title: Preschool Needle Pain Responding: Establishing 'Normal'.
abstract: The current study sets forth to provide descriptive data for preschool vaccination pain responding as well as examine longitudinal relationships over early childhood. Growth mixture modeling was first used to describe stable subgroups of preschoolers on the basis of their pain response patterns over 2-minutes post-needle. Secondly, a parallel-process growth curve model was used to assess the stability of acute pain responding from 12 months of age to preschool age. Specifically, we examined whether preschool pain-related distress or regulation could be predicted from 12-month acute pain responding. Preschool participants were part of a Canadian longitudinal cohort (The Opportunities to Understand Childhood Hurt [OUCH] cohort; N = 302). Growth mixture modeling analyses discerned 3 distinct groups of preschoolers, with an important minority not regulating to low-no pain by 2 minutes post-needle. There were no significant associations between 12-month and preschool pain responding. These results highlight the steep trajectory of development between these different stages of early childhood and the variability of pain responding at the preschool vaccination.
  
  
  
  This study provides descriptive data for preschool vaccination pain responding as well as examines longitudinal relationships over early childhood. Demonstrating significantly different pain patterns from infancy, 25% of preschoolers are displaying suboptimal regulation trajectories. This considerable minority poses a significant concern because of the established trajectory of phobia onset in middle childhood.
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: Jordana A
authors.initials: JA
authors.lastname: Waxman
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: Miranda G
authors.initials: MG
authors.lastname: DiLorenzo
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Electronic address: rpr@yorku.ca.
authors.forename: Rebecca R
authors.initials: RR
authors.lastname: Pillai Riddell
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: David B
authors.initials: DB
authors.lastname: Flora
authors.affiliation: Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Saul
authors.initials: S
authors.lastname: Greenberg
authors.affiliation: Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Hartley
authors.initials: H
authors.lastname: Garfield
mesh_terms: D059787:Acute Pain / Q000209:etiology*; D000223:Adaptation, Psychological; D002170:Canada; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D008137:Longitudinal Studies; D009339:Needles / Q000009:adverse effects*; D010147:Pain Measurement; D013315:Stress, Psychological; D013997:Time Factors; D014611:Vaccination / Q000009:adverse effects
keywords: Acute pain; child development; pain trajectory; preschool