Poster #107 - Maternal use of Distraction During Children’s Acute Pain: Associations with Chronic Pain

• In Event: 2-110 - Poster Session 07
  In Poster Session: PS 07 Section - Health, Growth, Injury

Integrative Statement

Background
Distraction is a common technique used by parents to help their children cope with pain and is currently a pediatrician-recommended strategy (Zeltzer & Schlank, 2005). Whereas the use of parental distraction during a cold pain-inducing task has been linked with increased pain tolerance (Moon, Chambers, & McGrath, 2011), its relation with child chronic pain symptoms is not well understood. Because benign chronic pain is common in children and adolescents (Peterson, Brulin, & Bergstorm, 2006) and is associated with greater risk for chronic pain in adulthood (Brattberg, 2004), elucidating environmental mechanisms contributing to children’s pain can aid interdisciplinary efforts to reduce the burden of chronic pain.

Purpose
This study examined associations between parental use of distraction during a pain-induction task with child acute and chronic pain symptoms.

Methods
Participants were mothers and their 9-year-old twin children (N=328 children; 50.9% male; 59.8% Caucasian, 24.7% Latino, 15.5% multi-race and other) who were recruited from birth records and enrolled in a community-based study of child socioemotional development. During study home visits, children participated in a cold-pressor pain induction task (CPT) with and without their mother present in counterbalanced order. Videotapes were coded for frequency of maternal verbal behavior designed to distract the child from the task (percent reliability >.90). Acute pain tolerance was measured by the number of seconds children kept their hand in the water (max. 240 seconds), and chronic pain symptoms were measured by a sum score (0-3) of child-reported monthly or more headaches, stomachaches, and backaches over the past 3 months. Analyses included multilevel modeling (twins clustered within families) to evaluate proposed relations.

Results
Parent percent of time spent distracting during child CPT was positively associated with child pain tolerance, both when parent was present (F(1,259) =12.35 , p <.001) and when not present (F(1,261) = 4.27, p < .05) (see Table 1). Regarding chronic pain symptoms, parent distracting was positively associated with number of sites in which twins reported monthly or more pain (F(1,211) =4.66 , p <.04). Maternal age, child age, child sex, and child ethnicity were tested as covariates, and only significant factors were retained in final models: child female sex was associated with longer pain tolerance during both CPT trials.

Conclusion
Consistent with Moon et al., (2011), parental use of distraction was associated with elevated acute pain tolerance during CPT in children, suggesting that distraction may be helpful in the management of acute pain. However, parental use of distraction was associated with increased child reports of monthly or more headache, stomachache, and backache. Because the associations are cross-sectional, it is possible that parents of children with more versus less recurrent pain use distraction more frequently to distract during child pain situations. An alternative explanation is that parents who use distraction techniques for their children encourage the suppression of pain sensations and thoughts, which may be associated with greater subsequent pain (Goubert et al., 2004; Johnson, 2005). Further research should examine the impact of parental distraction techniques on the early development of chronic pain.

Authors

• Shannon V. Moore, Arizona State University
  Presenting Author

• Mary C. Davis, Arizona State University
  Non-Presenting Author

• Kathryn Lemery-Chalfant, Arizona State University
  Non-Presenting Author