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Managing the Frightened Child

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... 8,9 Younger children in particular are at greater risk of receiving inadequate analgesia, 2,10-20 which can lead to diminished efficacy of analgesia in subsequent procedures [21][22][23][24][25] and an increased risk of developing needle phobia. 20,26,27 Although high-quality guidelines for the management of pediatric procedural pain are available, 3,20,[28][29][30][31][32][33][34][35][36][37][38][39] efforts to reduce children's exposure to pain and fear during laceration repair in the ED are hindered by a lack of documentation of pain scores and limited baseline data regarding the intensity and duration of distress experienced by pediatric patients undergoing medical procedures. [2][3][4]40 To our knowledge, no previous studies have specifically sought to quantify young children's pain throughout the facial laceration repair experience. ...
Article
Objectives: Our objectives were to quantify pain experienced by young children undergoing facial laceration repair and identify factors associated with low procedural pain scores. Methods: We conducted a prospective cohort study of children's distress among a convenience sample of children aged 1 to 5 years undergoing facial or scalp laceration repair in 2 pediatric emergency departments. We reviewed video recordings and documented pain scores at 15-second intervals using the Face, Leg, Activity, Cry, Consolability-Revised (FLACC-r) scale. We dichotomized FLACC-r into low/high scores (≤3 and >3) to evaluate practice variables. Results: We included 11,474 FLACC-r observations from 258 procedures in the analysis. Two-thirds of 3- to 5-year-olds completed their laceration repair without the use of restraint, sedation, or anxiolytics. Mean distress scores were low (≤2.5 out of 10) across all procedure phases for 2- to 5-year-old patients. One-year-old patients experienced significantly more distress than their older counterparts (mean ≤4.2 out of 10). Odds of having low FLACC scores (≤3) were greater for patients with an expert clinician (adjusted odds ratio [aOR]: 1.72; 95% confidence interval [CI], 1.05-2.84). Wound infiltration (aOR, 0.35; 95% CI, 0.13-0.93), patient observation of a needle (aOR, 0.21; 95% CI, 0.14-0.33), and restraint (aOR, 0.04; 95% CI, 0.02-0.06) were negatively associated with low FLACC score. Conclusion: The majority of 3- to 5-year-old patients were able to undergo facial laceration repair without restraint, sedation, or anxiolytics and with low mean distress scores. Our findings suggest that children's risk of experiencing moderate and severe distress during facial and scalp laceration repair may be reduced by prioritizing wound closure by expert-level clinicians, ensuring effective lidocaine-epinephrine-tetracaine application, avoiding restraint, and concealing needles from patient view.
... Children who need a clinical procedure such as a medical examination, blood test, radiological investigation, vaccination or the administration of treatment can often feel worried and anxious about what will happen. Even minor procedures can be worrying for children who will often be entering an unfamiliar clinical environment full of new people, sights, smells, sounds and equipment (Krauss & Krauss, 2019). Those with long term conditions may experience anticipatory anxiety (Racine et al., 2016) as they may be revisiting a place where they have previously experienced pain, discomfort or medical trauma (Morton, 2015(Morton, , 2020. ...
... Children who need a clinical procedure such as a medical examination, blood test, radiological investigation, vaccination or the administration of treatment can often feel worried and anxious about what will happen. Even minor procedures can be worrying for children who will often be entering an unfamiliar clinical environment full of new people, sights, smells, sounds and equipment (Krauss & Krauss, 2019). Those with long term conditions may experience anticipatory anxiety (Racine et al., 2016) as they may be revisiting a place where they have previously experienced pain, discomfort or medical trauma (Morton, 2015(Morton, , 2020. ...
... Se è vero, infatti, che a tutte le età è necessario instaurare un'efficace comunicazione empatica, è altrettanto vero che ci sono ancora evidenze insufficienti che un'adeguata informazione del bambino in età scolare riduca il livello di dolore associato a venipuntura 10 e che in età prescolare le tecniche di distrazione e saturazione sensoriale sono più efficaci rispetto a una comunicazione precisa. 25 Il principio della saturazione sensoriale è ben esemplificato dall'allattamento al seno e la suzione non nutritiva di neonati e lattanti, ma anche dall'applicazione di tecniche fisiche nelle età successive. L'effetto analgesico dell'allattamento al seno, infatti, è generato all'associazione di vari fattori, quali il contenuto glicidico del latte materno e il contatto fisico diretto con la madre, attraverso cui le dimensioni tattile, olfattiva e uditiva del bambino sono saturate, con conseguente attenuazione della trasmissione dello stimolo nocicettivo. ...
