Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
Research Group Health Psychology, KU Leuven, Leuven, Belgium.
Pain. 2019 Feb;160(2):322-333. doi: 10.1097/j.pain.0000000000001402.
This study investigated the moderating role of parental pain-related attention-set shifting and heart rate variability (HRV) for parental distress and pain control behaviour when faced with their child's pain. Participants were 54 schoolchildren and one of their parents. Parental HRV was assessed at study commencement followed by a cued-switching task indexing parental ability to flexibly shift attention between pain-related and neutral attentional sets. In a subsequent phase, parents observed their child perform a cold-pressor task [CPT], allowing for assessment of parental pain control behavior (indexed by latency to stop their child's CPT performance) and parental distress-assessed through self-report following observation of child CPT performance. Findings indicated that parental facilitated attentional shifting (ie, engage) towards a pain-related attentional set contributed to higher levels of pain control behaviour when faced with increasing levels of child facial display of pain. Pain control behaviour among parents who demonstrated impeded attentional shifting to a pain-related attentional set was equally pronounced regardless of low or high levels of child pain expression. Parental ability to shift attention away (ie, disengage) from a pain-related set to a neutral set did not impact findings. Results further indicated that although high levels of parental HRV buffer the impact of child facial pain display on parental emotional distress and pain control behaviour, low levels of HRV constitute a risk factor for higher levels of parental distress and pain control behaviour when faced with increased child facial pain display. Theoretical/clinical implications and further research directions are discussed.
本研究调查了父母与疼痛相关的注意力转换和心率变异性(HRV)在面对孩子疼痛时对父母痛苦和疼痛控制行为的调节作用。参与者包括 54 名学龄儿童及其父母中的一位。在研究开始时评估了父母的 HRV,随后进行了提示切换任务,该任务反映了父母在疼痛相关和中性注意力之间灵活转换注意力的能力。在随后的阶段,父母观察他们的孩子进行冷加压测试(CPT),从而评估父母的疼痛控制行为(通过观察孩子 CPT 表现后的自我报告来评估)和父母的痛苦(通过观察孩子 CPT 表现后的自我报告来评估)。研究结果表明,当面对孩子面部疼痛表情增加时,父母促进注意力向疼痛相关注意力集中(即参与)有助于提高疼痛控制行为水平。在注意力难以转移到疼痛相关注意力集中的父母中,疼痛控制行为同样明显,无论孩子的疼痛表达水平高低。父母从疼痛相关注意力集中转移到中性注意力集中的能力(即脱离)不会影响研究结果。研究结果进一步表明,尽管父母的 HRV 水平较高可以缓冲孩子面部疼痛表情对父母情绪困扰和疼痛控制行为的影响,但当孩子面部疼痛表情增加时,HRV 水平较低是父母情绪困扰和疼痛控制行为水平较高的风险因素。讨论了理论/临床意义和进一步的研究方向。