Browsing by Author "Pavlova, Maria"

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    Co-constructing the Past: Examining Mother- and Father-Child Narratives About Past Events Involving Pain versus Sadness
    (2019-08-26) Pavlova, Maria; Noel, Melanie; Graham, Susan A.; Madigan, Sheri L.; McMorris, Carly A.
    Background. Parent-child reminiscing about past events creates an influential sociolinguistic context within which children’s development occurs. Parents differ dramatically in their reminiscing styles, whereas some parents are highly elaborative (i.e., they use open-ended detailed questions) and focus on talking about emotions, other parents are repetitive and emphasize factual information. Elaborative reminiscing has been linked to more optimal developmental outcomes. No studies have examined how parent-children reminiscing about past pain compares to other stressful experiences (i.e., sadness, fear), and how parent-children reminiscing about past pain might be linked to children’s socio-emotional skills. This study was the first to examine the association between parent-child reminiscing about past pain and children’s prosocial acts to pain-related distress in others as well as overall children’s socio-emotional functioning. Methods. One hundred and sixteen 4-year old children (54% girls) and their parents (49% mothers) completed a structured narrative elicitation task wherein they reminisced about a unique past event involving pain, fear, and sadness. Children then witnessed a confederate pretending to be in pain (i.e., hurt fingers and a knee). Children’s prosocial responses and parent-child narratives about past pain were coded using established coding schemes based on the developmental psychology literature. Results. Parent-children narratives about pain were characterized by less emotion-laden and more coping and pain-related words as compared to sadness or fearful narratives. Parents, who used open-ended questions, provided new information, and talked about emotions and coping when talking about past events involving pain, had children who exhibited more prosocial acts and concern in response to other’s pain and had higher parent-reported levels of empathy. Discussion. Parent-children reminiscing about past pain differs from reminiscing about other types of distressing events (e.g., involving sadness or fear) and is linked to children’s socio-emotional skills. This highlights a possibility of differential socialization of pain. Parent-child reminiscing is amenable to intervention and offers a promising avenue for pediatric pain management interventions.
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    Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
    (2017-11-16) Pavlova, Maria; Ference, Jennifer; Hancock, Megan; Noel, Melanie
    Background. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders. Objective. To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain. Methods. Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms. Results. As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships. Discussion. For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.
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    Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
    (Hindawi, 2017) Pavlova, Maria; Ference, Jennifer; Hancock, Megan; Noel, Melanie
    Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders.
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    Early childhood risk factors for later onset of pediatric chronic pain: a multi-method longitudinal study
    (2024-08-08) Pavlova, Maria; Noel, Melanie; Orr, Serena L.; Walker, Andrew; Madigan, Sheri; McDonald, Sheila W.; Tough, Suzanne C.; Birnie, Kathryn A.
    Abstract Background Pediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years. Methods Available longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child’s pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models. Results Gut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11. Conclusions Some, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.
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    Parent-Child Reminiscing in the Context of Procedural and Postsurgical Pediatric Pain
    (2023-06) Pavlova, Maria; Noel, Melanie; Orr, Serena L.; Graham, Susan; Yeates, Keith O.
    Objective. Children experience pain often and remember it long after painful experiences are over. Up to 25% of children remember past pain in a negatively-biased way (i.e., recalling higher levels of pain as compared to the initial pain reports) and are at risk of experiencing higher levels of pain in the future. Pain memories are malleable and can be reframed through conversations. Recent evidence demonstrated that the way parents reminisce about past pain with their children influenced how children remembered their past pain. Yet, no interventions have used parental reminiscing to change children’s memories for pain. The present dissertation aimed to develop a parent-led memory-reframing intervention that harnesses parent-child reminiscing about past pain and to examine the intervention’s efficacy to change children’s memories for pain. Methods. Three randomized controlled trials investigated whether parents can be taught to reminisce about past pain optimally to, in turn, change children’s memories for pain to be more accurate/positively-biased (i.e., recalling lower levels of pain compared to the initial reports). Additionally, the dissertation examined whether optimal parent-child reminiscing would result in lower levels of future needle pain. Parental beliefs regarding reminiscing about past pain were investigated to optimize the intervention and increase parental motivation to engage in reminiscing about past pain. Results. The parent-led memory-reframing intervention resulted in young children remembering their past post-surgical, but not needle, pain in a more accurate/positively-biased way. The intervention also changed parental reminiscing style to include optimal strategies for reframing past painful experiences. Parents rated the intervention to be feasible and highly acceptable in the context of post-surgical and needle pain. Results also demonstrated that some parental beliefs regarding reminiscing about past painful experiences may be a barrier that prevents parents from engaging in reminiscing about past pain. Conclusions. This dissertation developed and examined the efficacy of a parent-led memory-reframing intervention, a new avenue in pediatric pain management that targets children’s pain memories. The intervention was efficacious in changing how children remember their past post-surgical pain. The preliminary results warrant future large-scale trials to further examine the intervention’s potential to change children’s pain and health trajectories.
