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BACKGROUND: Pediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years. METHODS: Available longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child's pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models. RESULTS: Gut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11. CONCLUSIONS: Some, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.
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Dor Crônica , Humanos , Dor Crônica/epidemiologia , Dor Crônica/psicologia , Dor Crônica/etiologia , Criança , Fatores de Risco , Feminino , Masculino , Estudos Longitudinais , Pré-Escolar , Lactente , Estudos ProspectivosRESUMO
OBJECTIVES: Perceived expectations for active aging (PEAA) reflect subjective exposure to social expectations about staying active and fit in old age, for example, by maintaining health and social engagement. We investigated whether motivational and personality factors were related to PEAA in the domains of physical health, mental health, and social engagement. METHOD: We used a nationally representative sample of German adults (SOEP-IS) covering the entire adult life span (N = 2,007, age range 16-94 years) to test our pre-registered hypotheses. RESULTS: Multiple regression analyses indicated that motivation (i.e. life goals and health-related worries) was consistently associated with PEAA in the matching domains and mediated the effects of openness to experience on PEAA. No other personality trait was associated with PEAA. CONCLUSION: Our findings suggest that individuals preferentially notice the expectations for active aging whose content relates to their personal concerns and goals.
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State-of-the-art therapy improves the five-year survival rate of patients under the age of 20 with cranial and craniospinal tumors by up to 74%. The urgency of dealing effectively with late treatment-associated cardiovascular complications is rising. Objective: We aimed to assess echocardiographic parameters and exercise performance in subjects with a history of complex treatment for cranial and craniospinal tumors in childhood. Methods: the study of 48 subjects who underwent cranial and craniospinal irradiation for CNS tumors in childhood and 20 healthy age- and sex-matched volunteers was conducted. The examination included hormone studies, cardiopulmonary exercise testing, and, in the main group, echocardiography (ECHO). Results: In five (10.4%) patients, ECHO changes were detected after complex anti-cancer treatment: thickening and calcification of the aortic valve leaflets (2%), and reduction in the systolic LV and RV function (8% and 6%, respectively). Irradiation of various areas was a significant predictor for reduced exercise tolerance, hyperventilation at rest and upon exertion, and an increased ventilatory equivalent for carbon dioxide. Low exercise tolerance was associated with a younger age at the time of treatment initiation. Significant differences were noted between the control group and the childhood cancer survivors with endocrine disorders. Conclusions: The obtained data confirm the importance of regular cardiovascular and endocrine monitoring of this group of cancer survivors.
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ABSTRACT: Research has consistently suggested that media consumption plays a vital role in children's socialization, including the socialization of painful experiences. Past research examining young children's popular media revealed worrisome trends in media depictions of pain; it consisted of narrow depictions of pain, gender stereotypes, and an overwhelming lack of empathy from observers, which could contribute to pain-related stigma. Research has not yet examined how pain is portrayed in adolescent media, despite adolescence being the developmental period when chronic pain often emerges. The current study extracted a cross-section of popular adolescent media selected based on popularity, including 10 movies and the first seasons of 6 TV shows. Pain instances were coded using 2 established observational coding schemes assessing sufferer pain characteristics and observer responses. Across 616 instances of pain, there was a preponderance of violence and injuries, whereas everyday, chronic-type, and medical/procedural pains were seldom represented. Individuals from marginalized (ie, gender diverse, girls) and minoritized groups (individuals with racialized identities) were underrepresented in pain instances. Furthermore, regardless of observed gender or "race," observers displayed a lack of empathy for sufferers and rarely engaged in prosocial behaviors. Popular media may serve as an agent of socialization in adolescence; thus, pain depictions may be a powerful force in propagating pain-related stigma and inequities. An opportunity exists to harness popular media to adaptively and accurately portray pain to adolescents.
