Socialization of Pain Memories: Parent-Child Reminiscing About Past Painful and Sad Events

Maria Pavlova, MSC; Susan A. Graham, PHD; Abbie Jordan, PHD; Jill Chorney, PHD; Jillian Vinall, PHD; Nivez Rasic, MD; James Brookes, MD; Monica Hoy, MD; Warren K. Yunker, MD, PHD; Melanie Noel, PHD

Disclosures

J Pediatr Psychol. 2019;44(6):679-691. 

In This Article

Abstract and Introduction

Abstract

Objective: Parent–child reminiscing about past negative events has been linked to a host of developmental outcomes. Previous research has identified two distinct between-parent reminiscing styles, wherein parents who are more elaborative (vs. repetitive) have children with more optimal outcomes. To date, however, research has not examined how parents and children talk about past painful experiences nor compared parent–child reminiscing about past painful versus other distressing events despite key developmental differences in how young children respond to pain versus sadness in others. This study aimed to fill that gap.

Methods: Seventy-eight children aged 4 to 7 years underwent a tonsillectomy. Two weeks postsurgery, children and one of their parents discussed past autobiographical events (i.e., the tonsillectomy, another painful event, a sad event). Parent–child conversations were coded using established coding schemes to capture parental reminiscing style, content, and autonomy support.

Results: Findings revealed robust differences in parent–child reminiscing about painful versus sad events. Parents were less elaborative, used less emotionally negative words and explanations, and were less supportive of their children's autonomy while reminiscing about past painful versus sad events.

Conclusions: These findings demonstrate that through reminiscing, parents may socialize children about pain in a way that is different from other distressing events (e.g., sadness). Future research should examine the influence of differential reminiscing about pain versus sadness on developmental and health outcomes.

Introduction

Parent–child reminiscing powerfully shapes young children's cognitive and socioemotional development by creating a foundational learning framework that helps children to process and assign meaning to their past distressing experiences (Nelson & Fivush, 2004). Through elaborative and supportive dialogs enriched with emotional language, children and parents cocreate coherent narratives about past distressing events, which, in turn, lead to children internalizing adaptive ways of processing distressing emotions (Fivush, Haden, & Reese, 2006). However, parent–child conversations about pain, a universal distressing sensory and emotional experience, and specifically past pain, have not been examined.

Past painful experiences are stressful, salient, and memorable. An investigation of children's memories for painful injuries that required a visit to the Emergency Department revealed that children as young as 3 years recalled many details of their injuries up to 10 years later (Peterson, 2015). Further, children's memories for pain are a more robust predictor of future pain than the initial reporting of pain (Noel, Chambers, McGrath, Klein, & Stewart, 2012). That is, young children with negatively biased memories for pain (i.e., recall of more pain as compared with initial reports) reported more pain during a future experimental pain task (Noel et al., 2012). Children's negatively biased pain memories postsurgery have been linked to higher pain at the time that it can transition to a chronic state (Noel, Rabbitts, Fales, Chorney, & Palermo, 2017). These pain memories are thought, in part, to be (re)constructed through parent–child verbal interactions following painful events (Noel, Palermo, Chambers, Taddio, & Hermann, 2015). Yet, research on parent–child reminiscing about painful events is scarce.

In addition to pain, children regularly experience other distressing events that are associated with interpersonal sadness and distress (e.g., separation from caregivers). These painful and distressing experiences are memorable and often become the topic of parent–child conversations (Laible & Song, 2006). During reminiscing, parents and children coconstruct children's memories, which then influences children's responses in similar situations in the future (Salmon & Reese, 2015, 2016). Indeed, research in developmental psychology has long established that parent–child reminiscing, particularly reminiscing about past negative autobiographical events, has a powerful influence on children's cognitive (attention, memory, language, and theory of mind), social (empathy), and emotional (emotion regulation) development (Leyva, Berrocal, & Nolivos, 2014; Leyva & Nolivos, 2015; Salmon & Reese, 2015, 2016).

The ways in which parents reminisce with children about past events vary markedly across parents. These differences in reminiscing have important implications for children's outcomes. While reminiscing, some parents are elaborative, in that that they use open-ended questions and emotion words and provide rich contextual details (Fivush & Fromhoff, 1988). Further, parents who use an elaborative reminiscing style tend to support children's conversational contributions by following in on children's statements, thus creating a more comprehensive memory account and providing validation (Cleveland & Morris, 2014; Cleveland & Reese, 2005). An elaborative reminiscing style has been linked to beneficial developmental outcomes, including more accurate and earlier autobiographical memories (Reese & Robertson, 2019; Salmon & Reese, 2015) and empathic prosocial responding (Laible & Song, 2006; Leyva et al., 2014). Conversely, parents who use a nonelaborative/repetitive reminiscing style use closed-ended questions and frequently switch conversation topics without providing additional contextual details (Sales, Fivush, & Peterson, 2003). These parents do not discuss emotions or support children's autonomy during these conversational exchanges. This reminiscing style is linked to poorer developmental outcomes. Specifically, children, whose parents provided less autonomy support, elaborations, and emotional language, recalled less unique details about past autobiographical events (Cleveland & Reese, 2005; Sales et al., 2003), demonstrated worse emotional understanding and prosocial behaviors (Laible, 2004).

Little is known about how different types of distressing events may pull for different or particular styles of reminiscing within parents. Fivush, Berlin, Sales, Mennuti-Washburn, & Cassidy (2003) compared parental reminiscing styles across three types of negative events (i.e., fear, sadness, and anger). Fear narratives were found to be more elaborative as compared with narratives about sadness and anger. However, no studies to date have examined differences between parent–child reminiscing about past painful events versus other types of negative events (e.g., events involving sadness). This question is relevant to the field of pediatric pain as developmental differences in young children's empathic behavioral responses (e.g., distracting the other person, providing verbal reassurance/sympathy) to pain versus sadness in others have been found (Bandstra, Chambers, McGrath, & Moore, 2011). When exposed to behavioral distress in an adult that originated from sadness or pain, children were more distressed by and empathically responsive to sadness versus pain (Bandstra et al., 2011). Individual difference variables (e.g., children's age, negative affectivity, and language) were predictive of some variance (8–13%) in children's empathic concern and personal distress related to pain in others (Bandstra et al., 2011). Yet, a large proportion of variance remained unexplained. This raises the possibility that the differences in children's prosocial responding to pain versus sadness in others may be partially driven by differential socialization of pain versus negative emotions, like sadness, and parent–child interactions.

This study addressed this gap by examining the reminiscing style and content across parent–child reminiscing about two painful autobiographical events (a recent surgery and another painful event) and a negative emotional autobiographical event (a sad event). Based on the differences in reminiscing styles that were revealed as a function of the reminiscing topic (Fivush, Berlin, et al., 2003) and the developmental differences found between young children's behavioral responses to pain versus sadness (Bandstra et al., 2011), we hypothesized that parents and children would reminisce differently when talking about a past event involving sadness as compared with pain. Given the dearth of research on parent–child reminiscing about past pain, we did not have specific directional hypotheses about the differences between reminiscing styles as a function of the event type.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....