A biopsychosocial perspective on sex differences and sex-specific effects in pediatric pain

Sex differences are a common finding in pain research involving adults, with women consistently reporting higher levels of pain and more chronic pain conditions than men. However, there has still been very little attention to this issue in children and adolescents. The present symposium will examine sex differences in pediatric pain, considering the biological, psychological, and social factors involved. Ms. Boerner's talk will focus specifically on social factors, looking at how children learn how to react to pain by observing their parent's behaviour during painful events. This talk will present the results of a research study where parents (50% mothers, 50% fathers) and 6-8 year-old children (50% girls, 50% boys) were asked to complete the cold pressor task (CPT), which is a safe and commonly used method of inducing mild to moderate levels of pain in the lab. Children first watched their parent complete the CPT and, unbeknownst to their child, parents had been randomly assigned to either show a natural, exaggerated, or minimized pain expression during the CPT. Then the child completed the CPT themselves. The pain experience of the parent and child was measured with self-reports of pain intensity, measured pain tolerance, as well as coding of their facial expressions. This talk will present the results of analyses examining whether the child's pain behaviour and reports of pain were influenced by their parent's pain behaviours, and whether this differed based on the sex of the parent and child (i.e., are boys more influenced by watching their father than their mother, and vice versa for girls?). This research will help increase our understanding of the role of fathers in child pain, as most previous research in this area has only studied mothers. The results of this study will also contribute to explanations of how pain behaviours can be learned through parental modeling, which will have clinical implications for family-based interventions.