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Journal of Pediatric Psychology 14(3) pp. 421-432, 1989
© 1989 Society of Pediatric Psychology

research-article

Development of Behavioral Distress in Reaction to Acute Pain in Two Cultures1

Marcel A. G. van Aken2, Cornelis F. M. van Lieshout, Ernest R. Katz and Theo J. M. Heezen

Department of Developmental Psychology, University of Nijmegen The Netherlands, Memorial Medical Center of Long Beach and the University of California, Los Angeles School of Medicine, Department of Medical Psychology, University of Nijmegen The Netherlands

2All correspondence should be sent to Marcel van Aken, Department of Development Psychology, Postbox 9104, 6500 HE Nijmegen, The Netherlands

Studied developmental and gender differences in distress behavior during separate phases of a medical treatment in 2 cultures. Distress reactions of 175 children with cancer (age 8 months-18 years 7 months) were observed during bone marrow aspirations (BMA) in 2 different treatment centers (one in the United States, one in The Netherlands) using a behavioral checklist (Procedure Behavioral Rating Scale). The BMAs contained a preparatory phase, the actual needle introduction, and a recovery period. In both cultures almost all separate distress behaviors occurred less in older children, except for increasing muscle tension during the actual puncture. Distress was highest during the needle introduction and significantly lower during the preparatory and recovery phases; in addition, somewhat different patterns of distress behavior were found in separate phases. Culture and sex differences were found. The latter were less robust than developmental and phase differences.

Key words: children; distress; cancer; pain; cultural differences.


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