Abstract
Pediatric pain is common, and memory for it may be distressing and have long-lasting effects. Children who develop more negatively biased memories for pain (ie, recalled pain is higher than initial pain report) are at risk of worse future pain outcomes. In adolescent samples, higher child and parent catastrophic thinking about pain was associated with negatively biased memories for postsurgical pain. This study examined the influence of child and parent anxiety on the development of younger children's postsurgical pain memories. Seventy-eight children undergoing a tonsillectomy and one of their parents participated. Parents reported on their anxiety (state and trait) before surgery, and trained researchers observationally coded children's anxiety at anaesthesia induction. Children reported on their postsurgical pain intensity and pain-related fear for 3 days after discharge. One month after surgery, children recalled their pain intensity and pain-related fear using the same scales previously administered. Results revealed that higher levels of postsurgical pain and higher parent trait anxiety predicted more negatively biased memories for pain-related fear. Parent state anxiety and child preoperative anxiety were not associated with children's recall. Children who developed negatively biased pain memories had worse postsurgical pain several days after surgery. These findings underscore the importance of reducing parental anxiety and effective postsurgical pain management to potentially buffer against the development of negatively biased pain memories in young children.
Highlights
Children’s memories for pain are a robust predictor of future pain experiences.[29]
Pain memories are believed to be most malleable and influenced by parents during early childhood[31]; research has not examined anxiety-related risk factors for biases in young children’s pain memory development after surgery. To address this critical gap, this study examined the influence of parent and child anxiety on the development of young children’s www.painjournalonline.com
Consistent with conceptual models of children’s acute pain memory development,[29] we hypothesized that (1) greater parent anxiety and (2) greater child preoperative anxiety would be associated with negatively biased memories for pain intensity and pain-related fear
Summary
Children’s memories for pain are a robust predictor of future pain experiences.[29]. These memories are highly susceptible to distortion. Children can either recall pain accurately (ie, recall the same level of pain as initially reported) or in a positively or negatively biased (ie, recall less or more pain than initially reported) way.[29] Negatively biased pain memories are linked to greater future pain intensity,[27] fear,[27] and distress.[27] amongst adolescents undergoing major surgery, more negatively biased memories for pain predicted higher postsurgical pain at a time when pain can transition to a chronic state.[33] As such, it is critical to identify risk factors for pain memory biases, early in development before pain problems first emerge. Consistent with conceptual models of children’s acute pain memory development,[29] we hypothesized that (1) greater parent (state and trait) anxiety and (2) greater child preoperative anxiety would be associated with negatively biased memories for pain intensity and pain-related fear. We hypothesized that children who developed negatively biased pain memories would have higher levels of postsurgical pain and fear during the recovery phase
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