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Meios de Comunicação de Massa , Dor , Humanos , Adolescente , Feminino , Masculino , Dor/psicologia , Empatia , Estudos TransversaisRESUMO
Background: Sensitivity to pain traumatization is defined as the propensity to develop cognitive, affective, and behavioral responses to pain that resemble a traumatic stress reaction. To date, sensitivity to pain traumatization has been assessed in adults (Sensitivity to Pain Traumatization Scale [SPTS-12]) and parents of youth with chronic pain (Sensitivity to Pain Traumatization Scale-Parent version [SPTS-P]). SPT may be relevant in the context of pediatric chronic pain given the substantial comorbidity between posttraumatic stress symptoms and pain. Aims: This prospective study aimed to adapt the SPTS-12 for use in youth and to evaluate the psychometric properties of the new scale. Methods: Participants included 175 youth with chronic pain (Mage = 14.31 years, 73% girls) referred to outpatient chronic pain programs. At baseline, youth self-reported the levels of their sensitivity to pain traumatization (Sensitivity to Pain Traumatization Scale-Child version [SPTS-C]), as well as their pain symptoms, pain-related anxiety, posttraumatic stress symptoms, and attentional control. Three months later, youth self-reported their pain symptoms and completed the SPTS-C. Results: The SPTS-C had a one-factor structure that explained 48% of variance and demonstrated good reliability and construct validity. SPTS-C baseline scores predicted follow-up levels of pain interference but not pain intensity or pain unpleasantness. Conclusions: The results provide preliminary evidence for the psychometric properties of the SPTS-C and the potential role of SPT in pediatric chronic pain outcomes.
Contexte: La sensibilité à la traumatisation de la douleur est définie comme la propension à développer des réponses cognitives, affectives et comportementales à la douleur qui ressemblent à une réaction de stress traumatique. À ce jour, la sensibilité à la traumatisation de la douleur a été évaluée chez les adultes (Échelle de sensibilité à la traumatisation de la douleur [SPTS-12]) et chez les parents de jeunes souffrant de douleur chronique (Échelle de sensibilité à la traumatisation de la douleur - Version parent [SPTS-P]). La sensibilité à la traumatisation de la douleur peut être pertinente dans le contexte de la douleur chronique pédiatrique étant donné la comorbidité importante entre les symptômes de stress post-traumatique et la douleur.Objectifs: Cette étude prospective visait à adapter le SPTS-12 pour une utilisation chez les jeunes et à évaluer les propriétés psychométriques de la nouvelle échelle.Méthodes: Les participants comprenaient 175 jeunes souffrant de douleur chronique (âge M = 14,31 ans, 73 % de filles) référés aux programmes de traitement ambulatoire de la douleur chronique. Au départ, les jeunes ont autodéclaré les niveaux de leur sensibilité à la traumatisation de la douleur (Échelle de sensibilité à la traumatisation de la douleur - version enfant [SPTS-C]), ainsi que leurs symptômes de douleur, leur anxiété liée à la douleur, leurs symptômes de stress post-traumatique et leur contrôle attentionnel. Trois mois plus tard, les jeunes ont autodéclaré leurs symptômes de douleur et ont répondu au SPTS-C.Résultats: Le SPTS-C avait une structure à un facteur qui expliquait 48 % de la variance et démontrait une bonne fiabilité ainsi qu'une bonne validité de la construction. Les scores obtenus au SPTS-C au départ prédisaient les niveaux d'interférence de la douleur au suivi mais pas l'intensité de la douleur ou le désagrément de la douleur.Conclusions: Les résultats présentent des preuves préliminaires des propriétés psychométriques du SPTSC et le rôle potentiel de la sensibilité à la traumatisation de la douleur dans les résultats liés à la douleur chronique pédiatrique.