Article
. Non pharmacologic interventions for pain associated to venipuncture in children: a literature review. Introduction: Venipuncture is one of the most common painful procedures performed on children. Pain prevention and control are essential in childhood, because the earlier is the nociceptive experience, the more it affects the response to subsequent painful events. Objective: To analyse the literature on non-pharmacological methods of pain management in children undergoing venipuncture. Method: The review was carried out between May and July 2019 by consulting the PubMed and Cochrane Database, combining Mesh terms and free text. The references reported in the articles found in the first part of the research were also analyzed, to identify further relevant studies. Results: A total of 20 articles were included in this review (8 randomized clinical trials, 10 systematic reviews, 1 meta-analysis and 1 pilot study), on a total population of almost 20,086 children aged 1-18 years. The settings considered by the studies were pediatric wards, pediatric outpatient, and Emergency Department. Non-pharmacological interventions can be classified in 4 categories: supportive or environmental therapies; physical therapies; cognitive-behavioral therapies; and non-nutritive suction for newborns and infants. The strength of evidence ranged from high to low or extremely low. Discussion: Most non-pharmacological methods are simple, cheap, easily acquired, and do not need excessive application time. They allow pain control and support the comfort and cooperation of children undergoing venipuncture, alone or combined to pharmacological treatment.
... Extensive use of face masks during the COVID-19 pandemic 1 poses a challenge for paediatric clinicians who rely on facial expression to engage with patients and overcome fear or apprehension. 2 The only previous study to address this 3 found that half of children aged 4-10 years preferred to be cared for by physicians wearing face shields as opposed to surgical masks; some cited fear of masked doctors. However, this study excluded younger children who may be the most fearful, did not compare to a control group and did not assess clinicians' perceptions. ...
Article
Veel kinderen ervaren ‘procedureel leed’: angst, pijn en verzet tijdens medische verrichtingen. Dat heeft grote invloed op hun vertrouwen, en dat van hun ouders, in de medische zorg. Verschillende technieken om patiënten zo goed mogelijk te begeleiden zijn verenigd in een multimodale aanpak, de zogeheten ‘procedurele comfortzorg’. Dit artikel gaat in op verschillende aspecten van deze aanpak.
Chapter
Available evidence from the literature shows that non-pharmacologic strategies should not only be regarded as a possible alternative for procedural sedation, but even more as a crucial adjunct to procedural sedation. Physicians should be well aware that continuous anxiety control is not only essential for effective and safe procedural sedation but also plays a role in allowing an improved quality of the patient’s and parents’ experience. This chapter gives a practical overview of non-pharmacologic strategies, from the perspective of optimal procedural comfort in children and parents. Non-pharmacologic strategies should not be considered as a stand-alone strategy but as part of an integrated perspective of procedural comfort care.
Chapter
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recently, we have begun to explore . . . [the] process of emotional contagion / people's conscious analyses give them a great deal of information about their social encounters / [people] can also focus their attention on their moment-to-moment emotional reactions to others, during their social encounters / this stream of reactions comes to them via their fleeting observations of others' faces, voices, postures, and instrumental behaviors / further, as they nonconsciously and automatically mimic their companions' fleeting expressions of emotion, people also may come to feel as their partners feel / by attending to the stream of tiny moment-to-moment reactions, people can gain a great deal of information on their own and their partners' emotional landscapes begin by defining emotion and emotional contagion and discussing several mechanisms that we believe might account for this phenomenon / review the evidence from a variety of disciplines that "primitive emotional contagion" exists / examine the role of individual differences in emotional contagion / outline some of the broad research questions researchers might profitably investigate (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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Examined personal space in 34 nursery school children by 2 methods. In one, unobtrusive observations of actual interpersonal distance choices in 4 different social situations were made. In the other, the same Ss chose interpersonal distances in 4 similar social situations represented symbolically by drawings. Results demonstrate that Ss already show regular variations in personal space based on acquaintance (acquaintances closer than strangers), sex (boys greater than girls), and social context (informal greater than formal). Three interactions were also significant. Projective and naturalistic observation measurement methods produced similar results, contrary to the conclusions of recent reviews. Conceptually, however, there may be 2 types of personal space—perceived and objective interpersonal distance. (French summary) (18 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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Pediatric venous access causes unnecessary anxiety and pain in children and, in turn, can have detrimental consequences. Behavioral approaches to pediatric venous access distress management can be organized temporally. Specifically, preparation before the procedure includes providing children with sensory and procedural information in an age-appropriate manner and providing training in coping skills. It is important to consider the timing, format, and content of the approach to provide optimal preparation for the unique circumstances of the individual patient. In addition to the child patient, preparing parents and teaching them which specific behaviors might be most helpful to their child should prove valuable to both patient and parents. During the procedure, there are benefits to providing secure and comfortable positioning. In addition, researchers recommend that adults encourage children to cope and actively engage children in distracting activities. For infants, there is support for the distress-mitigation properties of swaddling, skin-to-skin contact, breastfeeding, and sucrose. After venous access, distraction and encouragement of coping should speed recovery. In sum, research in behavioral approaches to pediatric pain management has provided recommendations for minimizing children's anxiety and pain associated with venous access.
