Sex differences in adolescent chronic pain and pain-related coping

Sex differences exist in pain and the strategies used to cope with pain. Although it is has been proposed that such differences become apparent around puberty, somewhat surprisingly very little research has specifically investigated sex as a moderator of pain within adolescents. The primary aim of the current study was to investigate sex differences in pain and coping within a group of 46 male and 115 female adolescent chronic pain sufferers. All were aged between 11 and 19 years and had been referred to the Pain Management Unit at the Royal National Hospital for Rheumatic Diseases, United Kingdom. Patients completed a battery of measures including pain experiences and a pain coping questionnaire. No sex differences were found in pain chronicity, although males and females did differ in self-reported pain experiences (females reported higher pain). Sex differences were also found in coping behaviours. Females used more social support, positive statements and internalizing/catastrophizing, whereas males reported engaging in more behavioural distraction. Of these strategies internalizing/catastrophizing was found to mediate the relationship between sex and pain. This suggests that not only do sex differences exist in the pain experiences and pain-coping strategies of adolescents with chronic pain, but that internalizing/catastrophizing may be an important mechanism in understanding such differences. More research examining potential sex differences in children and adolescents is recommended.     

Sex differences in perceptions of pain coping strategy usage

Sex differences are generally found in the perception and experience of pain, with women reporting more intense and frequent pain than men. One reason why such differences may occur has been linked to socially-acquired gender-role expectations associated with pain. Although there is evidence that men and women report using different pain coping strategies, we do not know the extent to which gender-specific expectations are associated with pain-related coping. The current study sought to examine this in more detail by administering a standard pain coping measures on three separate occasions, but with different instructions. Hundred and twenty two participants (57 male, 65 female) were asked to complete the coping measure as themselves, then again as they would expect the typical man and the typical woman to complete it. Results indicated that there were no significant differences between men and women in their own self-reported usage of pain coping strategies. However, there was general evidence to suggest that there are differences in stereotypical views of how men and women are thought to cope with pain. Furthermore, sex differences were also found in how participants viewed their own coping behaviours in comparison to that of the typical man and typical woman. These results confirm that alongside pain, men and women hold different gender-specific expectations with respect to certain pain coping strategies. Future research is required to examine whether these different coping expectations influence an individuals own choice of strategy, and whether this in turn affects actual pain experiences.     

慢性病儿童父母应对方式的调查研究

目的 描述慢性病儿童父母为保持正常家庭生活所采取的应对方式,并探讨父母性别、文化程度和家庭人均月收入水平等对应对方式的影响.方法 采用问卷调查法,利用父母应对方式量表(The Coping Health Inventory for Parents,CHIP)对慢性病儿童父母140名进行调查.结果 慢性病儿童父母不同文化程度间、家庭人均月收入不同水平间的应对方式得分差异均有显著性意义(P<0.001).结论 护士应指导父母,尤其是文化程度、家庭人均月收入水平较低的父母寻求积极有效的应对方式,促进其身心健康及维持正常的家庭生活.     

Sex differences in experimental pain among healthy children: A systematic review and meta-analysis

Sex differences in response to experimental pain are commonly reported in systematic reviews in the adult literature. The objective of the present research was to conduct a systematic review and meta-analysis of sex differences in healthy children’s responses to experimental pain (eg, cold pressor, heat pain, pressure pain) and, where possible, to conduct analyses separately for children and adolescents. A search was conducted of electronic databases for published papers in English of empirical research using experimental pain tasks to examine pain-related outcomes in healthy boys and girls between 0 and 18 years of age. Eighty articles were eligible for inclusion and were coded to extract information relevant to sex differences. The systematic review indicated that, across different experimental pain tasks, the majority of studies reported no significant differences between boys and girls on pain-related outcomes. However, the meta-analysis of available combined data found that girls reported significantly higher cold pressor pain intensity compared to boys in studies where the mean age of participants was greater than 12 years. Additionally, a meta-analysis of heat pain found that boys had significantly higher tolerance than girls overall, and boys had significantly higher heat pain threshold than girls in studies where the mean age of participants was 12 years or younger. These findings suggest that developmental stage may be relevant for understanding sex differences in pain.     

