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Age Related Differences in the Acute Pain Facial Expression During Infancy

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Date

2019-06

Authors

O'Neill, Monica C
Ahola Kohut, Sara
Pillai Riddell, Rebecca
Oster, Harriet

Journal Title

Journal ISSN

Volume Title

Publisher

European Journal of Pain

Abstract

Background Oster's (2005) ontogenetic perspective on the development of emotional expressions in infants holds that infants’ facial and vocal expressions evolved to serve crucial communicative functions in infancy and contribute to infants’ survival. Infants’ facial expressions should be contextualized by their own developmental stage rather than presuppositions from verbal populations. The overall aim of this paper was to examine age differences in the temporal patterning of elucidated facial expressions in the first minute following vaccination injections. Methods One hundred infants were videotaped longitudinally (2‐, 4‐, 6‐, and 12‐ months) during their routine vaccination appointment over the first year of life and 5 major negative facial configurations were identified using BabyFACS. In the current study, facial configurations were graphed in 5‐second epochs for 1‐minute post‐vaccination and subsequently analyzed for facial expression by time effects using Repeated Measures ANOVAs at each age. Results Clear differences in temporal patterns were displayed as infants aged. ANOVA analyses indicated significant facial expression by time interactions at each age. Conclusions Facial expressions illustrating intense/moderate distress and sensory overload were prominent in the first 15 seconds at the 2‐, 4‐ and 6‐month vaccination. However, expressions showing regulation of distress occurred progressively earlier over 1 minute post‐needle in older infants, suggesting a significant shift in regulatory capacity of pain‐related distress occurs after 6‐months of age. Significance An important developmental milestone was identified in infants’ ability to regulate distress at 6 months. Supporting parents’ infant pain management is particularly critical in the first months of life as infants’ initial facial expressions appear to be more reflective of an organism overwhelmed by distress. This article is protected by copyright. All rights reserved.

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Citation

O'Neill MC, Ahola Kohut S, Pillai Riddell R, Oster H. Age-related differences in the acute pain facial expression during infancy. Eur J Pain. 2019;23(9):1596-1607. doi:10.1002/ejp.1436