Article
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This study examined how cardiovascular reactivity to human touch is affected by the social context of the situation. Context for a ten-second touch was manipulated for 61 male and 64 female undergraduate participants in three ways: professional touch, were participants were touched on the wrist to have their pulse taken; social touch, an unexplained touch to the same area of the arm; and a no-touch control, where participants were told their pulse was being taken automatically without being touched. Social context was also manipulated by employing both same-sex and opposite-sex touch experimenters. In the professional touch and no-touch conditions, participants' heart rate and blood pressure decreased overall; however, in the social touch condition initial increases were observed for both measures. Female experimenters produced greater heart rate decreases than male experimenters. The greatest cardiovascular increases were found with women being touched by men in the social condition. These data suggest that both context and gender are important contextual factors in determining cardiovascular reactivity.
Article
When children need medical care, the situation can be stressful for both the parent and the child. Pain, fear, and unfamiliar surroundings can lead to a high level of anxiety, which may make accurate assessment and treatment challenging. When anxiety is alleviated, children are more likely to engage with clinicians and follow instructions, which makes it easier for the clinician to perform the procedure or physical examination and to obtain accurate and complete diagnostic information. This video describes and interprets the signs of acute anxiety in children and demonstrates approaches to interacting with children that minimize anxiety and maximize cooperation.
Article
Examined speech addressed to different categories of listeners in a study in which 80 undergraduate women taught a block design task to either a 5–7 yr old girl ( n = 6), a retarded adult (4 women, aged 20–33 yrs), a peer who spoke English as a 2nd language (4 adult women [foreigners]), or a peer who was an unimpaired native speaker of English (2 women undergraduates). Speech addressed to children differed from the speech addressed to native adults along every major dimension. It was clearer, simpler, more attention maintaining, and included longer pauses. Speech addressed to retarded adults was similar to speech addressed to 6-yr-olds. Speech to the retarded adults did differ in timing from the other styles of speaking in that it included fewer and somewhat shorter pauses. Speech addressed to foreigners was more repetitive than speech addressed to native speakers, but in all other ways it was similar. Results show that speakers fine-tuned their communications to the level of cognitive and linguistic sophistication of their listener. The hypothesis that baby talk (the speech addressed to children) is a prototypical special speech register from which other special registers are derived is discussed. (66 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Infants between 12 and 21 days of age can imitate both facial and manual gestures; this behavior cannot be explained in terms of either conditioning or innate releasing mechanisms. Such imitation implies that human neonates can equate their own unseen behaviors with gestures they see others perform.
Article
Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive routes of administration, pharmacology, and adverse effects. Copyright © 2015 Elsevier Ltd. All rights reserved.
Article
The chameleon effect refers to nonconscious mimicry of the postures, mannerisms, facial expressions, and other behaviors of one's interaction partners, such that one's behavior passively rind unintentionally changes to match that of others in one's current social environment. The authors suggest that the mechanism involved is the perception-behavior link, the recently documented finding (e.g., J. A. Bargh, M. Chen, & L. Burrows, 1996) that the mere perception of another' s behavior automatically increases the likelihood of engaging in that behavior oneself Experiment 1 showed that the motor behavior of participants unintentionally matched that of strangers with whom they worked on a task. Experiment 2 had confederates mimic the posture and movements of participants and showed that mimicry facilitates the smoothness of interactions and increases liking between interaction partners. Experiment 3 showed that dispositionally empathic individuals exhibit the chameleon effect to a greater extent than do other people.
