Emotion Regulation and Pain Responsivity in Children

描述（申请人提供）：在过去的十年中，情绪调节（ER）的临床和实验研究取得了巨大的发展。通过情绪回避、抑制或过度控制过度的情绪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消极情绪状态有关。此外，研究表明，有效（和无效）的情绪调节是通过从父母到孩子的各种途径进行社会化的。然而，在年轻人群中，关于内源性疼痛关系的研究还很缺乏。这项研究将首次测试慢性疼痛（复发性头痛）儿童（n = 60）和非临床儿童（n = 60）（8-17岁）的比较样本之间ER和急性实验室诱导疼痛反应之间的相关性差异。在这些样本中，儿童ER与性别、儿童年龄和母亲ER的相互作用也将被检查。儿童及其母亲（N = 240）将完成标准化的ER自我报告测量，并将接受三个先前验证的实验室疼痛任务：压力耐受性、冷压力和对诱发压力的敏感性。主要的假设是，总的来说，内质网缺损可以预测行为（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）疼痛反应领域疼痛反应的增加，并且这种内质网疼痛关系在慢性疼痛组中会更强。二级假设在两个样本中母亲和儿童ER之间存在显著关系；这种母子ER关系会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，以及母亲ER如何与儿童的这些过程联系在一起。这项研究的结果将有助于确定内质网策略，增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综合病人护理的一个重要方面。研究结果有可能改善这种治疗方法，从而显著减少与疼痛相关的残疾，抵消未来的心理和医疗残疾，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.