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In the present article, I review theory and evidence on the psychological mechanisms of mind wandering, paying special attention to its relation with executive control. I then suggest applying a dual-process framework (i.e., automatic vs. controlled processing) to mind wandering and goal-directed thought. I present theoretical arguments and empirical evidence in favor of the view that mind wandering is based on automatic processing, also considering its relation to the concept of working memory. After that, I outline three scenarios for an interplay between mind wandering and goal-directed thought during task performance (parallel automatic processing, off-task thought substituting on-task thought, and non-disruptive mind wandering during controlled processing) and address the ways in which the mind-wandering and focused-attention spells can terminate. Throughout the article, I formulate empirical predictions. In conclusion, I discuss how automatic and controlled processing may be balanced in human conscious cognition.
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Cognição , Pensamento , Humanos , Função Executiva , Memória de Curto Prazo , Estado de ConsciênciaRESUMO
Yersinia enterocolitica is a foodborne pathogen, mainly associated with disorders involving the gastrointestinal tract, including diarrhea, ileitis, and mesenteric lymphadenitis. Extraintestinal presentation is uncommon in healthy individuals, but bacteremia is reported in immunocompromised hosts. We present a 74-year-old male with Y. enterocolitica serogroup O:3 bacteremia who complicated to rupture of an abdominal aortic aneurysm. With the current case report, we aimed to emphasize the association of Y. enterocolitica bacteremia with abdominal aortic aneurysm rupture. Better surveillance is needed, not only to reduce morbidity and mortality but also to update current epidemiological data on the incidence of such associations.
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Children remember their memories of pain long after the painful experience is over. Those memories predict higher levels of future pain intensity. Young children's memories can be reframed to be less distressing. Parents and the way they reminisce about past events with their children play a key role in the formation of pain memories. A novel parent-led memory-reframing intervention changed children's memories of post-surgical pain to be less distressing. The intervention efficacy in the context of vaccine injections is unclear. This registered randomized controlled trial (NCT05217563) aimed to fill this gap. Seventy-four children aged 4.49 years (SD = 1.05) and scheduled to obtain two COVID-19 vaccine injections and one of their parents were randomized to receive: (1) standard care; (2) standard care and memory-reframing information; and (3) standard care and memory-reframing information with verbal instructions. Children reported their pain after vaccine injections. One week after the first vaccination, children reported memory of pain. Parents reported their use of memory-reframing strategies and intervention feasibility and acceptability. The intervention did not result in significant differences in children's recalled or future pain. Parents rated the intervention as acceptable and feasible.
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Older adults are faced with prescriptions to remain fit and socially engaged (active aging) or limit consumption of social resources (altruistic disengagement), and violations of these may result in backlash and marginalization. Despite such negative consequences that prescriptive views of aging (PVoA) may have for older adults, whether PVoA endorsement is modifiable is still to be examined. Thus, in our study, we investigated the malleability of PVoA endorsement. Further, we explored whether malleability of PVoA endorsement generalizes across specific age norms (active aging and altruistic disengagement), life domains (health and social), and targets (others and self). We conducted two preregistered experiments in which participants reflected on agreeing or disagreeing with PVoA. In Experiment 1, 536 adults (50-89 years) reflected on their personal agreement or disagreement with PVoA. In Experiment 2, 435 adults (50-87 years) reflected on agreement with PVoA in society. Reflecting on agreement changed endorsement of PVoA in both experiments: Participants who reflected on agreement reported higher endorsement of PVoA, whereas participants who reflected on disagreement reported lower endorsement. Our results indicated that the cognitive representation of PVoA is norm and domain specific: The endorsement effect did not transfer from active aging to altruistic disengagement (or vice versa) nor across health and social domains. Further, participants set the same prescriptions for their behavior as they set for others as shown by a transfer between endorsement of other- to self-related PVoA. Our findings attest to the complexity and specificity of PVoA and offer important insights for designing interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Envelhecimento , Participação Social , Idoso , Humanos , Envelhecimento/psicologia , Altruísmo , Pessoa de Meia-Idade , Idoso de 80 Anos ou maisRESUMO
The paper discusses the design and implementation process of an intelligent system for answering specialized questions about COVID-19. The system is based on deep learning and transfer learning techniques and uses the popular CORD-19 dataset as a source of scientific knowledge about the problem domain. The experiments performed with the pilot version of the system are presented and the obtained results are analyzed. Conclusions are formulated about the applicability and the opportunities for improvement of the proposed approach.