Article
A longitudinal design was used to explore the relation between a measure of nonverbal synchrony and self-report indications of rapport in a sample of college classrooms. Results show that posture sharing and rapport are positively related and that this relation is significant across time. Application of the cross-lag panel technique revealed no significant difference, but the direction of the effect suggests the hypothesis that posture sharing may be influential in establishing rapport.
Article
The present study examined the effects of four types of intergroup orientation on interpersonal postural mirroring both within and between groups. One hundred and four female subjects were assigned to quartets, each made up of two dyads in one of four conditions: (1) Control; (2) coacting; (3) cooperating; and (4) competing. As predicted, results showed greater intergroup relative to intragroup mirroring for cooperating dyads than for competing dyads. Unexpectedly, subjects in the coacting condition showed a significantly higher level of intergroup mirroring than any other condition. Both results are interpreted as evidence that postural mirroring is an obvious yet unobtrusive indicator of openness to interpersonal involvement.
Article
Observed 3-5 yr old children's free-play activities over a 2-yr period. Boys played outdoors consistently more than did girls, and girls spent more time indoors at craft tables and in the kitchen. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Personal space may be defined as the area immediately surrounding the individual in which the majority of his interactions with others take place; it has no fixed geographic reference points, moves about with the individual, and expands and contracts under varying conditions. The 1st hypothesis was that interactions between 2 persons classified variously as friends, acquaintances, or as strangers would take place at an increasing rank order of distances. The 2nd hypothesis was that average interaction distances would increase with increased impersonality of the setting, i.e., as the transaction shifted from a living room to an office, to a street corner. It was found that perceived interaction distances in a dyad are markedly influenced by the degree of acquaintance of the 2 members, and similarly, the setting in which the meeting takes place will in turn influence the perceived interaction distance between dyad members, a conclusion substantially verified for female Os, but less so for males. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The prosodic features of maternal speech addressed to 2-month-old infants were measured quantitatively in a tonal language, Mandarin Chinese, to determine whether the features are similar to those observed in nontonal languages such as English and German. Speech samples were recorded when 8 Mandarin-speaking mothers addressed an adult and their own infants. Eight prosodic features were measured by computer: fundamental frequency (pitch), frequency range per sample, frequency range per phrase, phrase duration, pause duration, number of phrases per sample, number of syllables per phrase, and the proportion of phrase time as opposed to pause time per sample. Results showed that fundamental frequency was significantly higher and exhibited a larger range over the entire sample as well as a larger range per phrase in infant-directed as opposed to adult-directed speech. Durational analyses indicated significantly shorter utterances and longer pauses in infant-directed speech. Significantly fewer phrases per sample, fewer syllables per phrase, and less phrase-time per sample occurred in infant-directed speech. This pattern of results for Mandarin motherese is similar to that reported in other languages and suggests that motherese may exhibit universal prosodic features. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
Article
Observations were made of the personal space behaviors of same-sex pairs of children, aged 6–16. Results indicated that children used more space as they grew older and that adult proxemic behaviors were acquired by age 12. While in the younger children no sex differences were present for the proxemic behaviors of distance and body orientation, males were found by early adolescence to stand farther apart and at greater angles than females. The development of personal space and of sex differences in these behaviors is discussed in the context of social learning.
Article
M. Taine's very interesting account of the mental development of an infant, translated in the last number of MIND (p. 252), has led me to look over a diary which I kept thirty-seven years ago with respect to one of my own infants. I had excellent opportunities for close observation, and wrote down at once whatever was observed. My chief object was expression, and my notes were used in my book on this subject; but as I attended to some other points, my observations may possibly possess some little interest in comparison with those by M. Taine, and with others which hereafter no doubt will be made. I feel sure, from what I have seen with my own infants, that the period of development of the several faculties will be found to differ considerably in different infants. During the first seven days various reflex actions, namely sneezing, hickuping, yawning, stretching
Article
Infants between 12 and 21 days of age can imitate both facial and manual gestures; this behavior cannot be explained in terms of either conditioning or innate releasing mechanisms. Such imitation implies that human neonates can equate their own unseen behaviors with gestures they see others perform.
