Trudi M. Walsh

The parents' postoperative pain measure: replication and extension to 2-6-year-old children

&NA; Pain assessment is a difficult task for parents at home following childrens surgery. The purpose of the present study was to confirm the psychometric properties of a behavioural measure of postoperative pain developed to assist parents with pain assessment in children aged 7–12 years following day surgery. The study also examined the reliability and validity of the measure with children aged 2–6 years. Participants were 51 parents of children aged 7–12 years and 107 parents of children aged 2–6 years. For the 2 days following surgery, parents completed a pain diary that included global ratings of their childrens pain and the 15‐item Parents’ Postoperative Pain Measure (PPPM). The older children provided self‐reports of their pain intensity. The PPPM items showed good internal consistency on the two postoperative days for both samples (&agr;’s=0.81–0.88) and scores on the PPPM were highly correlated with childrens (for the older children) and parents’ (for the young children) global ratings of pain (rs=0.53–0.72). As global pain ratings decreased from Days 1 to 2, so did scores on the PPPM. Scores on the PPPM were successful in discriminating between children who had undergone low/moderate and high pain surgeries. The results of this study provide evidence of the reliability and validity of the PPPM as a measure of postoperative pain among children aged 2 through to 12 years.

Gender differences in Childhood Anxiety Sensitivity Index (CASI) dimensions.

We examined the hierarchical structure of the Childhood Anxiety Sensitivity Index (CASI) as a function of gender and examined the occurrence of gender differences in anxiety sensitivity (AS) dimensions in a large nonclinical sample of children and adolescents (N = 1698). Separate principal components analyses (PCAs) on the 18 CASI items for the total sample, boys, and girls revealed similar lower-order three-factor structures for all groups. The three factors reflected Physical, Social/Control, and Psychological Concerns. PCAs on the lower-order factor scores revealed similar unidimensional higher-order solutions for all groups. Girls scored higher than boys on the Physical and, to a lesser extent, Social/Control Concerns factors; girls scored higher on the Physical Concerns factor relative to their scores on the Social/Control and Psychological Concerns factors; and boys scored higher on the Social/Control and Psychological Concerns factors relative to their scores on the Physical Concerns factor. Girls also scored higher than boys on the higher-order factor representing the Global AS construct. The present study provides additional support for the theoretical hierarchical structure of AS and suggests that there is a difference in the manifestation of AS between girls and boys.

Confirmatory Factor Analysis of the Childhood Anxiety Sensitivity Index: A Gender Comparison

The Childhood Anxiety Sensitivity Index (CASI) is an 18-item self-report tool designed to measure the construct of anxiety sensitivity (i.e. the belief that anxiety may have harmful consequences such as sickness, embarrassment, or loss of control) in children and adolescents. Previous factor analytic examinations of the CASI have produced varied results. Gender may play a role in this observed variability. In an effort to confirm the factor structure of the measure across gender, CASI items for 671 children and adolescents were subjected to confirmatory factor analysis. Results indicated that for boys two-, three-, and four-factor structures provided a relatively good fit to the data, with the three-factor structure emerging as having the best fit overall. In contrast, for girls only the three-factor structure fitted the data well. Direct comparison of fit of the three-factor model across gender provided evidence to support the notion that childhood anxiety sensitivity is similar in structure across gender.

Attachment dimensions and young children's response to pain

BACKGROUND/OBJECTIVE: The present study examined the relationship between attachment dimensions and child pain behaviour following both an everyday pain incident (eg, bumps and scrapes) and acute pain incident (eg, immunization) in 66 five-year-old children.

Relations between young children's responses to the depiction of separation and pain experiences

This study examined relations between young childrens representations of separation and pain experiences in 60, 4- and 5-year-old children. Separation representations were assessed with the Separation Anxiety Test (SAT) and pain representations were assessed by examining responses to pictures of children about to experience pain in the presence of parent figures. Results showed that representations of separation and pain experience were systematically related and the patterns were not accounted for by the childs ability to differentiate emotional states, language ability, or reports of emotional regulation. These findings are consistent with Bowlbys (1982) concept of secure base behaviour in response to a variety of distress, and support the hypothetical construct of an internal working model of attachment which organizes childrens behaviours, thoughts, and feelings in response to both separation experience and painful events.

Pain Correlates of Depressed Mood

OBJECTIVE: To provide an initial indication of the intensity and quality of pain in young adults reporting depressed mood and to investigate possible underlying mechanisms.