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      Relationship between Pain, Somatisation, and Emotional Awareness in Primary School Children

      research-article
      1 , 1 , 1 , 1 , 2 ,
      Pain Research and Treatment
      Hindawi

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          Abstract

          Poor emotional awareness (EA) seems to play an important role in the aetiology of functional somatic complaints featuring pain as a form of somatisation. The aim of this study was to shed more light on this relationship by investigating the links between pain, somatisation, and emotional awareness in a nonclinical population of 445 children aged 6–10. Assessing pain through the Children's Somatisation Inventory (CSI), a very high percentage of the entire sample complained of experiencing pain at least one site (84.07%) over the preceding 2 weeks. Although no difference in the prevalence of pain (whole) was found when the sample was subdivided by Levels of Emotional Awareness Scale-Children (LEAS-C), a relationship between low level of LEAS-Self and prevalence of headache (H) was detected ( χ2=7.69, p=0.02). LEAS (Self) was correlated with the intensity of back pain (BP) (r=-0.12; p< 0.05), H (r=-0.12; p< 0.05) but not with abdominal pain (AP). Pain worsened QoL, and the greatest negative correlation with total KidScreen-10 was found for abdominal pain (r=-0.14; p< 0.01). Our results suggest that low EA is a predictor of somatisation, BP severity, H, and severity of pain in general, but not AP.

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          Most cited references49

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          Anterior insular cortex and emotional awareness.

          This paper reviews the foundation for a role of the human anterior insular cortex (AIC) in emotional awareness, defined as the conscious experience of emotions. We first introduce the neuroanatomical features of AIC and existing findings on emotional awareness. Using empathy, the awareness and understanding of other people's emotional states, as a test case, we then present evidence to demonstrate: 1) AIC and anterior cingulate cortex (ACC) are commonly coactivated as revealed by a meta-analysis, 2) AIC is functionally dissociable from ACC, 3) AIC integrates stimulus-driven and top-down information, and 4) AIC is necessary for emotional awareness. We propose a model in which AIC serves two major functions: integrating bottom-up interoceptive signals with top-down predictions to generate a current awareness state and providing descending predictions to visceral systems that provide a point of reference for autonomic reflexes. We argue that AIC is critical and necessary for emotional awareness. Copyright © 2013 Wiley Periodicals, Inc.
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            The European KIDSCREEN approach to measure quality of life and well-being in children: development, current application, and future advances

            Purpose The KIDSCREEN questionnaires were developed by a collaborative effort of European pediatric researchers for use in epidemiologic public health surveys, clinical intervention studies, and research projects. The article gives an overview of the development of the tool, summarizes its extensive applications in Europe, and describes the development of a new computerized adaptive test (KIDS-CAT) based on KIDSCREEN experiences. Methods The KIDSCREEN versions (self-report and proxy versions with 52, 27, and 10 items) were simultaneously developed in 13 different European countries to warrant cross-cultural applicability, using methods based on classical test theory (CTT: descriptive statistics, CFA and MAP, internal consistency, retest reliability measures) and item response theory (IRT: Rasch modeling, DIF analyses, etc.). The KIDS-CAT was developed (in cooperation with the US pediatric PROMIS project) based on archival data of European KIDSCREEN health surveys using IRT more extensively (IRC). Results Research has shown that the KIDSCREEN is a reliable, valid, sensitive, and conceptually/linguistically appropriate QoL measure in 38 countries/languages by now. European and national norm data are available. New insights from KIDSCREEN studies stimulate pediatric health care. Based on KIDSCREEN, the Kids-CAT promises to facilitate a very efficient, precise, as well as reliable and valid assessment of QoL. Conclusions The KIDSCREEN has standardized QoL measurement in Europe in children as a valid and cross-cultural comparable tool. The Kids-CAT has the potential to further advance pediatric health measurement and care via Internet application.
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              The Dorsolateral Prefrontal Cortex in Acute and Chronic Pain.

              The dorsolateral prefrontal cortex (DLPFC) is a functionally and structurally heterogeneous region and a key node of several brain networks, implicated in cognitive, affective, and sensory processing. As such, the DLPFC is commonly activated in experimental pain studies, and shows abnormally increased function in chronic pain populations. Furthermore, several studies have shown that some chronic pains are associated with decreased left DLPFC gray matter and that successful interventions can reverse this structural abnormality. In addition, studies have indicated that noninvasive stimulation of the left DLPFC effectively treats some chronic pains. In this article, we review the neuroimaging literature regarding the role of the DLPFC and its potential as a therapeutic target for chronic pain conditions, including studies showing the involvement of the DLPFC in encoding and modulating acute pain and studies demonstrating the reversal of DLPFC functional and structural abnormalities after successful interventions for chronic pain. We also review studies of noninvasive brain stimulation of the DLPFC showing acute pain modulation and some effectiveness as a treatment for certain chronic pain conditions. We further discuss the network architecture of the DLPFC, and postulate mechanisms by which DLPFC stimulation alleviates chronic pain. Future work testing these mechanisms will allow for more effective therapies.
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                Author and article information

                Contributors
                Journal
                Pain Res Treat
                Pain Res Treat
                PRT
                Pain Research and Treatment
                Hindawi
                2090-1542
                2090-1550
                2018
                12 November 2018
                : 2018
                : 4316234
                Affiliations
                1Aplysia Onlus, GIFT Institute of Integrative Medicine, Pisa, Italy
                2Department of Surgical, Pathology and Clinical Area, Pisa, Italy
                Author notes

                Academic Editor: Steve McGaraughty

                Author information
                http://orcid.org/0000-0001-8456-3430
                Article
                10.1155/2018/4316234
                6260528
                85bb82b1-ea2e-487d-b384-b5de8d4eb451
                Copyright © 2018 M. Rossi et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 May 2018
                : 26 September 2018
                : 16 October 2018
                Categories
                Research Article

                Anesthesiology & Pain management
                Anesthesiology & Pain management

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