Article
This study compares the prosodic modifications in mothers' and fathers' speech to preverbal infants in French, Italian, German, Japanese, British English, and American English. At every stage of data collection and analysis, standardized procedures were used to enhance the comparability across data sets that is essential for valid cross-language comparison of the prosodic features of parental speech. In each of the six language groups, five mothers and five fathers were recorded in semi-structured home observations while speaking to their infant aged 0;10-1;2 and to an adult. Speech samples were instrumentally analysed to measure seven prosodic parameters: mean fundamental frequency (f0), f0-minimum, f0-maximum, f0-range, f0-variability, utterance duration, and pause duration. Results showed cross-language consistency in the patterns of prosodic modification used in parental speech to infants. Across languages, both mothers and fathers used higher mean-f0, f0-minimum, and f0-maximum, greater f0-variability, shorter utterances, and longer pauses in infant-directed speech than in adult-directed speech. Mothers, but not fathers, used a wider f0-range in speech to infants. American English parents showed the most extreme prosodic modifications, differing from the other language groups in the extent of intonational exaggeration in speech to infants. These results reveal common patterns in caretaker's use of intonation across languages, which may function developmentally to regulate infant arousal and attention, to communicate affect, and to facilitate speech perception and language comprehension. In addition to providing evidence for possibly universal prosodic features of speech to infants, these results suggest that language-specific variations are also important, and that the findings of the numerous studies of early language input based on American English are not necessarily generalisable to other cultures.
Article
Speech addressed to different categories of listeners was examined in a study in which undergraduate women taught a block design task to either a 6-year-old child, a retarded adult, a peer who spoke English as a second language (foreigner), or a peer who was an unimpaired native speaker of English. The speech addressed to children differed from the speech addressed to native adults along every major dimension that emerged in this study: It was clearer, simpler, and more attention maintaining, and it included longer pauses. Speech addressed to retarded adults was similar in numerous ways to the speech addressed to 6-year-olds; in some ways (e.g., repetitiveness), it was even more babyish. However, speech to the retarded adults did differ in timing from the other styles of speaking in that it included fewer and somewhat shorter pauses. Speech addressed to foreigners was more repetitive than speech addressed to native speakers, but in all other ways it was very similar. There was some evidence that speakers fine-tuned their communications to the level of cognitive and linguistic sophistication of their particular listener; for example, speakers addressing the more sophisticated foreigners (relative to those addressing the less sophisticated foreigners) used speech that included fewer devices for clarifying, simplifying, and maintaining the listeners' attention. We discuss the hypothesis that baby talk (the speech addressed to children) is a prototypical special speech register from which other special registers are derived.
Article
The purpose of the current study was to develop and assess the efficacy of a psychological intervention program to reduce the behavioral distress of pediatric cancer patients undergoing highly-painful medical procedures (bone-marrow aspirations and lumbar punctures) which are required for the diagnosis and treatment of their disease. The psychological intervention was delivered to 5 patients ages 3–7yr within the context of a staggered baseline design. Results suggested that the program was effective at reducing behavioral distress for all 5 patients during the initial intervention. However, 1 S showed some regression of intervention effects during a second treatment session. Possible alternative explanations for the results obtained were discussed and implications for future research were presented.
Article
Reviews major findings of personal-space research in clinical psychology, personality, demographic studies (including sex, age, cross-cultural studies), and studies of the effects of familiarity and affinity. The substantial lack of consistent findings in the literature is attributed to the lack of experimental controls in most of the personal-space research. It is suggested that researchers explore personal space using multivariate techniques. In addition to a brief exposition of theoretical developments, a theory is presented which suggests that personal space is a functional, mediating, cognitive construct which allows the human organism to operate at acceptable stress levels and aids in the control of intraspecies aggression. (3 p. ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
EXPLORED THE RELATIONSHIP OF POSTURE, ORIENTATION, AND DISTANCE OF A COMMUNICATOR TO AN ADDRESSEE TO ATTITUDES AND STATUS DIFFERENCES BETWEEN A COMMUNICATOR AND HIS ADDRESSEE. 2 EXPERIMENTS INVOLVED SEATING, AND 2 INVOLVED STANDING POSTURES. IN A DECODING METHOD, SS INFERRED ATTITUDES FROM PREPARED COMMUNICATIONS, WHILE IN ENCODING SS RESPONDED TO SITUATIONS WHICH INCLUDED LIKED-DISLIKED, HIGH-LOW STATUS, AND MALE-FEMALE ADDRESSEES, WHILE THEIR POSTURE, ORIENTATION, AND DISTANCE WERE RECORDED. RESULTS RELATE THE FOLLOWING SET OF VARIABLES TO ATTITUDES AND STATUS RELATIONSHIPS BETWEEN COMMUNICATORS: DISTANCE BETWEEN COMMUNICATORS, EYE CONTACT, DEGREE OF RELAXATION IN ARMS, LEGS, OR TOTAL POSTURE, DEGREE OF FORWARD VS. BACKWARD LEAN WHILE SEATED, OCCURRENCE OF ARMS-AKIMBO POSITION WHILE STANDING, ORIENTATION OF BODY TOWARD THE ADDRESSEE, ARM OPENNESS, LEG OPENNESS, AND HEAD LEVEL. (17 REF.)
