Sex Differences in Parent and Child Pain Ratings during an Experimental Child Pain Task

Abstract

Research in the field of pediatric pain has largely ignored the role of fathers in their children's pain experiences. The first objective of the present study was to examine the effect of the presence of mothers versus fathers on children's subjective ratings, facial expressions and physiological responses to acute pain. The second objective was to examine whether child and parent sex influence parents' proxy ratings of their children's pain. The final objective was to compare levels of agreement between mothers' and fathers' assessments of their children's pain. Participants included 73 children (37 boys, 36 girls), four to 12 years of age, along with 32 fathers and 41 mothers. Children undertook the cold pressor pain task while observed by one of their parents. During the task, the children's heart rates and facial expressions were recorded. Children provided self-reports and parents provided proxy reports of child pain intensity using the seven-point Faces Pain Scale. Neither child nor parent sex had a significant impact on children's subjective reports, facial expressions or heart rates in response to acute pain. Fathers gave their sons higher pain ratings than their daughters, whereas mothers' ratings of their sons' and daughters' pain did not differ. Kappa statistics and t tests revealed that fathers tended to be more accurate judges of their children's pain than mothers. Overall, this research highlights the importance of examining both parent and child sex differences in pediatric pain research.

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

“…Pain intensity. Data from 19 studies (published in 18 separate articles) were entered into the meta-analysis, which compared self-reported pain intensityduring the cold pressor taskin a total of 628 girls and 633 boys [16,26,39,40,54,75,76,78,82,84,85,93,94,96,99,105,106,109].…”

“…boys [16,26,39,75]. In each of the included studies, physiological reactions were measured using participant heart rate.…”

“…For studies with a mean age of less than 12 years, data from 12 studies were entered into the meta-analysis, with a total of 302 girls and 303 boys [16,26,39,54,75,76,82,84,85,93,96,99]. This analysis revealed a SMD of 0.01 [-0.15, 0.17], an I 2 of 0%, and no signficant differences between boys and girls on self-reported pain intensity (Z= 0.08, p = .93).…”

“…Pain intensity. Data from 19 studies (published in 18 separate articles) were entered into the meta-analysis, which compared self-reported pain intensityduring the cold pressor taskin a total of 628 girls and 633 boys [16,26,39,40,54,75,76,78,82,84,85,93,94,96,99,105,106,109].Pain intensity was measured using a variety of self-report tools, including the Faces Pain Scale The meta-analysis was repeated to separately examine studies for which the mean age of participants was greater/equal to or less than 12 years of age. For studies with a mean age of less than 12 years, data from 12 studies were entered into the meta-analysis, with a total of 302 girls and 303 boys [16,26,39,54,75,76,82,84,85,93,96,99].…”

“…This analysis revealed a SMD of 0.08 [-0.17 The meta-analysis was repeated to separately examine studies for which the mean age of participants was greater/equal to or less than 12 years of age. For studies with a mean age of less than 12 years, data from three studies were entered into the meta-analysis, with a total of 81 girls and 82 boys [16,59,75]. This analysis revealed a SMD of 0.08 [-0.22, 0.39], an I 2 of 0%, and no signficant differences between boys and girls in facial expressions in response to the cold pressor task (Z= 0.53, p = .60).…”