Children's Attitudes to Pain

Reviewed by: Dr Tony Ganado, FRCA, Consultant Anaesthetist.

There are many different influences on how children perceive pain. These are:

Previous experiences of pain

A child’s previous experience of pain may alter his or her perception of pain, for example, infants may cry in anticipation during subsequent visits to immunisation clinics.

Religion

Somewhat surprisingly, it has been documented that a child’s religious environment may influence their perception of pain. For example: Jewish people seek help, sympathy and second opinions, Hindus associate pain with karma, and some Christians believe that pain is a punishment for sin whilst others believe that God allows pain but enables them to suffer it.

Culture

Culture has also been shown to affect a child’s response and reaction to pain:

• British children tend to be stoical, but prefer to have company when they are in pain.
• Australian children prefer to be alone.
• Italian children tend to be more depressed and honest about their pain and concerned that they should be given immediate pain relief.
• Kikuyu and Masai men are expected to be quiet and dignified about their pain, but women are not.

Gender and personality

It has been suggested that boys tolerate pain better than girls. However, in experience, there is very little difference. There may be a difference in the expression of pain, with girls being more vocal and boys less (with the expectation that ‘big boys don’t cry’.)

Personality tests have revealed that extroversion has been associated with a higher tolerance to pain and introversion to a greater sensitivity to pain. Introverts, however, may complain less.

The influence of society and family

As children we developed and learned how to interact socially by mimicking the behaviour of our parents and other adults. Therefore, it follows that a child in a particular family will be influenced by how other family members cope with pain and their reaction to it. We have all seen that when children trip or fall, they tend to look immediately to their parent for reassurance - and also for their reaction. If the parent reacts with a smile and makes light of the incident, then the child usually does the same, while if the parent reacts in an anxious manner, the child may often cry and make a fuss.