Article
Investigated the functional relationships of a communicator's posture, orientation, and distance from his addressee to his attitude toward that addressee. Ss were 50 male and female undergraduates. The S played the role of a communicator to a hypothetical addressee. The independent variables were the latter's sex and the S's sex and liking for the addressee. The dependent variables were eye contact; distance; head, shoulder, and leg orientation; arm and leg openness; and measures of hand, leg, and body relaxation. The findings indicate that eye contact, distance, orientation of body, and relaxation of body (as measured by the seated communicator's reclining angle or backward lean and by his sideways lean) are significant indexes of S's liking for the addressee.
Article
On the basis of an assumed relation between psychological closeness and physical proximity, it was hypothesized that, as the distance between members of depicted dyads increases, (a) the degree of acquaintance assigned to them by children would decrease, and (b) the degree of liking assigned would decrease. 2 tasks designed to test these hypotheses were administered to sixth-grade children. The first personal space task required Ss to assign acquaintance or liking designations to printed silhouettes of peer dyads. Data indicated strong inverse relations between interfigure distances and both degree of acquaintance and degree of liking. It was concluded that sixth graders assume a correlation between physical proximity and psychological closeness. The second personal space task required Ss to place distances between a self-referent figure and printed peer figures variously described. Data again showed the inverse relations. The sex differences also found were explained in terms of sex-appropriate behavior.
Article
The purpose of the current study was to develop an initial assessment of the efficacy of astress-management program designed to reduce the behavioral distress of children undergoing highlypainful medical treatments for their burn injuries. The stress-management program was delivered to 4 male patients, ages 5–12 yr and its effects assessed in a combined multiple-baseline and reversal design. Results indicated that the program was moderately effective at reducing behavioral distress during the burntreatment procedures for 3 of the 4 patients and less effective with the fourth. However, the design also revealed that the presence of a therapist to coach the patient in the use of these techniques was essential and that distress levels rose substantially on days when there was no therapist present. Finally, speculations concerning the factors responsible for the effectiveness of the stress-management program as well as its reduced efficacy with 1 S were discussed.
Article
Previous research has demonstrated that different patterns of facial muscle activity are correlated with different emotional states. In the present study subjects were exposed to pictures of happy and angry facial expressions, in response to which their facial electromyographic (EMG) activities, heart rate (HR), and palmar skin conductance responses (SCRs) were recorded. It was found that happy and angry faces evoked different facial EMG response patterns, with increased zygomatic region activity to happy stimuli and increased corrugator region activity to angry stimuli. Furthermore, both happy and angry faced evoked HR decelerations and similar SCR magnitudes. The results are interpreted as suggesting that facial EMG recordings provide a method for distinguishing between response patterns to 'positive' and 'negative' emotional visual stimuli.
Article
Reviews literature on the influence of speaker's expressive behaviors on another's behavioral response in adult–adult and infant–adult dyads. Expressive behaviors include noncontent speech variables; indicators of affiliation such as gaze, distance, orientation, and question intimacy; verbal disclosure; body movements; and general indices of involvement. Interspeaker influence includes both interspeaker matching and compensation in overt behavior. Matching predominates in noncontent speech, verbal disclosure, and gaze. Compensatory responses are prompted by question intimacy and proximity. Both reciprocal and compensatory responses show limits, and are attenuated and even reversed by moderator variables associated with person differences and social-normative expectations. Continuities between adult–adult and infant–adult dyads are found for vocalization and gaze. Explanations of expressive social interaction must be flexible enough to account for both compensation and matching as well as the limits to and moderators of these responses. (5½ p ref)
Article
The effect of tactile stimulation on heart rate (HR) in humans was investigated under three conditions: 1) Experimenter outside of room in which subject is sitting; 2) experimenter in the room with the subject; 3) experimenter in the room while touching the subject's right wrist. Nonsignificant increases in HR were observed when the experimenter entered the room (X = 0.64 beats per minute (bpm)). Conversely, large decreases occurred when the experimenter placed his hand on the subject's wrist (X = 9.16 bpm, p is less than 0.05). To determine if tactile stimulation alone accounts for these differences three comparisons were made in a second experiment: 1) Experimenter out of test room, subject touches own wrist; 2) experimenter in room standing near subject; 3) experimenter touching subject's wrist. Subjects showed slightly elevated HR during the self-touch condition (X = 1.26 bpm, not significant). Although no change was noted with the experimenter standing beside the subject, there were decreases, as in Experiment I, when the experimenter touched the subject's wrist (X = 1.75 bpm, p is less than 0.05). These results suggest that the observed decreases in HR were contingent upon another person's touch. While self-tactile stimulation produced a slight increase in HR, tactile stimulation by another caused bradycardia.
