Pain-sensitive temperament: Does it predict procedural distress and response to psychological treatment among children with cancer?

Objective: To evaluate the relationship between pain sensitivity and childr en's distress during lumbar punctures (LPs), and whether pain sensitivity f unctions as a moderator of children's responses to a psychological interven tion aimed at reducing LP distress. Method: Fifty-five children with acute lymphoblastic leukemia (ages 3 to 18 ) and their parents completed a questionnaire measure of pain sensitivity. Self-report, physiological, and observed measures of distress were collecte d during the study baseline LP. Children were then randomized into a psycho logical intervention or an attention control group. Postintervention and fo llow-up LPs were observed. Results: Higher levels of pain sensitivity were associated with greater anx iety and pain, both prior to and during the LP. Preliminary analyses indica ted that pain sensitivity moderated the effects of intervention on distress . Children who were more pain-sensitive and who received no intervention sh owed greater increases in LP distress over time. In contrast, children who were more pain-sensitive and who received intervention showed greater decre ases in LP distress over time. Conclusions: A measurement of pain sensitivity may be useful in pediatric o ncology settings for effectively targeting pain-vulnerable children for psy chological intervention. Preliminary analyses indicate that an empirically- supported intervention for procedural distress is efficacious for those chi ldren who are most pain-sensitive.