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    Remembering the pain of surgery 1 year later: a longitudinal examination of anxiety in children's pain memory development
    (International Association for the Study of Pain, 2019-01) Noel, Melanie; Rosenbloom, Brittany N.; Pavlova, Maria; Campbell, Fiona; Isaac, Lisa A.; Pagé, M. Gabrielle; Stinson, Jennifer N.; Katz, Joel D.
    Children who develop greater negatively-biased recall of pain (ie, recalled pain is higher than the initial pain report) following surgery are at risk for developing chronic pain; therefore, identifying risk factors for the development of biased pain memories is important. Higher anxiety has been implicated in the development of greater negatively-biased recall of pain; however, studies have not examined anxiety at multiple time points before and after a surgery and its relationship to children's post-surgical pain memories after 1 year. This prospective study examined a cohort of 237 children and adolescents undergoing major surgery. Anxiety sensitivity, pain catastrophizing, and pain anxiety were assessed at baseline, 48 to 72 hours after surgery, and at 6- and 12-month follow-ups. Pain intensity at rest, movement-evoked pain intensity, and pain unpleasantness were assessed daily in hospital. Memories for pain were elicited via telephone 1-year post-surgery. Findings revealed that children who had higher levels of anxiety at baseline and 48 to 72 hours after surgery developed greater negatively-biased recall of pain intensity 12 months after surgery. Specifically, higher anxiety sensitivity at baseline and greater tendencies to catastrophize about pain at baseline and in the immediate acute recovery phase were most strongly linked to greater negatively-biased recall of pain. Greater negatively-biased recall of pain was related to higher pain intensity at 6 and 12 months post-surgery. Findings support conceptual models of anxiety and pain memory biases and can inform intervention efforts to reduce anxiety in the pre- and post-op periods to minimize negative biases in pain memories.
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    Role of anxiety in young children's pain memory development after surgery
    (International Association for the Study of Pain, 2019-04) Fischer, Shanaya; Vinall, Jillian; Pavlova, Maria; Graham, Susan; Jordan, Abbie; Chorney, Jill; Rasic, Nivez F.; Brookes, James T.; Hoy, Monica Y.; Yunker, Warren K.; Noel, Melanie
    Pediatric pain is common, and memory for it may be distressing and have long-lasting effects. Children who develop more negatively biased memories for pain (i.e., recalled pain is higher than initial pain report) are at risk of worse future pain outcomes. In adolescent samples, higher child and parent catastrophic thinking about pain was associated with negatively biased memories for post-surgical pain. This study examined the influence of child and parent anxiety on the development of younger children's post-surgical pain memories. Seventy-eight children undergoing a tonsillectomy and one of their parents participated. Parents reported on their anxiety (state and trait) before surgery, and trained researchers observationally-coded children's anxiety at anaesthesia induction. Children reported on their post-surgical pain intensity and pain-related fear for 3 days after discharge. One month after surgery, children recalled their pain intensity and pain-related fear using the same scales previously administered. Results revealed that higher levels of post-surgical pain and higher parent trait anxiety predicted more negatively biased memories for pain-related fear. Parent state anxiety and child preoperative anxiety were not associated with children's recall. Children who developed negatively biased pain memories had worse post-surgical pain several days after surgery. These findings underscore the importance of reducing parental anxiety and effective post-surgical pain management to potentially buffer against the development of negatively biased pain memories in young children.
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    Socialization of Pain Memories: Parent-Child Reminiscing About Past Painful and Sad Events
    (Oxford University Press on behalf of the Society for Pediatric Psychology : Journal of Pediatric Psychology, 2019-01) Pavlova, Maria; Graham, Susan; Jordan, Abbie; Chorney, Jill; Vinall, Jillian; Rasic, Nivez F.; Brookes, James T.; Hoy, Monica Y.; Yunker, Warren K.; Noel, Melanie
    Parent-child reminiscing about past negative events has been linked to a host of developmental outcomes. Previous research has identified two distinct between-parent reminiscing styles, wherein parents who are more elaborative (vs. repetitive) have children with more optimal outcomes. To date, however, research has not examined how parents and children talk about past painful experiences nor compared parent-child reminiscing about past painful versus other distressing events despite key developmental differences in how young children respond to pain versus sadness in others. This study aimed to fill that gap.