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Children's Behavioral Pain Cues: Implicit Automaticity and Control Dimensions in Observational Measures.
Kamal Kaur Sekhon1, Samantha R Fashler2, Judith Versloot3
1School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
Pain Research & Management
|March 22, 2017
Summary
This study found that children's pain behaviors can be categorized as automatic, controlled, or ambiguous. This distinction helps understand how pain is expressed and perceived in children.
Area of Science:
- Pediatric Psychology
- Pain Management
- Behavioral Science
Background:
- Pain behaviors in children are often observed, but their underlying control mechanisms (automatic vs. voluntary) are not fully understood.
- Existing observational pain measures may not adequately differentiate between these types of pain expressions.
Purpose of the Study:
- To investigate whether pain behaviors in children aged 4-12 can be classified as automatic or controlled.
- To identify distinct categories of pain cues used in observational pain assessment tools for children.
Main Methods:
- A systematic literature search identified 66 pain behavior items from 21 studies on children's observational pain assessment tools.
- 277 participants rated these items on scales measuring automaticity and control.
- Factor analysis was used to group the pain behavior items.
Main Results:
- Factor analysis revealed three distinct factors: 'Automatic' (e.g., facial expressions, vocalizations, consolability), 'Controlled' (e.g., intentional movements, verbalizations, social actions), and 'Ambiguous' (e.g., voluntary facial expressions).
- These findings support a dual-processing model of pain expression in children.
Conclusions:
- Pain behaviors in children can be reliably categorized as automatic, controlled, or ambiguous.
- This classification has implications for understanding pain perception, severity judgments, and the child's social-environmental control strategies.
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