Children's selective attention to pain and avoidance behaviour: the role of child and parental catastrophizing about pain

Pain. 2013 Oct;154(10):1979-1988. doi: 10.1016/j.pain.2013.05.052. Epub 2013 Jun 18.


The present study investigated selective attention to pain in children, its implications for child avoidance behaviour, and the moderating role of dimensions comprising child and parental catastrophizing about pain (ie, rumination, magnification, and helplessness). Participants were 59 children (31 boys) aged 10-16 years and one of their parents (41 mothers). Children performed a dot-probe task in which child facial pain displays of varying pain expressiveness were presented. Child avoidance behaviour was indexed by child pain tolerance during a cold-pressor task. Children and parents completed measures of child and parent pain catastrophizing, respectively. Findings indicated that both the nature of child selective attention to pain and the impact of selective attention upon child avoidance behaviour were differentially sensitive to specific dimensions of child and parental catastrophizing. Specifically, findings showed greater tendency to shift attention away from pain faces (i.e.,, attentional avoidance) among children reporting greater pain magnification. A similar pattern was observed in terms of parental characteristics, such that children increasingly shifted attention away from pain with increasing levels of parental rumination and helplessness. Furthermore, child attentional avoidance was associated with greater avoidance behaviour (i.e., lower pain tolerance) among children reporting high levels of pain magnification and those whose parents reported greater rumination about pain. The current findings corroborate catastrophizing as a multidimensional construct that may differentially impact outcomes and attest to the importance of assessing both child and parental characteristics in relation to child pain-related attention and avoidance behaviour. Further research directions are discussed.

Keywords: Children; Pain catastrophizing; Pain tolerance; Parents; Selective attention.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attention / physiology*
  • Avoidance Learning / physiology*
  • Catastrophization / diagnosis
  • Catastrophization / epidemiology
  • Catastrophization / psychology*
  • Child
  • Cold Temperature / adverse effects
  • Female
  • Humans
  • Male
  • Pain / diagnosis
  • Pain / epidemiology
  • Pain / psychology*
  • Pain Measurement / methods
  • Pain Measurement / psychology*
  • Parent-Child Relations*
  • Photic Stimulation / methods
  • Psychomotor Performance / physiology
  • Surveys and Questionnaires