http://repub.eur.nl/res/aut/27950/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/23427/ 2011-05-25T00:00:00Z Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (IAS P, 1979). Chronic pain of at least 3 months duration is quite common in children and even in toddlers. Levels and duration of acute pain and distress during medical procedures are high as well. Furthermore, there are significant consequences of both acute and chronic pain, such as an altered pain perception after high acute pain that increases fear and pain in future procedures, and impaired daily functioning and quality of life in children with chronic pain. Thus, it is important to gain understanding of what determinants might affect differences in children’s procedural distress and chronic pain. Theoretical models and previous evidence show various parent factors, such as anxiety, depression, and chronic pain, and child factors, such as temperament, as determinants of pediatric acute and chronic pain. Most studies so far have investigated children aged 3 or older and many have used clinical samples and/or cross-sectional designs. As a consequence, it is not clear what the early longitudinal risk factors are for toddlers’ pain. The aim of this thesis was to extend existing knowledge on prenatal and early postnatal determinants of young children’s acute pain and chronic pain. The studies presented in this dissertation were carried out within the Generation R Study, a prospective multi-ethnic population-based study investigating growth, development and health from fetal life onwards in Rotterdam, the Netherlands. http://repub.eur.nl/res/pub/22829/ 2011-04-01T00:00:00Z Objective: This study examined the effects of attachment and temperament on infant distress during venipuncture. Method: The study was embedded in the Generation R Study, a prospective population-based study. Two different research procedures (i.e., blood sampling and the Ainsworth Strange Situation Procedure) yielded measures of venipuncture distress and attachment security and disorganization in 246 infants aged 14 months. Four temperament traits (distress to limitations, fear, recovery from distress, and sadness) were assessed using the maternally reported Infant Behavior Questionnaire - Revised, at the age of 6 months. Results: There were no differences between mean levels of distress during venipuncture in infants classified as having insecure attachment, but there was a trend for disorganized attachment. The temperament traits were not related to distress. However, children with a disorganized attachment and higher temperamental fear had more venipuncture distress. Conclusion: When different risk factors are present simultaneously, infant distress is heightened. http://repub.eur.nl/res/pub/27777/ 2010-04-01T00:00:00Z ObjectiveTo investigate the effect of child temperament, maternal psychologic symptoms, maternal chronic pain, and parenting stress on children's somatic complaints.MethodsThe study was embedded in the Generation R Study, a population-based cohort study. Child somatic complaints were assessed via mother-report in 5,171 children of 18 months of age. Questionnaires assessed maternal somatic symptoms, symptoms of depression, anxiety during pregnancy and 2 months after delivery, maternal chronic pain during pregnancy, parenting stress 18 months after birth, and mother-reported child temperament 6 months after birth, as the determinants.ResultsFearful temperament, temperamental falling reactivity, maternal somatic symptoms, anxiety symptoms, and parenting stress each independently and prospectively increased the likelihood of children's somatic complaints at 18 months of age.ConclusionsIn toddlers, temperament, maternal stress, and maternal somatic symptoms seem particularly important for the development of somatic complaints, but long-term research is needed to establish causality and predictive value of these factors.