Pain tolerance in children and adolescents: Sex differences and psychosocial influences on pain threshold and endurance

Schmitz, Anne-Katharina; Vierhaus, Marc; Lohaus, Arnold

doi:10.1002/j.1532-2149.2012.00169.x

Cited by 84 publications

(68 citation statements)

References 18 publications

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“…As such, the presence of potential sex differences in those children who had undergone puberty may have been washed out because they were being considered along with pre-pubertal children. Previous research has had conflicting conclusions whether pubertal status or age is more important for understanding the development of sex differences in children's pain [62,90]. As pubertal status was only measured in two studies in the present review [3,64], age was used as a proxy, however, this was not ideal and future research is need to replicate our age-related findings.…”

Section: Sex Differences In Experimental Pain In Children 20mentioning

confidence: 86%

“…Heat pain tasks showed more variability in effect sizes, from small for pain intensity and threshold (SMD = 0.07 and -0.31, respectively), to quite large for pain tolerance (SMD = -1.26).Pressure pain tasks demonstrated small effect sizes for pain intensity and threshold (SMD = 0.17 and -.035, respectively). Researchers may consider using the effect sizes from the present study in calculating sample sizes, should they wish to examine sex [90] recently demonstrated important future directions for the field through the inclusion of large sample sizes and methodology designed explicitly to examine sex differences across pubertal development. Researchers should consider conducting similar studies looking at additional pain outcomes (e.g., pain intensity) and using different experimental pain paradigms.…”

Section: Strengths Limitations and Future Directionsmentioning

confidence: 99%

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Sex differences in experimental pain among healthy children: A systematic review and meta-analysis

Boerner

Birnie

Caes

et al. 2014

Pain

106

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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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Section: Sex Differences In Experimental Pain In Children 20mentioning

confidence: 86%

Section: Strengths Limitations and Future Directionsmentioning

confidence: 99%

Sex differences in experimental pain among healthy children: A systematic review and meta-analysis

Boerner

Birnie

Caes

et al. 2014

Pain

106

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that a child' s age, sex, and ethnicity are related to the child' s ability to describe pain, as well as the child' s perception and sensitivity to pain. [13][14][15][16][17][18][19] It is important, therefore, to determine whether the validity of the FPS-R and CAS varies in children based on their characteristics, and how suitable these scales are in different demographics.…”

mentioning

confidence: 99%

Validation of Self-Report Pain Scales in Children

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: The Faces Pain Scale-Revised and Color Analog Scale are self-report pain scales that are commonly used for children in the clinical and research settings. WHAT THIS STUDY ADDS:The Faces Pain Scale-Revised and Color Analog Scale overall demonstrate strong psychometric properties in children 4 to 17 years of age, including within subgroups of age, sex, and ethnicity. Convergent validity, however, is questionable in children ,7 years old. abstract BACKGROUND AND OBJECTIVES: The Faces Pain Scale-Revised (FPS-R) and Color Analog Scale (CAS) are self-report pain scales commonly used in children but insufficiently validated in the emergency department setting. Our objectives were to determine the psychometric properties (convergent validity, discriminative validity, responsivity, and reliability) of the FPS-R and CAS, and to determine whether degree of validity varied based on age, sex, and ethnicity. METHODS:We conducted a prospective, observational study of Englishand Spanish-speaking children ages 4 to 17 years. Children with painful conditions indicated their pain severity on the FPS-R and CAS before and 30 minutes after analgesia. We assessed convergent validity (Pearson correlations, Bland-Altman method), discriminative validity (comparing pain scores in children with pain against those without pain), responsivity (comparing pain scores pre-and postanalgesia), and reliability (Pearson correlations, repeatability coefficient). RESULTS:Of 620 patients analyzed, mean age was 9.2 6 3.8 years, 291 (46.8%) children were girls, 341(55%) were Hispanic, and 313(50.5%) were in the younger age group (,8 years). Pearson correlation was 0.85, with higher correlation in older children and girls. Lower convergent validity was noted in children ,7 years of age. All subgroups based on age, sex, and ethnicity demonstrated discriminative validity and responsivity for both scales. Reliability was acceptable for both the FPS-R and CAS. CONCLUSIONS:The FPS-R and CAS overall demonstrate strong psychometric properties in children ages 4 to 17 years, and between subgroups based on age, sex, and ethnicity. Convergent validity was questionable in children ,7 years old. Pediatrics 2013;132:e971-e979 AUTHORS:

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“…Lower pain threshold among women compared with men may explain part of the gender difference observed in the current study [34]. The lack of a significant association among healthy weight individuals also indicates that non-somatic symptoms, such weight-related anxiety, may potentially mediate the strong relationship between arthritis and depression among overweight adults.…”

Section: Discussionmentioning

confidence: 73%

The association between arthritis and depression is intensified by excessive body weight: Findings from a US national survey, 2005–2012

Politis

Johnson

Hansen

et al. 2016

Obesity Research & Clinical Practice

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Pain tolerance in children and adolescents: Sex differences and psychosocial influences on pain threshold and endurance

Cited by 84 publications

References 18 publications

Sex differences in experimental pain among healthy children: A systematic review and meta-analysis

Sex differences in experimental pain among healthy children: A systematic review and meta-analysis

Validation of Self-Report Pain Scales in Children

The association between arthritis and depression is intensified by excessive body weight: Findings from a US national survey, 2005–2012

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