The numerous pain rating scales using faces depicting varying degrees of distress to elicit reports of pain from children fall into two categories; those with a neutral face as the 'no pain' anchor, and those with a smiling face as the 'no pain' anchor. This study examined the potentially biasing impact of these anchor types on children's self-reports of pain in response to a series of vignettes. Participants were 100 children stratified by age (5-6 years, 7-8 years, 9-12 years) and randomly assigned to one of three groups: 1) neutral scale/sensory instructions; 2) smiling scale/sensory instructions; 3) smiling scale/affective instructions. Children completed a faces scale, a visual analogue scale (VAS), and emotions ratings in response to four scenarios depicting: 1) no pain/negative emotions; 2) pain/negative emotions; 3) no pain/positive emotions; 4) pain/positive emotions. Results showed that children who used the smiling scale had significantly higher pain scores for no pain and pain/negative emotions vignettes, and significantly lower faces scale scores for pain/positive vignettes, than children who used the neutral faces scale. Instructions varying in focus on sensory or affective qualities of pain had no effect on children's pain ratings. Group differences in children's ratings with the VAS and emotions measure suggested that rating pain with a smiling faces scale may alter a child's concept of pain. Age differences indicated the younger children rated the negative emotion vignettes as more painful than the older children. These findings suggest that children's pain ratings vary depending on the types of faces scale used, and that faces scales with smiling anchors may confound affective states with pain ratings.

The numerous pain rating scales using faces depicting varying degrees of distress to elicit reports of pain from children fall into two categories; those with a neutral face as the 'no pain' anchor, and those with a smiling face as the 'no pain' anchor. This study examined the potentially biasing impact of these anchor types on children's self-reports of pain in response to a series of vignettes. Participants were 100 children stratified by age (5-6 years, 7-8 years, 9-12 years) and randomly assigned to one of three groups: 1) neutral scale/sensory instructions; 2) smiling scale/sensory instructions; 3) smiling scale/affective instructions. Children completed a faces scale, a visual analogue scale (VAS), and emotions ratings in response to four scenarios depicting: 1) no pain/negative emotions; 2) pain/negative emotions; 3) no pain/positive emotions; 4) pain/positive emotions. Results showed that children who used the smiling scale had significantly higher pain scores for no pain and pain/negative emotions vignettes, and significantly lower faces scale scores for pain/positive vignettes, than children who used the neutral faces scale. Instructions varying in focus on sensory or affective qualities of pain had no effect on children's pain ratings. Group differences in children's ratings with the VAS and emotions measure suggested that rating pain with a smiling faces scale may alter a child's concept of pain. Age differences indicated the younger children rated the negative emotion vignettes as more painful than the older children. These findings suggest that children's pain ratings vary depending on the types of faces scale used, and that faces scales with smiling anchors may confound affective states with pain ratings. / Arts, Faculty of / Psychology, Department of / Graduate

Thesis (M.A.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains v, 69 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 36-40).

Thesis (M.S.)--Ohio State University, 2009. / Title from first page of PDF file. Includes vita. Includes bibliographical references (p. 26-28).

Thesis (Ph. D. in Psychology)--Vanderbilt University, Dec. 2009. / Title from title screen. Includes bibliographical references.

Examination of the published literature suggests that a substantial number of children are "undermedicated" for the painful conditions they are being evaluated for in the emergency department (ED). The purpose of this retrospective chart review was to examine the differences between the Agency for Health Care Policy and Research (AHCPR) recommendation for acute pain management and actual analgesic administration for children with known painful conditions, fractures, and burns, at one metropolitan level 1 trauma center. A researcher-developed data collection tool was used to examine demographic information, presenting conditions, documented pharmacologic and nonpharmacologic therapies, and documented analgesic administration to children. Results indicated that in all age groups ( n= 100), children received pain medication for known painful conditions (p=.00). Significance was demonstrated that 14-17 year olds are medicated more often compared with 0-4 year olds (p=.01), 5-9 year olds (p=.02) and 10-13 year olds (p=.04). There was no statistical significance in the use of pharmacological interventions for fractures or burns (p=.10). There was no statistical difference in nonpharmacological pain management measures for fractures or burns (p=. 78). Statistical significance was shown (p=.00) for fractures and burns not receiving adequate initial dosages of analgesics per AHCPR guidelines. These findings were consistent with suboptimal analgesic administration for known painful conditions based on AHCPR recommendations.

Thesis (M.A.)--Georgia State University, 2007. / Title from file title page. Lindsey L. Cohen, committee chair;Lisa Armistead, Chris Henrich, committee members. Electronic text (67 p. : ill.) : digital, PDF file. Description based on contents viewed Dec. 13, 2007. Includes bibliographical references (p. 42-49) and index.

Children are often required to repeatedly undergo painful medical procedures (e.g. immunizations) and their memories for pain are predictive of their health behaviours across the lifespan. Although trait anxiety has been shown to influence pain memories, little is known about the impact of state anxiety, and the influence of stable anxiety-related variables (e.g., anxiety sensitivity), on children’s memories for pain. Furthermore, although memory is often implicated in children’s reactions to future pain, there is a dearth of research directly examining the relationship between the two. The current dissertation project involved two studies. The first study investigated the impact of experimentally manipulated state anxiety, and the influence of anxiety-related variables, on children’s memories for a novel pain experience. The second study examined the influence of children’s pain memories on a subsequent pain experience. In Study 1, one hundred ten children (60 boys; 50 girls) between the ages of 8 and 12 years (Mage = 9.45 years, SD = 1.35) were randomly assigned to complete either a state anxiety induction task or a control task. Then, children completed a laboratory pain task (the cold pressor task) and provided pain ratings. Children also completed measures of state anxiety and stable anxiety-related variables. Two weeks following the laboratory visit, children were contacted by telephone and provided pain ratings based on their memories of the initial pain experience, as well as their expectancies about future pain. Results showed that children in the state anxiety induction group did not have more negative pain memories (i.e., they did not recall higher levels of pain) than children in the control group. However, irrespective of group assignment, children who had higher levels of state anxiety had more negative memories of pain intensity and pain-related fear than children with lower levels of state anxiety. Furthermore, state anxiety was a unique predictor of children’s pain memories over and above the influences of sex, stable anxiety-related variables, and experienced pain intensity and pain-related fear. Stable anxiety-related variables (anxiety sensitivity and trait anxiety) were also significant predictors of recalled pain-related fear. In Study 2, the same children once again completed the pain task and provided pain ratings one month following the initial laboratory visit. Results revealed that children’s memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial experience of pain intensity; in fact, children’s pain memories mediated the relationship between reporting of pain intensity at Lab Session 1 and Lab Session 2. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate and positively estimated pain memories. Overall, these data highlight the importance of anxiety in the development of children’s memories for pain and present a model of acute pain memories that add to the growing literature on pain memories across development. Results also highlight the powerful influence of pain memories on healthy children’s pain expectancies and subsequent pain experiences, and extend predictive models of subsequent pain reporting to childhood.

Thesis (Ph. D. in Psychology)--Vanderbilt University, Dec. 2007. / Title from title screen. Includes bibliographical references.

Thesis (Ph. D.)--University of Nevada, Reno, 2006. / "December 2006." Includes bibliographical references (leaves 61-72). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2006]. 1 microfilm reel ; 35 mm.