detect one additional child with ≥1 skeletal injury was 6 (95% CI: 4-11). ADDED VALUE OF THIS STUDY Performing BS in young children with suspected physical abuse after a negative RSS would allow for a clinically significant improvement in the detection rate of skeletal injuries for a limited number of BS procedures required.

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“…Additionally, various other factors buffer pain assessment and treatment of children, such as disparities between perceived and documented pain management (Probst et al, 2005), and inconsistent correlation between pediatric pain intensity and injury severity (Baxt et al, 2004; van Meijel et al, 2019). Notably, findings show that medical staff tend to evaluate the pain of abused children as less intense compared to other injuries (Drouineau et al, 2017). Taken together, it seems that in both medical and forensic arenas, pain assessments are often inadequate.…”

Section: Introductionmentioning

confidence: 99%

Peritraumatic Pain in Child Sexual Abuse: Children’s Descriptions of Pain as Conveyed in Their Testimonies Following Child Sexual Abuse

Tsur

Katz

Klebanov

2020

J Interpers Violence

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The literature on child sexual abuse (CSA) has contributed significantly to the understanding of its characteristics, epidemiology, and consequences. Considerably less attention has been dedicated, however, to the subjective experiences of the abused children, and more specifically to their experiences of pain. The current study explored the way children perceive and describe pain during and shortly following incidents of sexual abuse. The sample was comprised of 35 transcripts of forensic interviews following alleged CSA. Thematic analysis of the children’s narratives identified three themes: (a) pain during the abusive incidents, described using words indicating its intensity and quality; (b) pain shortly after the abusive incidents, including weeks later, and (c) pain as embedded within the complex dynamic with perpetrator. The children struggled to localize the pain, mainly using words such as “inside” and “deep.” Moreover, they testified that in the course of the abusive incidents, they were often silenced when trying to communicate their pain to the perpetrators. The children’s narratives provided us with a unique opportunity to learn about the pain not only during the abusive incidents but also following it. Additionally, children described suffering from pain in areas that were not directly injured during the CSA incidents, mainly referring to the head, abdomen and legs. The discussion addresses the potential intervening factors in peritraumatic CSA pain, as well as its potential links with chronic post-traumatic physical and mental morbidity. This study illuminates the necessity to address the complicated links between short- and long-term physical, emotional, cognitive, and interpersonal manifestations of CSA.

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Do abused young children feel less pain?

Cited by 13 publications

References 30 publications

Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review

Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review

Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children

Peritraumatic Pain in Child Sexual Abuse: Children’s Descriptions of Pain as Conveyed in Their Testimonies Following Child Sexual Abuse

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