慢性心力衰竭患者自我护理行为与应对方式的研究

目的:描述慢性心力衰竭患者自我护理行为及应对方式现状,探讨应对方式对自我护理行为的影响。方法:采用慢性心力衰竭自我护理行为量表和医学应对方式问卷对天津市某三级甲等综合性医院心内科102例慢性心力衰竭患者进行问卷调查。结果:慢性心力衰竭患者常采用面对的应对方式,自我护理行为平均分为(2.41±0.69)分。多元逐步回归结果提示,应对方式是自我护理行为的重要影响因素。结论:护理人员应帮助患者建立有效的应对方式,从而提高其自我护理行为。     

Appraisal and coping processes among chronic low back pain patients

OBJECTIVES: Appraisals and coping play important roles in musculoskeletal disorders, but how these aspects develop over time remains unknown. The aim of the current study was to examine the development of pain-related appraisals, coping and well behaviours among chronic low back pain (CLBP) patients. METHODS: Twenty-two outpatients (15 women, 7 men) of working age were interviewed about past and present experiences of CLBP. The interviews were analysed using Grounded theory. RESULTS: The majority of the participants used disregarding processes in response to CLBP. The disregarding process developed from a psychological defence into a conscious coping strategy, the transition mediated by a crisis. This defence seemed to protect the participants' self-concept and reduce emotional discomfort, although it did not promote rehabilitation. The disregarding strategy was usually employed in later phases of the disorder and was consistent with active attempts at changing pain-related behaviours. Study limitation: Most of the participants had experienced CLBP for several years, thus the risk of memory bias cannot be ruled out. Furthermore, the sample was composed of relatively healthy subjects, thus the findings may not apply to chronic low back patients in general. CONCLUSION: Acceptance of CLBP favoured rehabilitation and helped participants change pain-related behaviours.     

Sex differences in musculoskeletal pain

Epidemiologic, clinical, and experimental evidence points to sex differences in musculoskeletal pain. Adult women more often have musculoskeletal problems than do men. Discrepant findings regarding the presence of such differences during childhood and adolescence continue. Biologic and psychosocial factors might account for these differences. The authors review evidence showing that mechanically induced pressure is more likely to show sex differences than other noxious stimuli and to discriminate between individuals suffering from musculoskeletal pain and matched controls. The authors suggest that a state of increased pain sensitivity, with a peripheral or central origin, predisposes individuals to chronic muscle pain conditions, and that there are sex differences in the operation of these mechanisms; women are vulnerable to the development and maintenance of musculoskeletal pain conditions.     

高热惊厥患儿家属应对方式现状及其相关影响因素分析

目的 探究高热惊厥患儿家属应对方式现状及其相关影响因素。方法 选取2022年4月至2023年5月我院收治的100例高热惊厥患儿家属,采用简易应对方式问卷（SCSQ）评估患儿家属的应对方式,并收集相关资料,分析该类患儿家属应对方式的影响因素。结果 100例患儿家属中消极应对者32例,占32.00%。家属与患儿的关系、受教育程度、家庭关怀度、心理弹性与高热惊厥患儿家属的消极应对有关（P＜0.05）;经Logistic回归分析显示,患儿母亲、高中及以下是高热惊厥患儿家属消极应对的危险因素（OR＞1,P＜0.05）;家庭关怀度及心理弹性评分较高是高热惊厥患儿家属消极应对的保护因素（OR＜1,P＜0.05）。结论 高热惊厥患儿家属消极应对主要受其为患儿母亲、受教育程度较低、家庭关怀度较低、心理弹性较低等因素影响,临床可据此采取措施来改善其应对方式。     

Sex differences in the associations among psychological factors and pain report: a novel psychophysical study of patients with chronic low back pain.

Previous studies have consistently suggested that there are sex differences in pain report, but there is no consensus regarding sex differences in the associations among psychological factors and pain report. This cross-sectional study used a novel, clinically relevant, psychophysical pain-induction technique to examine sex differences between sensory and affective pain report and sex differences in the association of depression, pain related anxiety, and catastrophizing with pain report. Patients with chronic low back pain (N = 53) were recruited from an outpatient spine clinic, and those consenting completed self-report measures of pain-related anxiety, depression, pain catastrophizing, and pain. A measure of induced low back pain was obtained by having study participants perform a protocol on the MedXtrade mark Low-Back Exercise Apparatus. Our results indicated that no sex differences were detected in psychological factors and self-reported or induced low back pain. However, the relationships between pain related anxiety and self-report of low back pain (z = 2.51, P < .05) and between pain-related anxiety and induced low back pain (z = 3.00, P < .05) were significantly stronger in men than women. These findings suggest that anxiety was linked to self-reported and induced low back pain for men, but not for women. PERSPECTIVE: Results of this study suggest that pain-related anxiety has a stronger association with psychophysical and clinical reports of low back pain for men.     