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Voluntary participation is thought to promote the well-being of engaged individuals, especially in old age, but prior evidence on this link is mixed. In the present studies, we used the cross-sectional data from Round 6 (2012) of the European Social Survey (ESS) to investigate the variation in the associations between voluntary participation and eudaimonic (e.g., sense of direction) and social (e.g., perceived social support) well-being across types of participation (nonpolitical volunteering vs. political participation), age groups, and European countries. Study 1 addressed individual-level associations and age differences therein (preregistered at https://osf.io/2p9sz and https://osf.io/6twqe). Two-level multiple regression with an extensive set of control variables showed that at the within-country level, the associations between voluntary participation and well-being indicators were small on average. Nonpolitical volunteering had significantly more positive effects than did political participation, whereas few significant age differences emerged. Study 2 focused on the country-level variables that might explain the substantial cross-national variation in the main effects of voluntary participation (preregistered at https://osf.io/mq3dx). Only GDP per capita was a significant moderator at the country level: The associations of nonpolitical volunteering with eudaimonic well-being were more positive in the European countries with lower GDP. Other country-level variables (Gini coefficient, social welfare spending, and democracy indices) yielded no consistent moderation effects. Study 3 considered potential country-level explanations for the substantial cross-national variation in whether younger or older adults appeared to benefit more (preregistered at https://osf.io/7ks45). None of the country-level variables considered (effective retirement age in men, life expectancy at 65, average age of members of the national parliament and cabinet, and youth unemployment rate) could account for this variation. We conclude that, given the large cross-national variation in the effects of voluntary participation on well-being and in age differences therein, more attention to national specifics is warranted.
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Aposentadoria , Desemprego , Adolescente , Masculino , Humanos , Idoso , Estudos Transversais , Europa (Continente) , Participação SocialRESUMO
Exposure to expectations for active aging may be modulated by age and individual resources (socioeconomic status, social integration, and health) via multiple pathways. Using a cross-sectional, nationally representative sample of adults aged 17 to 94 (N = 2,007), we investigated the relations between age, individual resources, and perceived expectations for active aging (PEAA) in three domains (physical health, mental health, and social engagement). Across domains, young adults and individuals aged 70+ reported slightly lower PEAA than emerging adults did; no other age differences emerged. Multiple regression showed that a higher subjective socioeconomic status, better perceived general health, and partnership (in older adults) predicted higher PEAA (almost) across domains, whereas church attendance, employment status, and occupational prestige yielded domain- and age-specific effects, which were not always positive. We conclude that the effects of individual resources on PEAA are limited in general but vary depending on life domain and age.
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Motivação , Estereotipagem , Humanos , Idoso , Estudos Transversais , Envelhecimento/psicologiaRESUMO
D/E repeats are stretches of aspartic and/or glutamic acid residues found in over 150 human proteins. We examined genomic stability of D/E repeats and functional characteristics of D/E repeat-containing proteins vis-à-vis the proteins with poly-Q or poly-A repeats, which are known to undergo pathologic expansions. Mining of tumor sequencing data revealed that D/E repeat-coding regions are similar to those coding poly-Qs and poly-As in increased incidence of trinucleotide insertions/deletions but differ in types and incidence of substitutions. D/E repeat-containing proteins preferentially function in chromatin metabolism and are the more likely to be nuclear and interact with core histones, the longer their repeats are. One of the longest D/E repeats of unknown function is in ATAD2, a bromodomain family ATPase frequently overexpressed in tumors. We demonstrate that D/E repeat deletion in ATAD2 suppresses its binding to nascent and mature chromatin and to the constitutive pericentromeric heterochromatin, where ATAD2 represses satellite transcription.
