Predicting preschool pain-related anticipatory distress: the relative contribution of longitudinal and concurrent factors
Abstract
Anticipatory distress prior to a painful medical procedure can lead to negative sequelae
including heightened pain experiences, avoidance of future medical procedures, and
potential non-compliance with preventative healthcare such as vaccinations. Few
studies have examined the longitudinal and concurrent predictors of pain-related
anticipatory distress. This paper consists of two companion studies to examine both
the longitudinal factors from infancy, as well as concurrent factors from preschool that
predict pain-related anticipatory distress at the preschool age. Study 1 examined how
well preschool pain-related anticipatory distress was predicted by infant pain
responding at 2, 4, 6 and 12 months of age. In Study 2, using a developmental
psychopathology framework, longitudinal analyses examined the predisposing,
precipitating, perpetuating, and present factors that led to the development of
anticipatory distress during routine preschool vaccinations. A sample of 202 caregiverchild
dyads was observed during their infant and preschool vaccinations (OUCH
Cohort) and was used for both studies. In Study 1, pain responding during infancy was
not found to significantly predict pain-related anticipatory distress at preschool. In
Study 2, a strong explanatory model was created whereby 40% of the variance in
preschool anticipatory distress was explained. Parental behaviours from infancy and
preschool were the strongest predictors of child anticipatory distress at preschool.
Child age positively predicted child anticipatory distress. This strongly suggests that the
involvement of parents in pain management interventions during immunization is one
of the most critical factors in predicting anticipatory distress to the preschool
vaccination.
including heightened pain experiences, avoidance of future medical procedures, and
potential non-compliance with preventative healthcare such as vaccinations. Few
studies have examined the longitudinal and concurrent predictors of pain-related
anticipatory distress. This paper consists of two companion studies to examine both
the longitudinal factors from infancy, as well as concurrent factors from preschool that
predict pain-related anticipatory distress at the preschool age. Study 1 examined how
well preschool pain-related anticipatory distress was predicted by infant pain
responding at 2, 4, 6 and 12 months of age. In Study 2, using a developmental
psychopathology framework, longitudinal analyses examined the predisposing,
precipitating, perpetuating, and present factors that led to the development of
anticipatory distress during routine preschool vaccinations. A sample of 202 caregiverchild
dyads was observed during their infant and preschool vaccinations (OUCH
Cohort) and was used for both studies. In Study 1, pain responding during infancy was
not found to significantly predict pain-related anticipatory distress at preschool. In
Study 2, a strong explanatory model was created whereby 40% of the variance in
preschool anticipatory distress was explained. Parental behaviours from infancy and
preschool were the strongest predictors of child anticipatory distress at preschool.
Child age positively predicted child anticipatory distress. This strongly suggests that the
involvement of parents in pain management interventions during immunization is one
of the most critical factors in predicting anticipatory distress to the preschool
vaccination.