Does the way we talk to our children regarding pain affect their pain memories?

In a new study published in “Behavior Research and Therapy” last year, researchers from Ghent University in Belgium set out to investigate.

Experimentally induced pain was used to investigate the reciprocal relationship between children's attentional bias toward pain and their parent's narrative style, and its impact on the development of negatively-biased pain recollections. Past research in this field showed that parent’s narrative style can affect pain memories in their children. The researchers hypothesized that a more elaborate narrative style on the part of the parent would aid their child in reframing and understand the painful incident.

In this study data from 63 parent-child dyads who participated with healthy school children, ages varying between 9-15 years old.

The study set-up included several stages; 1) the children underwent calibration to moderate pain stimuli using the Method of Limits, 2) the children participated in a spatial cueing task which included heat stimuli while their parent observed from an adjacent room, 3) the children reported pain and pain-related fear, 4) a three-minute interaction between the parent and child was coded for the parent’s narrative style, 5) after two weeks the children were interviewed using validated questionnaires for fear (Children’s Fear Scale- Revised) and pain (adapted Faces Anxiety Scale).

Pain stimuli were administered using the TSA2 device with CHEPS thermode. This device and thermode combination allow for very rapid and precise noxious and non-noxious heat and cold stimuli.

The spatial cueing task was designed to assess for attention bias for pain-related information. It consisted of cues of either a color that could be followed by a noxious stimulus (pain-cue trial) or a color that could not be followed by a noxious stimulus (neutral cue trial), followed by a target, either at the same side as the cue or at the opposite side of the cue. This was mixed with catch trials without a target, to prevent anticipatory responses, and digit trials to encourage gaze fixing on the fixation cross during the trial. Four different trials were presented; 1) where the cue was on the same side as the target (valid trial), 2) where the cue was on the opposite side of the target (invalid trial) and threatening cue (with a cue that was sometimes followed by a noxious stimulus) or neutral cue (with a cue that was never followed by a noxious stimulus). It is expected that if the attention is biased toward pain-related cues, the participants’ reaction would be faster on those trials.

Memory bias for pain was calculated by the recalled pain intensity (2 weeks after the task) and the experienced pain intensity reported directly after the task. Fear memory bias was calculated by the recalled pain-related fear and the experienced pain-related fear as reported directly after the task. Fear or pain memory bias was defined as an overestimation of those indices two weeks after the task.

As expected, children were overall faster in their reactions on valid trials than on invalid trails, and on pain-cue trials as compared to neutral cue trials. Indeed, children had an attention bias toward cues signally a painful stimulus.

Different styles of parent pain-attending narratives were observed, the most common being parental elaboration (e.g. asking new information from the child), parental repetition (e.g. repeating old information) and parental evaluation (e.g. usually one-word exclamations like “yes”).

This study found that there were no absolute memory biases found for pain, which points to accurate recollections in children of their pain experience.

Parental Elaboration

Parental elaboration had its effect on the child’s pain memory bias, such that is the parent elaborated more directly after the task, the child was less likely to develop memory bias for pain.

In children with parents who had high levels of elaboration, higher attention bias was associated with less pain memory bias. In contrast, in children whose parents has lower levels of elaboration higher attention bias was associated with higher pain memory bias.

For children with low attention bias to pain, the parental elaboration did not affect pain memory bias.

Fear memory bias was also altered by parental elaboration such that children with high attention bias to pain whose parents had a high level of elaboration, developed less fear memory bias.

High parental elaboration seemed to form a barrier for the development of pain and fear memory bias.

Parental repetition

Parental repetition in narrating the child’s painful experience seems to lead to more fear memory bias in these children.

Parental evaluation

For parents with high levels of evaluation narrative, children with high attention bias to pain had more fear memory bias. However, when the parents had low levels of evaluation, their children with high attention bias to pain showed lower levels of fear memory bias.

To conclude, the effect of the parental narrative on pain memory bias and fear memory bias in children seems in a large part to be influenced by the child’s attention bias to pain.

According to this study, the effectiveness in parental narration after the painful event for their children much depended on the attentional bias to pain and its interplay with the specific narrative style and intensity of their parents.

Something to think about next time you talk with your children about their painful experience!

Reference:

Wauters, A., Vervoort, T., Noel, M., Rheel, E., & Van Ryckeghem, D. M. (2022). The relation between children's attention bias to pain and children's pain-related memory biases is moderated by parental narrative style. Behaviour Research and Therapy, 159, 104202.