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Memory biases for previous pain experiences are known to be strong predictors of postsurgical pain outcomes in children. Until recently, much research on the subject in youth has assessed the sensory and affective components of recall using single-item self-report pain ratings. However, a newly emerging focus in the field has been on the episodic specificity of autobiographical pain memories. Still in its infancy, cross-sectional work has identified the presence of various memory biases in adults living with chronic pain, one of which concerns the lack of spatiotemporal specificity. Moreover, a recent prospective longitudinal study found that adults scheduled for major surgery who produced fewer specific pain memories before surgery were at greater risk of developing chronic postsurgical pain up to 12 months later. The present review draws on this research to highlight the timely need for a similar line of investigation into autobiographical pain memories in pediatric surgical populations. We (1) provide an overview of the literature on children's pain memories and underscore the need for further research pertaining to memory specificity and related neurobiological factors in chronic pain and an overview of the (2) important role of parent (and sibling) psychosocial characteristics in influencing children's pain development, (3) cognitive mechanisms underlying overgeneral memory, and (4) interplay between memory and other psychological factors in its contributions to chronic pain and (5) conclude with a discussion of the implications this research has for novel interventions that target memory biases to attenuate, and possibly eliminate, the risk that acute pain after pediatric surgery becomes chronic.
Les biais de mémoire concernant les expériences douloureuses antérieures sont connus pour être de puissants prédicteurs de la douleur post-chirurgicale chez les enfants. Jusqu'à récemment, la plupart des études sur ce sujet menées auprés des jeunes évaluaient les composantes sensorielles et affectives du souvenir en utilisant des auto-évaluations de la douleur comportant un seul énoncé. Cependant, la spécificité épisodique des souvenirs autobiographiques de la douleur a récemment fait son apparition en tant que nouveau centre d'intérêt dans le domaine. Bien qu'ils en soient encore à leurs premiers balbutiements, des travaux transversaux ont déterminé que divers biais de mémoire étaient présents chez les adultes vivant avec la douleur chronique, dont l'un concerne le manque de spécificité spatiotemporelle. De plus, une étude longitudinale prospective récente a révélé que les adultes en attente d'une chirurgie majeure qui avaient moins de souvenirs spécifiques de la douleur avant la chirurgie étaient plus à risque de développer de la douleur post-chirurgicale chronique jusqu'à 12 mois plus tard. La présente étude s'appuie sur cette étude pour souligner la nécessité de mener des études similaires sur les souvenirs autobiographiques de la douleur au sein de la population chirurgicale pédiatrique. Nous (1) faisons un survol de la littérature sur les souvenirs de la douleur chez les enfants et soulignons la nécessité de poursuivre la recherche sur la spécificité de la mémoire et sur les facteurs neurobiologiques liés à la douleur chronique, ainsi qu'un survol (2) du rôle important des caractéristiques psychosociales des parents (et des fréres et sÅurs) dans le développement de la douleur chez les enfants, (3) les mécanismes cognitifs qui sous-tendent la mémoire surgénérale et (4) l'interaction entre la mémoire et d'autres facteurs psychologiques qui contribue à la douleur chronique et (5) concluons par une discussions sur les implications de cette étude pour les interventions novatrices qui ciblent les biais de mémoire pour atténuer, et possiblement éliminer, le risque que la douleur aigue aprés une chirurgie pédiatrique devienne chronique.
