Emotion Regulation and Pain Responsivity in Children

描述(申请人提供)：情绪调节(ER)的临床和实验研究在过去十年中有了巨大的发展。通过情绪回避、抑制或过度控制对情绪的过度上调或下调与成人情绪障碍的发展和维持有关，也可能在儿童的情绪障碍中发挥作用。最近的证据表明，情绪失调与疼痛相关的压力和负面情绪状态有关。此外，研究表明，有效的(和无效的)情绪调节是通过从父母到孩子的各种途径社会化的。然而，关于年轻人群中ER-疼痛关系的研究很少。这项研究将首次测试患有慢性疼痛(复发性头痛)的儿童(n=60)和非临床儿童(n=60)(8-17岁)的对照样本中ER和急性实验室诱导的疼痛反应之间的差异。在这些样本中，还将检查儿童ER与性别、儿童年龄和母亲ER的交互作用。儿童和他们的母亲(总共240名)将完成ER的标准化自我报告测量，并将接受三项先前验证的实验室疼痛任务：压力耐受性、冷加压和对诱发压力的敏感性。初步假设，总的来说，ER缺陷将预测行为(耐受性)、自我报告(疼痛强度)、心血管(心率、血压、心脏迷走神经张力)和神经内分泌(皮质醇)疼痛反应领域的疼痛反应增加，并且这种ER-疼痛关系在慢性疼痛组中将更加强烈。次级假设假设在两个样本中都存在母子ER之间的显著关系；这种母子ER关系将受到儿童性别和年龄的调节。目前的研究有可能扩大我们对与疼痛相关的情绪过程的理解，以及母体ER是如何与儿童的这些过程联系起来的。这项研究的结果将有助于确定ER策略，以加强慢性疼痛和非临床儿童在一系列发育阶段的急性疼痛反应的特定领域。这项研究的结果将进一步加深我们对导致疼痛的心理、社会和生物因素之间复杂相互作用的理解，并可能为有针对性的、基于情绪调节的干预措施的发展提供信息。心理治疗方法被认为是全面病人护理的一个基本方面。研究结果有可能改进这种治疗方法，从而大大减少与疼痛相关的残疾，抵消未来的心理和医学残疾，并显著降低公共卫生成本。

DESCRIPTION (provided by applicant): Clinical and experimental research on emotion regulation (ER) has grown tremendously over the past decade. Excessive up- or down-regulation of emotions through emotional avoidance, inhibition, or overcontrol has been implicated in the development and maintenance of emotional disorders in adults, and may also play a role in such disorders in children. Recent evidence points toward emotional dysregulation as a correlate of pain-related stress and negative emotional states. Furthermore, research suggests that effective (and ineffective) modulation of emotions is socialized through various pathways from parents to children. Yet, there is a paucity of research on ER-pain relationships in younger populations. This study will be the first to test for differences in the association between ER and acute laboratory-induced pain responses in children with chronic pain (recurrent headache) (n = 60) and a comparison sample of non- clinical children (n = 60) (aged 8-17 years). Interactions of child ER with sex, child age, and maternal ER will also be examined in these samples. Children and their mothers (N = 240 total) will complete standardized self-report measures of ER and will undergo three previously validated laboratory pain tasks: pressure tolerance, cold pressor, and sensitivity to evoked pressure. Primary hypotheses posit that overall, ER deficits will predict increased pain responsivity across behavioral (tolerance), self-report (pain intensity), cardiovascular (heart rate, blood pressure, cardiac vagal tone), and neuroendocrine (cortisol) pain response domains, and that this ER-pain relationship will be stronger in the chronic pain group. Secondary hypotheses posit a significant relationship between mother and child ER in both samples; this mother-child ER relationship will be moderated by children's sex and age. The current study has the potential to expand our understanding of the emotional processes related to pain, and how maternal ER is linked with these processes in children. The results of this study will help identify ER strategies that potentiate specific domains of the acute pain response in chronic pain and non-clinical children across a range of developmental stages. Results from the proposed study will further our understanding of the complex interactions among psychological, social, and biological factors contributing to pain, and may inform the development of targeted, emotion-regulation-based interventions. Psychological treatment approaches are considered an essential aspect of comprehensive patient care. The study findings have the potential to improve such treatment approaches, thereby dramatically reducing pain-related disability, offsetting future psychological and medical disabilities, and significantly reducing public health costs.