Determinants for positive and negative experiences of interpersonal touch: context matters.

The goal of the study was to determine which aspects of interpersonal touch interactions lead to a positive or negative experience. Previous research has focused primarily on physical characteristics. We suggest that this may not be sufficient to fully capture the complexity of the experience. Specifically, we examined how fulfilment of psychological needs influences touch experiences and how this relates to physical touch characteristics and situational factors.In two mixed-method studies, participants described their most positive and most negative interpersonal touch experience within a specific time frame. They reported fulfilment of nine needs, affect, intention, and reason for positivity/negativity, as well as the body part(s) touched, location, type of touch, interaction partner, and particular touch characteristics (e.g. humidity).Positive and negative touch experiences shared similar touch types, locations, and body parts touched, but differed in intended purpose and reasons. Overall, the valence of a touch experience could be predicted from fulfilment of relatedness, the interaction partner and initiator, and physical touch characteristics. Positive affect increased with need fulfilment, and negative affect decreased.The results highlight the importance of relatedness and reciprocity for the valence of touch, and emphasise the need to incorporate psychological needs in touch research.

Signs and symptoms of pediatric complex regional pain syndrome - type 1: A retrospective cohort study.

Background: Complex regional pain syndrome (CRPS) presents with an array of symptoms that can vary from child to child, making it difficult to diagnose and differentiate from other pain conditions such as chronic musculoskeletal (MSK) pain. Thirteen symptoms and signs are outlined in the Budapest criteria for CRPS (developed and validated for adults) but have not been well described in pediatrics. Aims: The aim of this study was to describe the signs and symptoms of pediatric CRPS type 1 (CRPS 1) and determine whether a cluster of symptoms can differentiate CRPS 1 from chronic MSK pain. Methods: A retrospective cohort study of pediatric patients with CRPS 1 and MSK pain in a pediatric pain program was conducted. Descriptive statistics were used to report demographics and pain characteristics. The chi-square test was used to evaluate differences in signs and symptoms between patients with CRPS and MSK pain. A logistic regression model was used to evaluate whether a cluster of symptoms could predict a diagnosis of CRPS 1. Results: The sample included 187 patients (99 with CRPS 1 and 88 with MSK pain); 81% were female with a mean age 14.1 years. The most prevalent CRPS symptoms were hyperalgesia (54%) and allodynia (52%). A cluster of symptoms (hyperalgesia, color changes, and range of motion) predicted the probability of a diagnosis of CRPS 1. Conclusions: A cluster of symptoms may be critical in differentiating pediatric CRPS 1 and MSK pain. Future research is needed to determine if this model is valid in external populations and to explore whether a similar model can differentiate CRPS 1 from other pain conditions (e.g., neuropathic pain).

Contexte: Le syndrome douloureux régional complexe présente un éventail de symptômes qui peuvent varier d'un enfant à l'autre, ce qui rend difficile le diagnostic et la différenciation des autres affections douloureuses telles que la douleur musculo-squelettique chronique. Treize symptômes et signes sont décrits dans les critères de Budapest pour le syndrome douloureux régional complexe (développés et validés pour les adultes) mais ceux-ci n'ont pas encore été bien décrits en pédiatrie.Objectifs: L'objectif de cette étude était de décrire les signes et symptômes du syndrome douloureux régional complexe pédiatrique de type 1 et de déterminer si un groupe de symptômes pouvait le différencier de la douleur musculo-squelettique chronique.Méthodes: Une étude de cohorte rétrospective de patients pédiatriques atteints de syndrome douloureux régional complexe de type 1 et de douleur musculo-squelettique chronique dans le cadre d'un programme de lutte contre la douleur pédiatrique a été mis en place. Des statistiques descriptives ont été utilisées pour rendre compte des données démographiques et des caractéristiques de la douleur. Le test du chi carré a été utilisé pour évaluer les différences dans les signes et les symptômes entre les patients souffrant de syndrome douloureux régional complexe et de douleur musculo-squelettique chronique. Un modèle de régression logistique a été utilisé pour évaluer si un groupe de symptômes pourrait prédire un diagnostic de syndrome douloureux régional complexe de type 1 en pédiatrie.Résultats: L'échantillon comprenait 187 patients pédiatriques (99 atteints de syndrome douloureux régional complexe de type 1 et 88 atteints de douleur musculo-squelettique chronique); 81 % étaient de sexe féminin, avec un âge moyen de 14,1 ans. Les symptômes de syndrome douloureux régional complexe de type 1 pédiatrique les plus fréquents étaient l'hyperalgésie (54 %) et l'allodynie (52 %). Un groupe de symptômes (hyperalgésie, changements de couleur et amplitude de mouvement) prédisait la probabilité d'un diagnostic de syndrome douloureux régional complexe d type 1 pédiatrique.Conclusions: Un groupe de symptômes peut être essentiel pour différencier le syndrome douloureux régional complexe de type 1 pédiatrique de la douleur musculo-squelettique chronique. D'autres études sont nécessaires pour déterminer si ce modèle est valide parmi les populations externes et pour déterminer si un modèle similaire peut différencier le syndrome douloureux régional complexe de type 1 pédiatrique d'autres conditions douloureuses (p. ex., la douleur neuropathique).

