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Poster #107 - Computer Coding of Children’s Facial Expressions of Acute Pain: The Role of Effortful Control

Thu, March 21, 9:30 to 10:45am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Objective:
The Facial Action Coding System (FACS; Ekman & Rosenberg, 1997) is a reliable way to gather an unbiased representation of the ways a person reacts to painful external stimuli (Graig, Rrkachin, & Grunau, 1992). In previous research, eight Action Units (facial muscle movements) have been identified as important for the expression of pain in adult human faces (Deyo, Prkachin, & Mercer, 2004; Prkachin, 2009), but facial expressions of pain among children have not been examined. The goals of this project were to examine whether or not a) the eight previously identified action units indicating pain facial expressions in adults held together in a sample of 9-year-old children using factor analysis, and b) the resulting factor(s) representing pain facial expressions were related to children’s temperament.

Method:
Participants included 181 twin children (50% female, 56.4% Non-Hispanic White, 30% Hispanic) from an ongoing, longitudinal study of twins. Families were recruited from birth records, and when children were nine-years of age, they participated in an intensive health assessment in the home that included the cold pressor pain induction task (CP). During the CP, children immersed their hand into ice cold water and kept it submerged for as long as they could, up to four minutes. Children’s facial expressions during the CP were coded using Affectiva software, a new and validated coding method (iMotions, 2016). The percent of time children displayed each of the eight facial Action Units comprised the facial expression data. Primary caregivers completed the Temperament in Middle Childhood Questionnaire for each of their twins to assess aspects of effortful control (Simonds & Rothbart, 2007).

Results:
To address the first goal, a principal components analysis with the eight facial Action Units, which yielded two components corresponding to two types of pain facial expressions: a surprise pain face (composed of brow furrow, mouth open, cheek raise, lip stretch, and jaw drop), and a scrunched pain face (composed of eye closure and nose wrinkle). Component scores were computed and square root transformed to address skewness and kurtosis.

To address the second goal, mixed model regression analyses that accounted for twin interdependence were conducted to predict the surprise and scrunched pain faces from children’s temperament. Controlling for age, sex, and family socioeconomic status, the surprise pain face was predicted by children’s attentional focusing (b = 0.02, p = .020) and inhibitory control (b = -0.04, p = .002), whereas the scrunched pain face was unrelated to temperament.

Conclusions:
The surprise pain face was related to lower inhibitory control and greater attentional focusing, the two components of overall effortful control. Effortful control, “the ability to suppress a dominant response in order to perform a subdominant response” (Rothbart, et al., 2003, p. 1154), is a common measure of self-regulation in childhood and may relate to a child’s ability to endure acute pain. Future work is needed to examine the genetic and environmental contributions to the association of children’s pain and temperament.

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