ArticleSocial modulation of facial pain display in high-catastrophizing children: An observational study in schoolchildren and their parentsVervoort, Tinea,*; Caes, Linea; Trost, Zinab; Sullivan, Michaelb; Vangronsveld, Karolinea; Goubert, Liesbeta Author Information Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. aDepartment of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium bDepartment of Psychology, Medicine and Neurology, McGill University, Montréal, Quebec, Canada *Corresponding author. Address: Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium. Tel.: +32 (0)9 264 91 08; fax: +32 (0)9 264 64 71. E-mail address:[email protected] Article history: Received 24 November 2010; Received in revised form 14 February 2011; Accepted 24 February 2011. Pain: July 2011 - Volume 152 - Issue 7 - p 1591-1599 doi: 10.1016/j.pain.2011.02.048 Buy Metrics Abstract The present study examined existing communal and operant accounts of children’s pain behavior by looking at the impact of parental presence and parental attention upon children’s pain expression as a function of child pain catastrophizing. Participants were 38 school children and 1 of their parents. Children completed a cold pressor pain task (CPT) twice, first when told that no one was observing (alone condition) and subsequently when told that they were being observed by their parent (parent-present condition). A 3-minute parent–child interaction occurred between the 2 CPT immersions, allowing measurement of parental attention to their child’s pain (ie, parental pain-attending talk vs non-pain-attending talk). Findings showed that child pain catastrophizing moderated the impact of parental presence upon facial displays of pain. Specifically, low-catastrophizing children expressed more pain in the presence of their parent, whereas high-catastrophizing children showed equally pronounced pain expression when alone or in the presence of a parent. Furthermore, children’s catastrophizing moderated the impact of parental attention upon facial displays and self-reports of pain; higher levels of parental nonpain talk were associated with increased facial expression and self-reports of pain among high-catastrophizing children; for low-catastrophizing children, facial and self-report of pain was independent of parental attention to pain. The findings are discussed in terms of possible mechanisms that may drive and maintain pain expression in high-catastrophizing children, as well as potential limitations of traditional theories in explaining pediatric pain expression. The impact of parental presence and parental attention to the child’s pain upon the child’s pain expression is moderated by the child’s catastrophizing about pain. © 2011 Lippincott Williams & Wilkins, Inc.