直肠癌Miles术后患者压力应对方式调查研究

目的:调查直肠癌结肠造口患者在诊断、治疗和预后过程中面对不同程度的生理、心理、社会压力状况及采取的应对方式。方法:对60例行直肠癌Miles术患者分别在术后1个月、3个月、1年进行问卷调查。采用Jalowice的应对量表(JCS)以测试患者应对策略的应用及所用策略的效果。结果:直肠癌Miles术后1个月患者多采用情感、逃避、听天由命、自我依赖的消极应对方式;造口术后3个月患者多采用面对、支持、乐观、自我依赖的应对方式;术后1年的肠造口患者多采用面对、支持、乐观的应对方式来缓解压力。结论:行直肠癌Miles术患者在不同时期采取多种不同的应对策略去缓解心理压力。在确诊初期多数是采取"以缓解应激而导致的情绪变化"的消极应对策略,病情缓解后多采用"以改变应激事件本身为主体的应对"策略缓解心理压力。     

Readiness to self-manage pain is associated with coping and with psychological and physical functioning among patients with chronic pain

A patient's readiness to adopt a self-management approach to pain has been suggested as a construct that may explain differences among patients in coping, adjustment, and response to multidisciplinary pain treatment. The pain stages of change questionnaire (PSOCQ; Pain, 72 (1997) 227) was designed to assess four components of this construct. The current study tested the following two hypotheses in two different samples of persons with chronic pain. PSOCQ scales are associated with (1) coping strategies used to manage pain and (2) patient disability and depression. The findings supported the first hypothesis and provided mixed support for the second. The implications of the findings for understanding the readiness to self-manage pain construct and the validity of the PSOCQ for assessing this construct are discussed.     

Sex,gender, coping,and self‐efficacy: Mediation of sex differences in pain perception in children and adolescents

Sex differences in pain perception have been reported in an expanding literature based on adult samples in epidemiological as well as laboratory studies. Especially with respect to the latter, studies with children and adolescents do not consistently show that females report higher pain ratings and display lower pain tolerance than males. The first aim of the presented studies is to comparably examine sex differences in children and adolescents based on experimental and questionnaire approach indices of pain perception. The second aim is to examine the contribution of three prominent psychosocial factors (gender‐role expectations, coping with pain, and pain self‐efficacy) to these sex differences. In Study 1, a total of 118 children and adolescents from grades 5 to 9 were tested with the Cold Pressor Task (CPT) and a Pain Perception Questionnaire. In Study 2, 148 participants additionally reported on their gender‐role expectations, coping with pain, and pain self‐efficacy. Although the results reveal only medium‐sized correlations between the CPT and the questionnaire measures, both measures indicate substantial sex differences in pain perception in both studies. In Study 2, sex differences are also present for masculinity, femininity, catastrophizing as well as pain self‐efficacy. However, while the relation between sex and the CPT rating is partially mediated by pain self‐efficacy, catastrophizing partially mediates the relation between sex and the questionnaire based pain ratings. The results of both studies are discussed with respect to the difference between experimental assessments of pain perception and assessments by questionnaire in children and adolescents.     

Pain coping profiles in adolescents with chronic pain

This study sought to evaluate the extent to which the pain coping profiles observed by Walker and colleagues in a sample of patients with chronic abdominal pain also were evident in a sample of adolescent patients who presented to a tertiary care clinic for evaluation of a variety of diverse pain conditions. In addition, we aimed to evaluate the relation of these pain coping profiles to patients' emotional and physical functioning. Participants (n=254) were adolescent patients aged 12-17 years. Patients completed the Pain Response Inventory (PRI) as well as measures of pain, somatic symptoms, anxiety and depressive symptoms, and functional disability. Using the PRI classification algorithm developed by Walker and colleagues, we successfully classified all the patients in our sample. We also found that the pain coping profiles successfully differentiated among patients with different levels of symptoms, disability, and emotional distress, further demonstrating the external validity of these profiles. Results have implications for tailoring pain treatment interventions to patients' particular coping profiles.     

Religiosity, religious coping styles, and health service use: racial differences among elderly women

This study explored racial differences in the effects of religiosity and religious coping styles on health service use. The sample (N = 274) consisted of a cross-section of women ages 55 and older living in publicly subsidized high-rise dwellings in Nashville, Tennessee (1999 to 2000) and included 159 White and 115 African American women. The results suggested the effects of religiosity on health service use are generally negative for both groups. However, the effects of religious coping styles on health service use differed by race. The self-directing coping style was associated with higher levels of use for White women, but with lower levels of use for African American women. The deferring coping style was associated with greater physician visits and inpatient days among White women, but with fewer inpatient days among African American women. The collaborative coping style was associated with higher inpatient days among African American women, but had no significant effect on use patterns for White women. Conducting assessments of religiosity and religious coping styles would enhance holistic nursing practice.     

