NEW YORK (Reuters Health)—How parents and children reminisce about the child’s recent surgery affects the child’s pain memory, researchers from Canada report.
Children who recall pain that is higher than initially reported are more likely to report more pain and distress during future pain experiences. These negatively biased memories, formed early in life, set the stage for how individuals cope with pain and approach or avoid medical care into adulthood.
Considerable research has shown that how parents reminisce with children about emotional events influences the accuracy of children’s own memory development. But so far no studies have investigated the influence of parent-child reminiscing about past painful events on the development of biases in children’s recall of pain.
Dr. Melanie Noel of the University of Calgary and Alberta Children’s Hospital Research Institute, in Canada, and colleagues examined the influence of parent-child reminiscing about a recent past surgery in the subsequent development of children’s recall of pain in their longitudinal study of 112 children and one of their parents (34% fathers). The children were about 5 years old on average.
Children reported a pain intensity of 2.9/10 and pain-related fear of 0.8/4 two to three hours after tonsillectomy. Ratings were 3.9/10 for pain intensity and 0.8/4 for pain-related fear on day 1 post-surgery and 3.7/10 and 0.8/4, respectively, on days 1-3.
One month later, children recalled a pain intensity of 4.6/10 and pain-related fear of 1.4/4 immediately after surgery; 4.6/10 and 1.4/4, respectively, on day 1 after surgery; and 4.5/10 and 1.3/4 on days 1-3 after the surgery, the researchers report in Pain, online March 21.
A higher proportion of statement elaborations (that is, utterances containing new information) was associated with more positively biased recall of pain-related fear on days 1-3. Higher levels of overall parent use of elaboration were associated with more positively biased recall of pain-related fear on day 1 after surgery.
Greater parental use of words related to positive emotions and emotions in general was significantly associated with more positively biased recall of days 1-3 pain intensity, whereas a higher proportion of pain-related words was tied to more negatively biased recall of day-of-surgery pain intensity and pain-related fear. The same was true of child narrative content.
Recall biases and narrative styles did not differ significantly between boys and girls, and children of fathers versus mothers did not differ in their recall of pain.
Fathers used explanations more often than mothers, and children of fathers used more words related to negative emotions (compared with children of mothers).
Fathers used negative-emotion words similarly with boys and girls, whereas mothers used negative-emotion words more frequently with boys than with girls.
Boys used pain-related words with the same frequency when talking with mothers and fathers, whereas girls used more pain-related words when reminiscing with mothers than with fathers.
“Taken together,” the researchers note, “these findings underscore the importance of parent-child reminiscing about painful events in influencing children’s subsequent pain memory development and begin to isolate specific narrative elements that are linked to negative biases in children’s pain memories.”
“From a clinical perspective, we do not believe that this research suggests that parents should not reminisce with their children about pain,” they write. “Rather, it points to how parents may most adaptively reminisce about past painful experiences to potentially buffer against children developing negatively biased pain memories.”
“By using an elaborative reminiscing style, parents engage their children in a rich discussion about their past experience, filling in new details, encouraging and fostering a coherent narrative about this past experience, and also coconstructing the meaning of that experience,” they explain. “Moreover, talking about painful experiences need not over focus on the sensory and affective aspects of pain itself but rather emphasize other aspects of the overall experience.”
“This research underscores the importance of parent-child reminiscing in children’s pain memory development and may be used to inform the development of a parent-led memory reframing intervention to improve pediatric pain management,” the authors conclude.
Dr. Noel did not respond to a request for comments.
- Noel M, Pavlova M, Lund T, et al. The role of narrative in the development of children’s pain memories: influences of father– and mother-child reminiscing on children’s recall of pain. Pain. 2019 Mar 21. [Epub ahead of print]