Ives Lindsay T, Stein Kate, Rivera-Cancel Alannah M, Nicholas Julia K, Caldwell Kristen, Datta Nandini, Mauro Christian, Egger Helen, Puffer Eve, Zucker Nancy L
Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA.
Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK.
Children (Basel). 2021 May 27;8(6):452. doi: 10.3390/children8060452.
Functional abdominal pain (FAP) is one of the most common childhood medical complaints, associated with significant distress and impairment. Little is known about how children understand their pain. Do they attribute it to personal weakness? Do they perceive pain as having global impact, affecting a variety of activities? How do they cope with pain? We explored the pain beliefs of 5- to 9-year-old children with FAP using a novel Teddy Bear Interview task in which children answered questions about a Teddy bear's pain. Responses were analyzed quantitatively and qualitatively. Results indicate that the majority of young children with FAP are optimistic about pain outcomes. Children generated many types of coping strategies for Teddy's pain and adjusted their calibration of Teddy's pain tolerance dependent on the activity being performed. Early warning signs also emerged: a subset of children were pessimistic about Teddy's pain, and several children identified coping strategies that, while developmentally appropriate, could lead to excessive help seeking if not intervened upon (e.g., physician consultation and shot). The Teddy Bear Interview allows children to externalize their pain, making it a useful tool to access cognitive pain constructs in younger children. Thus, these findings highlight the importance of early intervention for childhood FAP.
功能性腹痛(FAP)是儿童期最常见的医学主诉之一,会导致明显的痛苦和功能损害。关于儿童如何理解自己的疼痛,我们知之甚少。他们会将疼痛归因于个人弱点吗?他们是否认为疼痛具有广泛影响,会影响各种活动?他们如何应对疼痛?我们使用一种新颖的泰迪熊访谈任务,探究了5至9岁功能性腹痛儿童的疼痛观念,在该任务中,孩子们回答有关一只泰迪熊疼痛的问题。对回答进行了定量和定性分析。结果表明,大多数患有功能性腹痛的幼儿对疼痛结果持乐观态度。孩子们为泰迪的疼痛想出了多种应对策略,并根据所进行的活动调整了对泰迪疼痛耐受性的判断。早期预警信号也出现了:一部分孩子对泰迪的疼痛持悲观态度,还有几个孩子确定了一些应对策略,这些策略虽然在发育上是适当的,但如果不加以干预,可能会导致过度寻求帮助(例如,咨询医生和打针)。泰迪熊访谈让孩子们能够将自己的疼痛外化,使其成为了解年幼儿童认知疼痛结构的有用工具。因此,这些发现凸显了对儿童功能性腹痛进行早期干预的重要性。