Experimental Pain Responses in Children with Chronic Pain and in Healthy Children: How Do They Differ?

Tsao, Jennie C.I.; Evans, Subhadra; Seidman, Laura C; Zeltzer, Lonnie K.

doi:10.1155/2012/592108

Cited by 24 publications

(23 citation statements)

References 31 publications

(54 reference statements)

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“…These data reflect previous research demonstrating higher levels of pain catastrophizing in chronic pain populations [16], and is in line with some previous studies showing no differences in cold pressor pain intensity between Chronic Pain and No Pain groups [32]. This may be because our population is younger and differences in laboratory-based pain responses have not yet emerged.…”

Section: Discussionsupporting

confidence: 93%

Pain Catastrophizing Predicts Menstrual Pain Ratings in Adolescent Girls with Chronic Pain

Payne¹,

Rapkin

Lung³

et al. 2015

Pain Med

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Objectives The current study aimed to explore relationships among self-reported menstrual pain ratings, acute laboratory pain, pain catastrophizing, and anxiety sensitivity in a sample of girls without pain (No Pain group) and girls with a chronic pain condition (Chronic Pain group). Setting A laboratory at an off-campus Medical School office building. Subjects Eighty-four postmenarchal girls (43 No Pain, 41 Chronic Pain) ages 10–17 participated in the study. Methods All participants completed self-report questionnaires assessing menstrual pain, pain catastrophizing, and anxiety sensitivity and completed a cold pressor task. Pain intensity during the task was rated on a 0 (no pain) to 10 (worst pain possible) numeric rating scale. Results After controlling for age, average menstrual pain ratings (without medication) were significantly correlated with cold pressor pain intensity for the No Pain group only. In the Chronic Pain group, menstrual pain ratings were significantly correlated with pain catastrophizing and anxiety sensitivity. In a multiple linear regression analysis, after controlling for age, only pain catastrophizing emerged as a significant predictor of menstrual pain ratings in the Chronic Pain group. Conclusion Results demonstrate differences in relationships among menstrual pain, acute laboratory pain, and psychological variables in girls with no pain compared with girls with chronic pain. In addition, pain catastrophizing may be a particularly salient factor associated with menstrual pain in girls with chronic pain that warrants further investigation.

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Section: Discussionsupporting

confidence: 93%

Pain Catastrophizing Predicts Menstrual Pain Ratings in Adolescent Girls with Chronic Pain

Payne¹,

Rapkin

Lung³

et al. 2015

Pain Med

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“…Future studies are necessary to determine the MCSD and ICSD in children with chronic and recurrent pain states, such as sickle cell disease, because they perceive pain differently and should have their self-reported changes on pain scales interpreted accordingly. 40–42 …”

Section: Limitationsmentioning

confidence: 99%

Clinically Significant Differences in Acute Pain Measured on Self‐report Pain Scales in Children

Tsze

Hirschfeld

Baeyer

et al. 2015

Academic Emergency Medicine

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Objectives The objective was to determine the minimum and ideal clinically significant differences (MCSD, ICSD) of the Faces Pain Scale–Revised (FPS-R) and the Color Analog Scale (CAS) in children and to identify any differences in these estimates based on patient characteristics. Methods This was a prospective study of children aged 4 to 17 years with acute pain presenting to two urban pediatric emergency departments. Participants self-reported their pain severity using the FPS-R and CAS and qualitatively described their changes in pain. Changes in pain score reported using the FPS-R and CAS that were associated with “a little less” and “much less” pain (MCSD and ICSD, respectively) were identified using a receiver operating characteristic–based method and expressed as raw change score and percent reductions. Estimates of MCSD and ICSD were determined for each category of initial pain severity (mild, moderate, and severe) and patient characteristics (age, sex, and ethnicity). Post hoc exploratory analyses evaluated categories of race, primary language, and etiology of pain. Results A total of 314 children with acute pain were enrolled; mean (±SD) age was 9.8 (±3.8) years. The FPS-R raw change score and percent reduction MCSD estimates were 2/10 and 25%, with ICSD estimates of 3/10 and 60%. For the CAS, raw change score and percent reduction MCSD estimates were 1/10 and 15%, with ICSD estimates of 2.75/10 and 52%. For both scales, raw change score and percent reduction estimates of the MCSD remained unchanged in children with either moderate or severe pain. For both scales, estimates of ICSD were not stable across categories of initial pain severity. There was no difference in MCSD or ICSD based on age, sex, ethnicity, race, primary language, or etiology of pain. Conclusions The MCSD estimates can be expressed as raw change score and percent reductions for the FPS-R and CAS. These estimates appear stable for children with moderate to severe pain, irrespective of age, sex, and ethnicity. Estimates of ICSD were not stable across different categories of initial pain severity, therefore limiting their potential generalizability.

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“…Studies most frequently include healthy children and adolescents, with increasing use with clinical samples, such as children with chronic pain, anxiety, low mood, or premature birth [29,30]. Efforts have also been made to provide normative data for pain outcomes with healthy children [31] and those with chronic pain [20,32,33]. …”

Section: Cold Pressor Taskmentioning

confidence: 99%

“…These tasks include application of pressure to various parts of the body, with the goal of obtaining information about pressure pain threshold or tolerance. Pressure tasks have largely been used previously with samples of healthy children [11,17,69,70], as well as children with growing pains [71], abdominal pain [72], joint and temporomandibular joint pain [73], headache [74], and in a small sample of children with mixed chronic pain problems [32]. Some investigators have used pressure applied to the fingertip, while others have utilized locations previously identified as fibromyalgia tender points.…”

Section: Pressure Painmentioning

confidence: 99%

“…In addition to continuing exploration of psychosocial influences, experimental pain has been increasingly used with adults to investigate biological, neurological, and genetic pain mechanisms [22,90–93] and race/ethnicity [94]. To date, research using the cold pressor task with children has assessed biomarkers of heart rate [12,39,84], blood pressure [32] and cortisol [95], as well as associations with race [96,97]. To our knowledge, of the other experimental pain modalities, biomarkers have only been examined in relation to conditioned pain modulation (i.e., heart rate variability) [83], and racial differences have not been investigated.…”

Section: Conclusion and Future Perspectivementioning

confidence: 99%

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A Practical Guide and Perspectives on the Use of Experimental Pain Modalities with Children and Adolescents

et al. 2014

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Use of experimental pain is vital for addressing research questions that would otherwise be impossible to examine in the real world. Experimental induction of pain in children is highly scrutinized given the potential for harm and lack of direct benefit to a vulnerable population. However, its use has critically advanced our understanding of the mechanisms, assessment and treatment of pain in both healthy and chronically ill children. This article introduces various experimental pain modalities, including the cold pressor task, the water load symptom provocation test, thermal pain, pressure pain and conditioned pain modulation, and discusses their application for use with children and adolescents. It addresses practical implementation and ethical issues, as well as the advantages and disadvantages offered by each task. The incredible potential for future research is discussed given the array of experimental pain modalities now available to pediatric researchers

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Experimental Pain Responses in Children with Chronic Pain and in Healthy Children: How Do They Differ?

Cited by 24 publications

References 31 publications

Pain Catastrophizing Predicts Menstrual Pain Ratings in Adolescent Girls with Chronic Pain

Pain Catastrophizing Predicts Menstrual Pain Ratings in Adolescent Girls with Chronic Pain

Clinically Significant Differences in Acute Pain Measured on Self‐report Pain Scales in Children

A Practical Guide and Perspectives on the Use of Experimental Pain Modalities with Children and Adolescents

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