Children's_Catastrophic_Thinking_About_Their_Pain_Predicts_Pain_and_Disability_6_Months_Later

Children’s catastrophic thinking about their pain predicts pain and disability 6 months later The problem: The study is carried out to determine if children’s catastrophic thinking about pain would lead to future pain and functional disability in six months. This study is carried out because chronic pain could be disruptive to a person’s life as the manifestation of pain could affect one’s behavior, such as changes in postures and facial distress. Furthermore, catastrophizers would increased the intensity of pain even more which in turn affected one’s lifestyle and normal functioning. Catastrophizers are defined as individuals who had the tendency to magnify or exaggerate the intensity or seriousness of pain (Sullivan et al., 53). Since pain is a psychological experience and is usually up to an individual to interpret the extent of pain, extreme catastrophic pain could lead to long-term undesirable psychological distress, which in turn resulted in functional disability. Functional disability includes serious sensory impairments and developmental delay. The huge negative impacts on human’s normal functioning caused by one’s catastrophic thinking of pain poses a serious problem and hence, catastrophic thinking about pain is important for investigation. According to Sullivan al et., the relation between catastrophizing and pain has been reported in younger samples (2001). Children are more prone to catastrophic thinking of pain because they lack the knowledge to adjust to pain when they experienced it. Hence, this study attempts to collect a data of the prospective roles of catastrophic thinking about pain and trait anxiety of various schoolchildren and measure the relations to later pain and disability. Research design: The main research methods that are used in this study are correlational study and self-reports. It is hard to measure pain objectively since the only way to measure it is through self-reports like the McGill Pain Questionnaire, which consists of a wide range of vocabulary words that are used to describe the intensity of pain a patient felt. Likewise, this study used the Dutch version of the Pain Catastrophizing Scale for Children that consist of 13 items describing different thoughts and feelings that children may experience when they were in pain (Vervoot et al., 2010). Other questionnaires measuring pain intensity and trait anxiety include the Visual Analogue Scale and the Dutch version State-Trait Anxiety Inventory for Children respectively. In addition, researchers used a self-report inventory to measure functional disability known as the Functional Disability Inventory. A correlational study then describes the relationship between two or more variables. In this case, there is a correlational relationship between pain catastrophizing at Time 1 and pain intensity and functional disability at Time 2 (six months later). The study states that the relationship is a positive one, which means that functional disability is related to a higher level of catastrophic pain. A linear regression is also used to predict pain intensity and functional disability. Catastrophic pain variable is used to predict pain intensity and functional disability variable over the period of six months. However, there are continuous variables, that would affect the result one way or another, that researchers had taken into account. These continuous variables are gender, trait anxiety and age. Nonetheless, there are certain limitations to these research methods. Biases may be present in self-report measurement as participants would sometimes response in a socially desirable manner, as they are too often concerned with how they will be perceived. Furthermore, correlation does not mean causation; hence, we can never use the correlational relationship between these variables to conclude that catastrophic pain causes pain intensity and functional disability. Subject selection: The children were randomly selected from eleven different high schools ranging from grade 4 to grade 9. Parental consent was obtained prior to the study and the researchers sent out letters to explain to the parents the purpose of the study (Vervoot et al., 2010). After which questionnaires such as the Pain Catastrophizing Scale for Children were sent out to 1373 children for self-evaluation. However only 323 children completed the follow-up questionnaires for functional disability and pain intensity after six months. There are limitations to the way children were screened for the study. Firstly, more than a hundred of students did not complete more than 25% of the total questions, which resulted in invalid use. Researchers should instead implement a rule for parents to watch over their children while they filled up the questionnaires to ensure that all questions are completed. Another problem with the broad selection is that it generalizes all children instead of narrowing the children down to the ones who frequently experienced pain or has had experienced some sort of chronic pain before. Author's conclusions: The author did a final conclusion that higher levels of catastrophizing contribute to deleterious pain and disability outcomes only when their initial pain intensity level was low (Vervoot et al., 2010). I agree with this finding because the result has shown significant consistency with the results from their previous study on adult’s catastrophic pain, which further supported this finding. The author also took account of continuous factors like the children’s age and gender that might affect the relationship between catastrophic pain and functional disability. This helps to increase the reliability of the study. I also completely agree with the conclusion of the author because the author is not bias with his findings as he admitted in his research that there are many extraneous factors that could affect the result so he feels the need to do further studies to confirm his current result. One example of extraneous factor is that high catastrophizers may be biased towards pain or pain-related information because they tend to seek for attention. Link to textbook: The article links with what is stated on our textbook with regards to pain, that pain can cause disruption to one’s life. For example, pain sufferers may face difficulties performing simple tasks of self-care. However, catastrophic pain has not been touched in the textbook except for a brief mention on page 251. I find this topic very relevant to the chapter on pain and it should be included in the textbook. Firstly, catastrophic thinking about pain is a psychologically experience any individual may experience if they lack the knowledge of coping with it and it may lead to a greater disruption to one’s life. Catastrophic thinking of pain should be brought to awareness in the textbook and that therapies and pain control technique can help to decrease catastrophic thinking of pain. 1. Sullivan, Michael J.L., Beverly Thorn, Jennifer A. Haythornthwaite, Francis Keefe, and Michelle Martin. "Theoretical Perspectives on the Relation Between Catastrophizing and Pain." The Clinical Journal of Pain 17.1 (2001): 52-64. Web. 2. Vervoort, T. "Children’s Catastrophic Thinking about Their Pain Predicts Pain and Disability 6 Months Later." European Journal of Pain 14 (2010): 90-96. Web.