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Background: Three to 22% of youth undergoing surgery develop chronic postsurgical pain (CPSP). Negative biases in pain memories (i.e., recalling higher levels of pain as compared to initial reports) are a risk factor for CPSP development. Children's memories for pain are modifiable. Existing memory-reframing interventions reduced negatively biased memories associated with procedural pain and pain after minor surgery. However, not one study has tested the feasibility and acceptability of the memory-reframing intervention in youth undergoing major surgery. Aims: The current pilot randomized clinical trial (RCT; NCT03110367; clinicaltrials.gov) examined the feasibility and acceptability of, as well as adherence to, a memory reframing intervention. Methods: Youth undergoing a major surgery reported their baseline and postsurgery pain levels. Four weeks postsurgery, youth and one of their parents were randomized to receive control or memory-reframing instructions. Following the instructions, parents and youth reminisced about the surgery either as they normally would (control) or using the memory-reframing strategies (intervention). Six weeks postsurgery, youth completed a pain memory interview; parents reported intervention acceptability. Four months postsurgery, youth reported their pain. Results: Seventeen youth (76% girls, Mage = 14.1 years) completed the study. The intervention was feasible and acceptable. Parents, but not youth, adhered to the intervention principles. The effect sizes of the intervention on youth pain memories (ηp 2 = 0.22) and pain outcomes (ηp 2 = 0.23) were used to inform a larger RCT sample size. Conclusions: Memory reframing is a promising avenue in pediatric pain research. Larger RCTs are needed to determine intervention efficacy to improve pain outcomes.
Contexte: Trois à 22 % des jeunes qui subissent une chirurgie développent une douleur post-chirurgicale chronique. Les biais négatifs dans les souvenirs de douleur (c.-à-d., se rappeler de niveaux de douleur plus élevés comparativement aux niveaux initialement rapportés) sont un facteur de risque pour le développement de la douleur post-chirurgicale chronique. Les souvenirs qu'ont les jeunes de la douleur sont modifiables. Les interventions de recadrage des souvenirs existantes ont réduit les souvenirs polarisés négativement qui sont associés à la douleur procédurale et à la douleur aprés une intervention chirurgicale mineure. Cependant, aucune étude n'a testé la faisabilité et l'acceptabilité de l'intervention de recadrage des souvenirs chez les jeunes subissant une intervention chirurgicale majeure.Buts: L'essai clinique randomisé pilote actuel (RCT; NCT03110367; clinicaltrials.gov) a examiné la faisabilité et l'acceptabilité d'une intervention de recadrage des souvenirs, ainsi que l'observance de celle-ci.Méthodes: Des jeunes subissant une intervention chirurgicale majeure ont rapporté leur niveau de douleur initial et post-chirurgical. Quatre semaines aprés la chirurgie, les jeunes et l'un de leurs parents ont été randomisés pour recevoir des instructions de contrôle ou de recadrage des souvenirs. En suivant les instructions, les parents et les jeunes se sont rappelé la chirurgie comme ils le feraient normalement (contrôle) ou en utilisant les stratégies de recadrage des souvenirs (intervention). Six semaines aprés la chirurgie, les jeunes ont été interviewés sur leurs souvenirs de la douleur; les parents ont rapporté l'acceptabilité de l'intervention. Quatre mois aprés la chirurgie, les jeunes ont rapporté leur douleur.Résultats: Dix-sept jeunes (76 % de filles, Mâge = 14,1 ans) ont terminé l'étude. L'intervention s'est révélée faisable et acceptable. Les parents, mais pas les jeunes, ont observé les principes de l'intervention. L'ampleur des effets de l'intervention sur les souvenirs de douleur des jeunes (ηp2 = 0,22) et les résultats de douleur (ηp2 = 0,23) ont été utilisés pour déterminer une taille d'échantillon d'essai contrôlé randomisé plus grande.Conclusions: Le recadrage de la mémoire est une voie prometteuse dans la recherche sur la douleur pédiatrique. Des essais contrôlés randomisés de plus grande taille sont nécessaires pour déterminer l'efficacité de l'intervention pour améliorer les résultats de la douleur.
