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Pediatric pain: interacting behavioral and physical factors
L K Zeltzer1, R G Barr, P A McGrath
1Department of Pediatrics, UCLA School of Medicine.
Insights
Understanding pediatric pain from a developmental viewpoint is crucial. This research highlights the need for multidisciplinary studies to improve pain assessment and treatment in children.
Area of Science:
- Developmental Psychology
- Pediatric Medicine
- Pain Research
Background:
- Pediatric pain is understudied and undertreated.
- Maturation of physical, emotional, and cognitive systems impacts pain experience and expression in children.
- A developmental perspective is essential for understanding pediatric pain.
Purpose of the Study:
- To present key issues in the study of pediatric pain.
- To illustrate these issues using recurrent abdominal pain syndrome as a model.
- To advocate for a developmental approach in pediatric pain research and clinical practice.
Main Methods:
- Literature review and synthesis of existing research on pediatric pain.
- Case illustration using recurrent abdominal pain syndrome.
- Discussion of multidisciplinary research approaches.
Main Results:
- Recurrent abdominal pain syndrome exemplifies challenges in pediatric pain epidemiology, assessment, and intervention.
- Multidisciplinary research is vital for understanding pain pathways, expression, and contextual influences.
- A developmental framework is necessary for both clinical and nonclinical pediatric populations.
Conclusions:
- Pediatric pain requires a developmental lens for effective study and management.
- Multidisciplinary research advances understanding of pain development and context.
- The ultimate goal is to develop interventions reducing children's pain and disability.
Abstract:
Pain in infants, children, and adolescents warrants study from a developmental, behavioral, and physiological perspective because maturation of physical, emotional, and cognitive systems influences the way in which pain is experienced and expressed. Pediatric pain is an underdeveloped area ripe for study within the realm of developmental and behavioral pediatrics, as noted by documentation of its undertreatment in children. The focus of this paper is to present issues relevant to the study of pain in children, using the example of the recurrent abdominal pain syndrome to illustrate points regarding epidemiology, assessment, and intervention. It is the opinion of these authors that pediatric pain must be understood from a developmental perspective in both clinical and nonclinical populations of children. Multidisciplinary approaches to research in pain aids in understanding the development of nociceptive transmission and inhibitory systems, the development of pain expression, and the influence of context on pain experience and behavior. The goal of research in pediatric pain is to understand these systems within a developmental context so that preventive and therapeutic intervention strategies can be developed to reduce children's distress and pain-related disability.