Postoperative Pain Expression in Preschool Children: Validation of the Child Facial Coding System

Gilbert, Cheryl A.; Lilley, Christine M.; Craig, Kenneth D.; McGrath, Patrick J.; Court, Colleen A.; Bennett, Stephanie; Montgomery, Carolyne J.

doi:10.1097/00002508-199909000-00006

Cited by 86 publications

(46 citation statements)

References 22 publications

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“…Children's facial display of pain during CPT performance was video recorded and coded using the Child Facial Coding System [CFCS; 15,21,33]. The CFCS is an observational rating system of 13 discrete facial actions (brow lowering, squint, eye squeeze, nose wrinkle, nasolabial furrow, cheek raise, upper lip raise, lip corner pull, vertical mouth stretch, horizontal mouth stretch, blink, flared nostrils and open lips).…”

Section: Child Facial Pain Expressionmentioning

confidence: 99%

“…The CFCS is an observational rating system of 13 discrete facial actions (brow lowering, squint, eye squeeze, nose wrinkle, nasolabial furrow, cheek raise, upper lip raise, lip corner pull, vertical mouth stretch, horizontal mouth stretch, blink, flared nostrils and open lips). The CFCS has shown good reliability and validity in coding children's facial pain expressions [33]. Facial actions were coded by two trained coders.…”

Section: Child Facial Pain Expressionmentioning

confidence: 99%

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Emotion regulatory function of parent attention to child pain and associated implications for parental pain control behaviour

Vervoort

Trost

Sütterlin

et al. 2014

Pain

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We investigated the function of parental attention to child pain in regulating parental distress and pain control behaviour when observing their child performing a painful (cold pressor) task (CPT); we also studied the moderating role of parental state anxiety. Participants were 62 schoolchildren and one of their parents. Parental attention towards or away from child pain (ie, attend to pain vs avoid pain) was experimentally manipulated during a viewing task pairing unfamiliar children's neutral and pain faces. Before and after the viewing task, parental distress regulation was assessed by heart rate (HR) and heart rate variability (HRV). In a subsequent phase, parents observed their own child perform a CPT task, allowing assessment of parental pain control behaviour (indexed by latency to stop their child's CPT performance) and parental distress, which was assessed via self-report before and after observation of child CPT performance. Eye tracking during the viewing task and self-reported attention to own child's pain confirmed successful attention manipulation. Further, findings indicated that the effect of attentional strategy on parental emotion regulation (indexed by HR, self-report) and pain control behaviour depended on parents' state anxiety. Specifically, whereas low anxious parents reported more distress and demonstrated more pain control behaviour in the Attend to Pain condition, high anxious parents reported more distress and showed more pain control behaviour in the Avoid Pain condition. This inverse pattern was likewise apparent in physiological distress indices (HR) in response to the initial viewing task. Theoretical/clinical implications and further research directions are discussed

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Section: Child Facial Pain Expressionmentioning

confidence: 99%

Section: Child Facial Pain Expressionmentioning

confidence: 99%

Emotion regulatory function of parent attention to child pain and associated implications for parental pain control behaviour

Vervoort

Trost

Sütterlin

et al. 2014

Pain

View full text Add to dashboard Cite

show abstract

“…It was not possible to make fine-grained codings in this set-up, so we could not use the CFCS as in study one. Therefore, only the key facial pain expressions as identified in the CFCS [9,24], were coded. The core facial pain grimace is characterized by the lowering of the brow, wrinkling of the nose, raising of the cheeks, raising of the upper lips and closing or narrowing of the eyelids [56].…”

Section: Pain Behaviormentioning

confidence: 99%

Parental catastrophizing about child's pain and its relationship with activity restriction: The mediating role of parental distress

Caes

Vervoort

Eccleston

et al. 2011

Pain

156

144

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“…The CFCS is an observational rating system of 13 discrete facial actions (brow lowering, squint, eye squeeze, nose wrinkle, nasolabial furrow, cheek raiser, upper lip raise, lip corner pull, vertical mouth )" " stretch, horizontal mouth stretch, blink, flared nostril and open lips). The CFCS has shown good reliability and validity in coding children's facial pain expressions [24]. Facial actions were coded by two trained raters who were blind to the children's pain and catastrophizing ratings as well as parental behaviours.…”

Section: Facial Pain Expressionmentioning

confidence: 99%

Social modulation of facial pain display in high-catastrophizing children: An observational study in schoolchildren and their parents

Vervoort

Caes

Trost

et al. 2011

Pain

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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 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved

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Postoperative Pain Expression in Preschool Children: Validation of the Child Facial Coding System

Abstract: The present study demonstrated that the CFCS serves as a valid measurement tool for persistent pain in children.

Cited by 86 publications

References 22 publications

Emotion regulatory function of parent attention to child pain and associated implications for parental pain control behaviour

Emotion regulatory function of parent attention to child pain and associated implications for parental pain control behaviour

Parental catastrophizing about child's pain and its relationship with activity restriction: The mediating role of parental distress

Social modulation of facial pain display in high-catastrophizing children: An observational study in schoolchildren and their parents

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