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The cold pressor pain paradigm in children: feasibility of an intervention model (Part II)
Lonnie K Zeltzer1, Debra Fanurik, Samuel LeBaron
1Division of Hematology/Oncology, Children's Hospital of Los Angeles, and Division of Child Development and Biobehavioral Pediatrics, Department of Pediatrics, UCLA School of Medicine, Los Angeles, CAU.S.A. University of Alabama, Tuscaloosa, ALU.S.A. University of Calgary, Faculty of Medicine, Calgary, AlbertaCanada.
Insights
Hypnosis effectively reduced pain in children using the cold pressor test. Younger children and females in warmer water showed less response to hypnotic pain reduction.
Area of Science:
- Pediatric Psychology
- Pain Management Research
- Clinical Intervention Studies
Background:
- The cold pressor paradigm is a validated method for inducing and measuring pain in research settings.
- Understanding psychological interventions for pediatric pain is crucial for improving patient outcomes.
- Hypnosis has shown potential as a non-pharmacological approach to pain management.
Purpose of the Study:
- To assess the feasibility of using the cold pressor paradigm to test hypnosis for pain reduction in children.
- To evaluate the efficacy of hypnosis compared to a control condition in alleviating experimentally induced pain in pediatric participants.
- To explore the influence of factors like age, sex, and hypnotic susceptibility on the effectiveness of hypnosis for pain relief.
Main Methods:
- A randomized controlled trial involving 6-12-year-old children (n=66) exposed to cold water immersion (15°C and 12°C).
- Participants underwent baseline pain assessments followed by trials with either hypnosis or a control condition.
- Pain ratings and arm immersion duration were recorded at 10-second intervals.
Main Results:
- Hypnosis significantly reduced pain perception compared to the control group across both temperature conditions.
- Younger children reported higher pain and withdrew their arms earlier, demonstrating a lesser response to hypnosis.
- Sex differences in pain ratings were observed at 15°C but diminished at 12°C; hypnotic susceptibility was not a strong predictor of pain reduction.
Conclusions:
- The cold pressor paradigm is a feasible and effective tool for investigating pain intervention strategies in children.
- Hypnosis shows promise as an intervention for reducing experimental pain in pediatric populations.
- Age and water temperature significantly moderate pain responses and the efficacy of hypnosis in children.
Abstract:
The purpose of this study was to examine the feasibility of testing a psychological approach (hypnosis) to pain reduction in children using the cold pressor paradigm. Children's pain ratings at 10 sec intervals and duration of arm immersion (40 sec maximum) in 15 degrees C (n = 37) and 12 degrees C water (n = 29) were assessed in 6-12-year-old children during 2 baseline trials (alternating arms), followed by 2 more trials after randomization to a control or hypnosis treatment condition. Hypnosis was found to reduce pain significantly more than the control condition in both 15 degrees C and 12 degrees C water. Hypnotic susceptibility was not strongly related to hypnotic pain reduction. However, age was significant, with younger children showing higher pain ratings and early arm withdrawal rates and less response to hypnosis than older children. In 15 degrees C water, females had higher pain ratings and early withdrawal rates than males, but this sex discrepancy disappeared in 12 degrees C water. This study demonstrated the feasibility of the cold pressor paradigm for testing intervention strategies and its potential for enhancing our understanding of pain in children.