Article
The chameleon effect refers to nonconscious mimicry of the postures, mannerisms, facial expressions, and other behaviors of one's interaction partners, such that one's behavior passively and unintentionally changes to match that of others in one's current social environment. The authors suggest that the mechanism involved is the perception-behavior link, the recently documented finding (e.g., J. A. Bargh, M. Chen, & L. Burrows, 1996) that the mere perception of another's behavior automatically increases the likelihood of engaging in that behavior oneself. Experiment 1 showed that the motor behavior of participants unintentionally matched that of strangers with whom they worked on a task. Experiment 2 had confederates mimic the posture and movements of participants and showed that mimicry facilitates the smoothness of interactions and increases liking between interaction partners. Experiment 3 showed that dispositionally empathic individuals exhibit the chameleon effect to a greater extent than do other people.
Article
Studies reveal that when people are exposed to emotional facial expressions, they spontaneously react with distinct facial electromyographic (EMG) reactions in emotion-relevant facial muscles. These reactions reflect, in part, a tendency to mimic the facial stimuli. We investigated whether corresponding facial reactions can be elicited when people are unconsciously exposed to happy and angry facial expressions. Through use of the backward-masking technique, the subjects were prevented from consciously perceiving 30-ms exposures of happy, neutral, and angry target faces, which immediately were followed and masked by neutral faces. Despite the fact that exposure to happy and angry faces was unconscious, the subjects reacted with distinct facial muscle reactions that corresponded to the happy and angry stimulus faces. Our results show that both positive and negative emotional reactions can be unconsciously evoked, and particularly that important aspects of emotional face-to-face communication can occur on an unconscious level.
Article
Nonconscious behavioral mimicry occurs when a person unwittingly imitates the behaviors of another person. This mimicry has been attributed to a direct link between perceiving a behavior and performing that same behavior. The current experiments explored whether having a goal to affiliate augments the tendency to mimic the behaviors of interaction partners. Experiment 1 demonstrated that having an affiliation goal increases nonconscious mimicry, and Experiment 2 further supported this proposition by demonstrating that people who have unsuccessfully attempted to affiliate in an interaction subsequently exhibit more mimicry than those who have not experienced such a failure. Results suggest that behavioral mimicry may be part of a person's repertoire of behaviors, used nonconsciously, when there is a desire to create rapport.
Article
Studies of paediatric procedural distress have flourished over the past two decades, with psychological intervention strategies showing consistently high efficacy in reducing pain and fear. This review concentrates briefly on the acquisition and treatment of fear, arguing that what is witnessed clinically is not needle fear or phobia, but anticipatory or procedural distress. The main focus is on how such procedures could be amended to incorporate psychological techniques routinely, outlining specific guidelines for clinical practice.
Current concepts in the management of pain in children in the emergency department.
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Krauss BS, Callgaris S, Green SM, et al. Current concepts in the management of pain in children in the emergency department. Lancet. 2016;387:83-92.
Beyond the drugs: nonpharmacologic strategies to optimize procedural care in children.
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Leroy PL, Costa LR, Emmanouil D, et al. Beyond the drugs: nonpharmacologic strategies to optimize procedural care in children. Curr Opin Anaesthesiol. 2016;29(suppl 1):S1-S13.
Nonverbal Communication in Human Interaction.
  • Knapp M.L.
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Knapp ML, Hall JA. Nonverbal Communication in Human Interaction. 7th ed. Boston, MA: Cengage; 2010.
Exclusion and nonconscious behavioral mimicry.
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