The effect of social modeling on illness behaviour of children of chronic headache sufferers and children of illness free parents
Mikail, Samuel Fouad
Recent epidemiological studies have revealed that as many as 78% of chronic pain sufferers come from families in which at least one other family member has suffered from chronic pain. This finding, along with results of a number of analogue studies, suggests that social modeling processes may be potent operative factors in the development of people's perceptions and responses to pain. The present study investigated the effects of social modeling on children's pain behaviours. These effects were related to parental health status. Parent groups included chronic headache patients and individuals having no physical or psychiatric illness. Children were exposed to an auditory stimulus task in which a tone was presented at increasing intensity levels. This was preceded by exposure to either a tolerant or an intolerant model undergoing the same procedure. It was predicted that children's responses to the stimulus would be influenced by the modeling condition to which they were exposed. It was further predicted that this effect would be mediated by the child's nonverbal receiving ability and the parent's level of pain expressiveness. The study also compared parent ratings of general family functioning across the two groups, as well as the incidence of pain related illness among their offspring. Analyses revealed no main effect for modeling or group membership. Predicted interactions between modeling condition and children's nonverbal receiving ability, and modeling condition and parental expressiveness were also statistically non-significant. However, a significant interaction between modeling and group assignment was observed when using children's degree of nonverbal expressiveness as a dependent measure. This result is discussed in terms of children's responses to stress and pain expressions of others. When comparing children of headache sufferers to children of illness free parents it was evident that (1) children of headache sufferers were more somatically focused than their control counterparts, (2) this heightened concern with their health status may be either a reaction to, or a means of coping with ongoing stress, and (3) this way of coping tends to be predictive of the higher frequency of headaches reported by these children. A number of strong correlations between parents' and their children's level of emotional adjustment are reported. The implications of these findings for general family health status, and characteristic coping styles are discussed. Finally, ratings of family environment were compared across groups. No significant differences were found. However, in the chronic headache group a number of dimensions of family environment were found to be related to ratings of pain severity. This result is discussed in relation to previous discussions of family dynamics and the psychosomatic family.