Unravelling age effects and sex differences in needle pain: ratings of sensory intensity and unpleasantness of venipuncture pain by children and their parents

Abstract

Age and sex differences were investigated in children's self-report of venipuncture pain. Equal numbers of boys and girls aged 3-15 years (n = 110) made separate ratings of the intensity and unpleasantness of their needle pain, using a paired Visual Analogue Scale (VAS) technique. The parents of these children used the same method to give ratings of predicted pain and unpleasantness before the needle, as well as ratings based on observing their child during the needle. Results showed that, across age, children's intensity and unpleasantness scores were highly correlated (r = 0.78), and that both of these ratings decreased with increasing age. Analyses of covariance showed that, with the variance in the unpleasantness ratings accounted for, a significant age main effect persisted for the intensity ratings (scores decreasing with increasing age), with no effect of sex. In the corollary analysis, with intensity scores entered as a covariate, unpleasantness ratings showed no main effect of age, but a significant main effect of sex emerged: girls' ratings of pain unpleasantness, when averaged across age, were significantly higher than boys'. The interaction between age and sex was explored in analysis of the relative difference between intensity and unpleasantness ratings. The results indicated that, from approximately 8-years of age, children (especially girls) gave significantly higher ratings of unpleasantness than sensory intensity of needle pain. Prior to the age of 8 years, children tended to give equivalent ratings of intensity and unpleasantness, with no evidence of a sex difference. The agreement between parental and children's ratings was higher for parents' observed, as opposed to predicted, scores, especially for pain intensity, with no systematic influence of the child's age and sex. In conclusion, it is suggested that age effects in children's self-report of needle pain are predominantly manifest in ratings of sensory intensity, whilst sex effects are predominantly manifest in ratings of an affective (unpleasantness) dimension. It is argued that both age and sex differences are largely the function of pain reporting variables, rather than reflecting fundamental age or sex based variance in nociceptive processing.

Survey of the prevalence of immunization non-compliance due to needle fears in children and adults

“…Also consistent with previous studies, correlates of needle fear included younger age and female sex [18,19]. We found that parents under-reported needle fear in their children when compared to children's self-report.…”

Effects of severe dentoalveolar trauma on the quality‐of‐life of children and parents

“…Values obtained in the current study largely exceeded the VAS pain perception scores reported for venipuncture (23,24). The parents in both the venipuncture study and this study rated their children's pain higher than the children did.…”

Interference of age and repetition of the same noxious stimulus on hyperalgesia

“…In a study comparing needle puncture sensitivity in children aging from 7 to 11 years, and 12 to 16 years, younger ones presented lower thresholds than elder ones (Goodenough et al 1999). In an other study with children undergoing venipuncture and divided in groups that received previous anesthetic block, placebo and no kind of prevention, authors showed age difference with younger children more sensitive, and a strong positive correlation between anxiety and high predictive pain scores (Goodenough et al 1997).…”

“…This explanation can justify high anxiety degree influencing pain expectance (Lander & Fowler-Kerry 1991, Capone & Aloisi 2004). It's impossible to register pain report in animals as well as their emotional discomfort; however it's possible to estimate that anxiety by repetition of a same acute and intense stimulus in a period which memory has been poorly fed (GF3) due to short time living produced more vigorous responses with lower pain thresholds, in the same way that the idea that capability to deal with uncomfortable events modifies pain reaction (Lander & Fowler-Kerry 1991, Goodenough et al 1999, Al-Chaer et al 2000.…”

“…Children of different ages may experience the same painful stimulus, however, due to differences on development of the ability to graduate and report stimuli or other pain components, responses may vary largely (Goodenough et al 1999, Al-Chaer et al 2000. Some authors postulate that children and adults may see pain as a stress and functional disability generator.…”