癌症病人的疼痛程度与疼痛应对方式的相关性研究

[目的]探讨癌症病人的疼痛程度、疼痛应对方式以及两者的关系.[方法]应用癌症疼痛情况调查表Riley和Robinson的疼痛应对方式问卷-修正版(CSQ-R)分别对203例癌症病人的疼痛程度、疼痛应对方式进行问卷调查.[结果]癌症病人经历不同程度(轻～剧烈)的疼痛:目前平均疼痛程度以轻度疼痛病人居多(55.66%),中度、重度、剧烈疼痛的病人分别占27.59%、10.34%、6.41%;癌症病人最常采用的应对方式依次为分散注意力.癌症病人厄运感祈祷的应对方式与疼痛程度呈正相关,癌痛病人越常使用上述疼痛应对方式,疼痛程度越严重;忽视疼痛勇敢面对的应对方式与疼痛程度呈负相关,癌痛病人越常使用上述疼痛应对方式,疼痛程度越能够得以缓解.[结论]在临床护理工作中,应提高对癌痛病人疼痛应对方式的关注程度,及时发现病人对癌症疼痛错误的应对.     

Sex differences in experimental and clinical pain sensitivity for patients with shoulder pain

Previous research demonstrates that men and women differ in the way that they perceive and process pain. Much of this work has been done in healthy adults with a lack of consensus in clinical pain populations. The purpose of this study was to investigate how men and women with shoulder pain differ in their experience of experimental and clinical pain and whether psychological processes differentially affect these responses. Fifty‐nine consecutive subjects (24 women, 35 men) seeking operative treatment for shoulder pain were enrolled in this study. Subjects completed self report questionnaires to assess clinical pain, catastrophizing, anxiety and depression and underwent a series of experimental pain tests consisting of pressure pain, thermal pain (threshold and tolerance), and thermal temporal summation. Results indicated that women experienced greater clinical pain and enhanced sensitivity to pressure pain. Age did not affect the observed sex differences. There were no sex differences in psychological association with experimental and clinical pain in this cohort. The relationship between clinical and experimental pressure pain was stronger in women as compared to men. These findings offer insight into the interactions between biological and psychosocial influences of pain and how these interactions vary by sex.     

Self-efficacy for managing pain is associated with disability, depression, and pain coping among retirement community residents with chronic pain.

Little is known about cognitive and behavioral factors that influence older adults' adjustment to chronic pain. The objective of this study was to investigate the relationship of self-efficacy for managing pain to reports of pain intensity, pain-related disability, depressive symptoms, and pain coping strategy use among 140 retirement community residents (88% female; age mean = 81.7, range 66-99 years) with chronic pain. The 8-item Arthritis Self-Efficacy Scale, modified to specify pain rather than arthritis, demonstrated good psychometric characteristics (Cronbach alpha = .89, minimal floor and ceiling effects, and validity) in this sample. Controlling for age, gender, and pain intensity, self-efficacy was associated significantly and negatively with pain-related disability and depressive symptoms (P values < .001), and positively with use of pain coping strategies previously found to be associated with better outcomes (task persistence, exercise/stretch, coping self-statements, activity pacing; P values < .05). Self-efficacy for managing pain appears to be important in the adjustment of older adults with pain. Research is needed to determine whether interventions designed to increase self-efficacy improve quality of life and prevent functional declines in this population. PERSPECTIVE: Among retirement community residents (mean age of 82 years) with chronic pain, higher self-efficacy for managing pain is associated with less disability and depression and with the use of pain coping strategies related to better adjustment. This suggests the potential value of interventions to increase self-efficacy in this population.     

Sex differences in delayed onset muscle pain

OBJECTIVE: In contrast to the research using typical experimental pain stimuli, there is no consensus that women are more sensitive to delayed onset muscle pain than men. The purpose of this study was to examine sex differences in delayed onset muscle pain with use of a quantified stimulus intensity and multidimensional and valid pain measures. METHODS: Ninety-five participants (49.5% women) completed eccentric exercise and then returned to the laboratory at 24 and 48 hours postexercise. The same relative intensity of the eccentric exercise was administered to women and men based on their eccentric strength. RESULTS: The occurrence of muscle pain was confirmed by increases in intensity, F2, 182 = 162.28, P<0.01, eta = 0.64, and unpleasantness, F2, 182 = 204.03, P < 0.01, eta = 0.69, and standardized pain ratings, F2, 180 = 67.44, P < 0.01, eta = 0.43. The affective ratios indicated that the muscle pain was more unpleasant than intense. No sex differences were detected except that men reported higher affective ratios than women, F1, 92 = 4.06, P < 0.05, eta = 0.04. DISCUSSION: The absence of higher muscle pain ratings in women than men in this investigation resembles a review of the delayed onset muscle soreness and pain literature. However, the findings contradict a few other acute muscle pain investigations, in which actual muscle tissue damage was not induced by eccentric contractions. Additional research is required to identify the parameters that influence the detection of sex differences.