Pain reactivity and illness behaviour in kindergarten-aged children

Little is known about the factors that influence pain and somatization in young children. This study tested a proposed model to examine the predictors of pain reactivity and illness behaviour in children. A sample of 157 kindergarten aged children requiring routine inoculation and their mothers participated. To assess the prediction that mothers' sensitivity to variations in facial pain expressions would influence children's pain reactivity, mothers watched and rated 12 video clips of facial pain expressions. Next, children's responses to inoculation were videotaped and coded for pain reactivity using the Facial Action Coding System. Mothers completed questionnaires assessing: their child's previous experience with medical procedures, family history of pain, parental encouragement of illness behaviour (Illness Behavior Encouragement Scale}, level of somatic complaints (Children's Somatization Inventory}, and temperament (Behavioral Style Questionnaire). A multiple regression examining the predictors of pain reactivity was significant, F(6, 151 ) = 4.1, p < .001. Children's temperament and experience with previous medical procedures were significant predictors. A multiple regression examining the predictors of illness behavior was significant, F(3, 154) = 2.6, p <.05. Pain reactivity was the only significant predictor. These findings suggest that continued consideration be given to the role of children's previous experiences with medical procedures and temperamental style in response to painful stimuli. Moreover, because pain reactivity was significantly related to illness behaviour, interventions designed to minimize non-adaptive pain response in children who exhibit extreme reactivity may lead to decreased somatization. Results are discussed in terms of future research directions and clinical implications.