Tsao Jennie C I, Lu Qian, Myers Cynthia D, Kim Su C, Turk Norman, Zeltzer Lonnie K
Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90024, USA.
J Pain. 2006 May;7(5):319-26. doi: 10.1016/j.jpain.2005.12.004.
Anxiety sensitivity (AS) or fear of anxiety sensations has been linked to childhood learning history for somatic symptoms, suggesting that parental AS may impact children's responses to pain. Using structural equation modeling, we tested a conceptual model in which parent AS predicted child AS, which in turn predicted a hypothesized latent construct consisting of children's pain intensity ratings for 3 laboratory pain tasks (cold pressor, thermal heat, and pressure). This conceptual model was tested in 211 nonclinical parent-child pairs (104 girls, 107 boys; mean age 12.4 years; 178 mothers, 33 fathers). Our model was supported in girls only, indicating that the sex of the child moderated the hypothesized relationships. Thus, parent AS was related to child laboratory pain intensity via its contribution to child AS in girls but not in boys. In girls, 42% of the effect of parent AS on laboratory pain intensity was explained via child AS. In boys, there was no clear link between parent AS and child AS, although child AS was predictive of experimental pain intensity across sex. Our results are consistent with the notion that parent AS may operate via healthy girls' own fear of anxiety symptoms to influence their responses to laboratory pain stimuli.
The present study highlights sex differences in the links among parent and child anxiety sensitivity (fear of anxiety sensations) and children's experimental pain responses. Among girls, childhood learning history related to somatic symptoms may be a particularly salient factor in the development of anxiety sensitivity and pain responsivity.
焦虑敏感性（AS）或对焦虑感觉的恐惧与儿童期躯体症状的学习经历有关，这表明父母的AS可能会影响孩子对疼痛的反应。我们使用结构方程模型测试了一个概念模型，其中父母的AS预测孩子的AS，而孩子的AS又预测一个假设的潜在结构，该结构由孩子对3项实验室疼痛任务（冷压痛、热刺激和压力）的疼痛强度评分组成。这个概念模型在211对非临床亲子对中进行了测试（104名女孩，107名男孩；平均年龄12.4岁；178名母亲，33名父亲）。我们的模型仅在女孩中得到支持，这表明孩子的性别调节了假设的关系。因此，父母的AS通过对女孩而非男孩的AS的影响与孩子的实验室疼痛强度相关。在女孩中，父母的AS对实验室疼痛强度的影响有42%是通过孩子的AS来解释的。在男孩中，父母的AS与孩子的AS之间没有明显的联系，尽管孩子的AS在不同性别中都能预测实验性疼痛强度。我们的结果与这样的观点一致，即父母的AS可能通过健康女孩自身对焦虑症状的恐惧来影响她们对实验室疼痛刺激的反应。
本研究突出了父母与孩子焦虑敏感性（对焦虑感觉的恐惧）以及孩子的实验性疼痛反应之间联系的性别差异。在女孩中，与躯体症状相关的儿童期学习经历可能是焦虑敏感性和疼痛反应性发展中一个特别突出的因素。
