Noel Melanie, Rabbitts Jennifer A, Tai Gabrielle G, Palermo Tonya M
Center for Child Health, Behavior and Development, Seattle Children's Research Institute Department of Anesthesiology & Pain Medicine, University of Washington Departments of Pediatrics, and Psychiatry, University of Washington, Seattle, WA, USA.
Pain. 2015 May;156(5):800-808. doi: 10.1097/j.pain.0000000000000102.
Children's memories for pain play a powerful role in their pain experiences. Parents' memories may also influence children's pain experiences, by influencing parent-child interactions about pain and children's cognitions and behaviors. Pain catastrophizing of children and parents has been implicated as a factor underlying memory biases; however, this has not been empirically examined. The current longitudinal study is the first to examine the role of pain catastrophizing of children and parents in the development of their pain memories after surgery. Participants were 49 youth (32 girls) aged 10 to 18 years undergoing major surgery and their parents. One week before surgery, children and parents completed measures of pain catastrophizing. Two weeks after surgery (the acute recovery period), children and parents completed measures of child pain intensity and affect. Two to 4 months after surgery, children's and parents' memories of child pain intensity and affect were elicited. Hierarchical linear regression models revealed that over and above covariates, parent catastrophizing about their child's pain (magnification, rumination) accounted for a significant portion of variance in children's affective and parents' sensory pain memories. Although parent catastrophizing had a direct effect on pain memories, mediation analyses revealed that child catastrophizing (helplessness) indirectly influenced children's and parents' pain memories through the child's postoperative pain experience. Findings highlight that aspects of catastrophic thinking about child pain before surgery are linked to distressing pain memories several months later. Although both child and parent catastrophizing influence pain memory development, parent catastrophizing is most influential to both children's and parents' evolving cognitions about child pain.
儿童对疼痛的记忆在他们的疼痛体验中起着重要作用。父母的记忆也可能通过影响亲子间关于疼痛的互动以及孩子的认知和行为，来影响孩子的疼痛体验。儿童和父母的疼痛灾难化被认为是记忆偏差的一个潜在因素；然而，这一点尚未得到实证检验。当前的纵向研究首次考察了儿童和父母的疼痛灾难化在手术后疼痛记忆发展中的作用。参与者为49名10至18岁接受大手术的青少年（32名女孩）及其父母。手术前一周，儿童和父母完成疼痛灾难化测量。手术后两周（急性恢复期），儿童和父母完成儿童疼痛强度和情感测量。手术后两到四个月，引出儿童和父母对儿童疼痛强度和情感的记忆。分层线性回归模型显示，除协变量外，父母对孩子疼痛的灾难化（放大、反复思考）在孩子的情感疼痛记忆和父母的感觉疼痛记忆中占了很大一部分方差。虽然父母的灾难化对疼痛记忆有直接影响，但中介分析表明，儿童的灾难化（无助感）通过孩子的术后疼痛经历间接影响孩子和父母的疼痛记忆。研究结果突出表明，手术前对儿童疼痛的灾难化思维与几个月后痛苦的疼痛记忆有关。虽然儿童和父母的灾难化都影响疼痛记忆的发展，但父母的灾难化对孩子和父母对儿童疼痛不断演变的认知影响最大。