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Evidence suggests that children's popular media may model maladaptive and distorted experiences of pain to young children. In a recent study, pain depicted in popular media targeting 4-6-year-olds was frequently and unrealistically portrayed, evoked little response or empathy from observing characters, and perpetuated unhelpful gender stereotypes. Parents play a critical role in both children's pain experiences and children's media consumption. Yet, no study to date has examined parents' beliefs and attitudes regarding how pain is portrayed in media for young children. The present study aimed to fill this gap by examining how parents perceive and appraise painful instances depicted in children's popular media. Sixty parents (48% fathers) of children aged 4 to 6 years completed a semi-structured interview to assess their general beliefs and attitudes toward how pain is portrayed in children's media. Inductive reflexive thematic analysis was conducted to identify and analyze key patterns in the data. Qualitative analyses generated two major themes representing parental beliefs regarding pain that is portrayed in children's media: "entertaining pain" and "valuable lessons". Findings reveal that parents believe that pain portrayed in popular media serves either a function of entertaining and amusing children or can provide valuable lessons about appropriate emotional responses and empathic reactions. Further, pain portrayals could also instill valuable lessons and provide children with a point of reference and language for their own painful experiences. Parents serve as a primary socialization agent for young children; thus, it is important that parents remain aware of underlying messages about how pain is portrayed in children's popular media so that they can optimally discuss these portrayals, promote their children's pain education and understanding and positively impact future pain experiences.
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OBJECTIVES: Chronic pain and mental illness in youth and parents are poised to reach new heights amidst the societal and healthcare impacts of the COVID-19 pandemic. Evidence from natural disasters (i.e., hurricanes) suggests that a degree of personal impact and individual personality may moderate the effects of high stress events, such as the COVID-19 pandemic, on mental health. METHODS: In a pre-existing cohort of 84 youth with chronic pain (Mage = 14.39; 12-18 years; 67.8% female) and 90 parents (86.7% female), we examined changes in youth pain interference and youth and parent mental health (depression, anxiety) from before to during the first wave of the COVID-19 pandemic, and the influence of personal impact of the pandemic (i.e., financial, familial, health, social, occupational, and educational domains) and individual personality (neuroticism, conscientiousness, extroversion). RESULTS: Overall, youth reported significantly lower pain interference and anxiety as compared to pre-pandemic; however, those more personally impacted by the pandemic reported worsening pain interference and anxiety symptoms. Overall, parents reported greater depressive symptoms as compared to pre-pandemic; however, those more personally impacted by the pandemic reported increased anxiety symptoms. Personality traits (high neuroticism, and low conscientiousness and extroversion) predicted worsened pain and mental health, and exacerbated effects of COVID-19-related personal impact on youth and parent anxiety symptoms. DISCUSSION: Identifying risk and resilience profiles in youth and parents at high risk for worsening pain and mental health may better inform matching interventions to individual need.
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Children's memories for past pain set the stage for their future pain experiences. Parent-child reminiscing about pain plays a key role in shaping children's pain memories. Parental beliefs about the functions of reminiscing are associated with parental reminiscing behaviors. To date, no studies have investigated parental beliefs regarding the functions of reminiscing about past pain or the associations between parental beliefs and reminiscing about past pain. This study aimed to fill these gaps. One-hundred and seven parents (52% fathers) of young children were asked about their beliefs regarding reminiscing about past pain. Interview data were first analyzed using inductive reflexive thematic analysis. A coding scheme was created based on the generated themes to quantitatively characterize parental beliefs. Parents also reminisced with their children about unique past events involving pain. Parent-child reminiscing narratives were coded to capture parent reminiscing behaviors. Inductive reflexive thematic analysis generated three major themes representing parental beliefs regarding reminiscing about past pain: "reminiscing to process past pain," "reminiscing as a learning tool," and "avoiding reminiscing about past pain." Parents who endorsed avoiding reminiscing used fewer optimal reminiscing elements (i.e., open-ended questions) when reminiscing about past painful experiences with children. Parents who endorsed reminiscing to process past pain used more emotion-laden language when reminiscing about past pain. Mothers and fathers of boys and girls endorsed the reminiscing functions to a similar degree. Parents of older, vs. younger, children endorsed reminiscing to process past pain to a greater degree. Developmental considerations and clinical implications of the findings are discussed.