Goodman Julie E, McGrath Patrick J
Child Development Centre, Hotel Dieu Hospital, Kingston, ON, Canada Departments of Psychology, Paediatrics, and Psychiatry, Dalhousie University; Pain Service, IWK Health Centre, Halifax, NS, Canada B3H 4J1.
Pain. 2003 Aug;104(3):559-565. doi: 10.1016/S0304-3959(03)00090-3.
We set out to determine whether observing one's mother's reaction during a cold pressor test changes ratings of pain threshold, pain intensity, and observed pain-related facial behavior during a cold pressor test, using a Repeated Measures Mixed Factorial design in the setting of the Psychology Department, Dalhousie University, Halifax, Canada. The participants were: 96 mothers (mean age 41 years,) and 96 children (48 males, mean age 12.6 years), all in good general health. Pain intensity was measured using a 0-10 rating scale. Pain threshold was measured by asking participants to signal the moment any pain began and recording time elapsed since immersion. The Child Facial Coding System (CFCS; Revised manual for the child facial coding system (unpublished). Dalhousie University and University of British Columbia; Chambers et al., 1996) measured pain-related facial behavior. Mothers assigned to the Exaggerate condition were instructed, via videotape, to slightly exaggerate their display of pain and indicate a pain threshold within the first 10-20 s of a 4-min cold pressor task using water at 10 degrees C. Mothers in the Minimize condition were instructed to minimize their display of pain. Mothers assigned to the Control condition were given no specific instructions. All mothers privately rated their own pain intensity every 30 s. Children then completed a similar cold pressor task and made similar ratings. Children assigned to the Exaggerate Group (mean 21.7 s; SD 3.9) had lower thresholds than did children in the Control Group (mean 35.6 s; SD 21.8; t(1,76)=2.515, P=0.014). No difference in threshold was observed between the Control and the Minimize Groups (mean 32.2 s; SD 4.2; t(1,76)=0.610, P=0.544). No differences were observed in the self-report pain ratings of children between groups (F<1). CFCS Scores were significantly lower in the Minimize group compared to the Control group (95% CI 4.98-20.19, P=0.001), but no difference was noted between the Exaggerate and Control groups (95% CI -8.03-6.93, P=0.884). Children's pain threshold and their facial behavior are altered by exposure to mother's behavior during a cold pressor task suggesting that modeling has an impact on a child's pain behavior.
我们开展了一项研究,旨在确定在加拿大哈利法克斯市戴尔豪斯大学心理学系的环境中,采用重复测量混合因子设计,观察母亲在冷加压测试中的反应是否会改变冷加压测试中的疼痛阈值、疼痛强度评分以及观察到的与疼痛相关的面部行为。参与者包括:96名母亲(平均年龄41岁)和96名儿童(48名男性,平均年龄12.6岁),他们的总体健康状况良好。使用0至10的评分量表测量疼痛强度。通过要求参与者在任何疼痛开始的瞬间发出信号,并记录从浸入开始经过的时间来测量疼痛阈值。使用儿童面部编码系统(CFCS;儿童面部编码系统修订手册(未发表)。戴尔豪斯大学和英属哥伦比亚大学;钱伯斯等人,1996年)测量与疼痛相关的面部行为。被分配到“夸大”条件的母亲通过录像带接受指导,要稍微夸大她们的疼痛表现,并在4分钟的冷加压任务(使用10摄氏度的水)的前10至20秒内指出疼痛阈值。处于“最小化”条件的母亲被要求尽量减少她们的疼痛表现。被分配到“对照”条件的母亲没有得到具体的指导。所有母亲每隔30秒私下对自己的疼痛强度进行评分。然后孩子们完成类似的冷加压任务并进行类似的评分。被分配到“夸大”组的孩子(平均21.7秒;标准差3.9)的阈值低于对照组的孩子(平均35.6秒;标准差21.8;t(1,76)=2.515,P=0.014)。在“对照”组和“最小化”组之间未观察到阈值差异(平均32.2秒;标准差4.2;t(1,76)=0.610,P=0.544)。在不同组的孩子自我报告的疼痛评分中未观察到差异(F<1)。与对照组相比,“最小化”组的CFCS分数显著更低(95%置信区间4.98 - 20.19,P=0.001),但在“夸大”组和对照组之间未发现差异(95%置信区间 - 8.03 - 6.93,P=0.884)。在冷加压任务中,孩子接触母亲的行为会改变他们的疼痛阈值和面部行为,这表明模仿对孩子的疼痛行为有影响。