Gentle as a mother's touch: C-tactile touch promotes autonomic regulation in preterm infants.

Preterm infants are challenged to adapt to an extrauterine milieu, while their interoceptive system and autonomic regulation capacity is still immature. Caressing parental touch is known to foster parasympathetic regulation in infants by stimulating C-tactile (CT) afferents and in preterm infants, slow stroking stimulation also leads to a heart rate decrease. The particular impact of maternal stroking has not yet been investigated and factors influencing the maturation of the CT system in preterm infants remain unclear. We therefore analysed 53 standardized events in which preterm infants (24 to 36 weeks gestational age at birth) were stroked by their mothers. Video analysis revealed that mothers use CT optimal velocities to stroke their preterm child. Analysis of pulse oximetric data showed no effect of stroking on infantile blood oxygenation, but a significant decrease of the heart rate. Compared to term-born children, this decrease was delayed by about two minutes. Furthermore, our data suggested that more immature preterm infants benefited less from stroking than more mature ones. We conclude that maternal stroking touch targets CT afferents in preterm infants and that the preterm CT system is not yet mature.

Exposure to Parental Depressive Symptoms: A Longitudinal Analysis on the Association with Adolescents' Depressive Symptoms and Adjustment Problems.

OBJECTIVE: Parental depressive symptoms have been associated with depressive symptoms and adjustment problems in adolescents. However, longitudinal studies assessing both mothers' and fathers' depressive symptoms over time and their association with adolescents' outcomes are sparse. METHODS: Data were obtained from the Study of Early Child Care and Youth Development. A total of 1364 children and families were followed from the child's birth until the age of 15 years. Adolescents' depressive symptoms were evaluated via self-reported questionnaire at ages 11 to 15 years. Adjustment problems at 15 years of age were defined as high internalizing and/or externalizing problems. Parental depressive symptoms were assessed several times during the study period. Trajectories created using partitional clustering analyses were entered in logistic regression models to predict adolescents' outcomes. RESULTS: After adjusting for sociodemographic variables, adolescents' outcomes were associated with every additional time point of reported maternal (depressive symptoms: odds ratio [OR] = 1.2, p = 0.001; adjustment problems: OR = 1.1, p = 0.003) and paternal depressive symptoms (adjustment problems: OR = 1.2, p = 0.027). When maternal and paternal depressive symptom trajectories were combined, we found adolescents' depressive symptoms to be significantly associated with mother elevated and stable subclinical father scores (OR = 3.3, p = 0.003) and girls (OR = 5.4, p < 0.001). Adjustment problems were associated with father elevated and stable subclinical mother (OR = 1.9, p = 0.003) and mother elevated and stable subclinical father (OR = 2.1, p = 0.001) trajectories. CONCLUSION: Parental depressive symptoms are an important risk factor for adolescents' outcomes. This highlights the importance of continuously evaluating parents' mental status across child development. The cumulative effect of recurrent depressive symptoms and the combined parental trajectories are especially predictive for the development of adolescents' outcomes.

Assessment of Pain-related Disability in Pediatric Chronic Pain: A Comparison of the Functional Disability Inventory and the Pediatric Pain Disability Index.

OBJECTIVES: The assessment of pain-related disability in pediatric chronic pain patients plays an important role in research on the effectiveness of pain treatment. The present study aimed to compare the 2 available measures of pain-related disability in the German language, the Functional Disability Inventory (FDI) and Pediatric Pain Disability Index (PPDI), in terms of psychometric properties and convergent validity. In addition, associations between FDI/PPDI scores and sex, age, and pain locations were investigated. MATERIALS AND METHODS: Data of N=250 pediatric pain patients (Mage=14.4, SD=1.8) were collected at the patients' initial presentation to a specialized pediatric pain center. RESULTS: The results revealed similarly sound psychometric properties in terms of model fit, item difficulties, corrected item-total correlations, and missing values for both measures. However, item difficulties for the FDI were rather low. Both measures displayed good convergent validity in terms of associations with pain intensity, pain-related school absence, and emotional functioning (anxiety, depression). In both measures, girls had significantly higher scores than boys. No associations were found between the FDI/PPDI total scores and age or pain location. DISCUSSION: In conclusion, both measures are equally suited to assess pain-related disability in adolescents with chronic pain. The FDI should be used with caution in epidemiological studies due to the risk of floor effects. Further research is needed with regard to the relationship between pain-related disability and sex.