• Julie E Goodman and Patrick J McGrath.
• Child Development Centre, Hotel Dieu Hospital, Kingston, ON, Canada.
• Pain. 2003 Aug 1;104(3):559-65.

AbstractWe set out to determine whether observing one's mother's reaction during a cold pressor test changes ratings of pain threshold, pain intensity, and observed pain-related facial behavior during a cold pressor test, using a Repeated Measures Mixed Factorial design in the setting of the Psychology Department, Dalhousie University, Halifax, Canada. The participants were: 96 mothers (mean age 41 years,) and 96 children (48 males, mean age 12.6 years), all in good general health. Pain intensity was measured using a 0-10 rating scale. Pain threshold was measured by asking participants to signal the moment any pain began and recording time elapsed since immersion. The Child Facial Coding System (CFCS; Revised manual for the child facial coding system (unpublished). Dalhousie University and University of British Columbia; Chambers et al., 1996) measured pain-related facial behavior. Mothers assigned to the Exaggerate condition were instructed, via videotape, to slightly exaggerate their display of pain and indicate a pain threshold within the first 10-20 s of a 4-min cold pressor task using water at 10 degrees C. Mothers in the Minimize condition were instructed to minimize their display of pain. Mothers assigned to the Control condition were given no specific instructions. All mothers privately rated their own pain intensity every 30 s. Children then completed a similar cold pressor task and made similar ratings. Children assigned to the Exaggerate Group (mean 21.7 s; SD 3.9) had lower thresholds than did children in the Control Group (mean 35.6 s; SD 21.8; t(1,76)=2.515, P=0.014). No difference in threshold was observed between the Control and the Minimize Groups (mean 32.2 s; SD 4.2; t(1,76)=0.610, P=0.544). No differences were observed in the self-report pain ratings of children between groups (F<1). CFCS Scores were significantly lower in the Minimize group compared to the Control group (95% CI 4.98-20.19, P=0.001), but no difference was noted between the Exaggerate and Control groups (95% CI -8.03-6.93, P=0.884). Children's pain threshold and their facial behavior are altered by exposure to mother's behavior during a cold pressor task suggesting that modeling has an impact on a child's pain behavior.

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