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Biomedical subjects

K D Craig

Publications and source records attributed to K D Craig.

At least 37 records · Page 2Linked to original sources
PubMed1994

Judging pain in newborns: facial and cry determinants.

Explored the facial and cry characteristics that adults use when judging an infant's pain. Sixteen women viewed videotaped reactions of 36 newborns subjected to noninvasive thigh rubs and vitamin K injections in the course of routine care and rated discomfort. The group mean interrater reliability was high. Detailed descriptions of the infants' facial reactions and cry sounds permitted specification of the determinants of distress judgments. Several facial variables (a brow bulge, eyes squeezed shut, and deepened nasolabial fold constellation, and taut tongue) accounted for 49% of the variance in ratings of affective discomfort after controlling for ratings of discomfort during a noninvasive event. In a separate analysis not including facial activity, several cry variables (formant frequency, latency to cry) also accounted for variance (38%) in ratings. When the facial and cry variables were considered together, cry variables added little to the prediction of ratings in comparison to facial variables. Cry would seem to command attention, but facial activity, rather than cry, can account for the major variations in adults' judgments of neonatal pain.

Adolescent↗
PubMed1992

Judgments of genuine, suppressed, and faked facial expressions of pain.

The process of discriminating among genuine, suppressed, and faked expressions of pain was examined. Untrained judges estimated the severity of pain being experienced when viewing videotaped facial expressions of chronic pain patients undergoing a painful diagnostic test or dissimulating reactions. Verbal feedback as to whether pain was experienced also was provided, so as to be either consistent or inconsistent with the facial expression. Judges were able to distinguish genuine pain faces from baseline expressions but, relative to genuine pain faces, attributed more pain to faked faces and less pain to suppressed ones. Advance warning of deception did not improve discrimination but led to a more conservative or nonempathic judging style. Verbal feedback increased or decreased judgments, as appropriate, but facial information consistently was assigned greater weight. An augmenting model of the judgment process that attaches considerable importance to the context in which information is provided was supported.

Adult↗
PubMed1989

Developmental and psychological factors in children's pain.

It is clear that previously we were ill-informed and misinformed about children's pain. Recent investigations have led not only to a burgeoning of understanding of pediatric pain, but also an increase in our ability to appropriately measure and treat children's pain. Both pharmaceutical and nonpharmaceutical treatments have made major strides in the past few years. Even more crucial is the change that has happened in the willingness of health professionals to recognize that children do suffer pain and that aggressive treatment is often indicated. However, careful consideration must be given to physiologic, cognitive, affective, and psychosocial development, both in order to maximize the effectiveness of interventions and to recognize the limits that development may place on any specific approach.

Adolescent↗
PubMed1986

Social influences on factored dimensions of the McGill Pain Questionnaire.

The McGill Pain Questionnaire (MPQ) was administered to 268 subjects following electrical stimulation to pain-tolerance limits. Subjects received stimulation under four social modeling conditions: tolerant, intolerant, control, and no model. The number of factors and degree of obliqueness most appropriate for the MPQ scores were determined using multiple criteria. Five factors, reflecting 46.6% of the total variance, were derived and labelled as follows: affective-arousal, sensory-pressure, perception of harm, somesthetic pressure, and cutaneous sensitivity. The various modeling conditions did not produce any significant between-group differences on the factors. The repeated demonstration that the MPQ assesses substantially more than the three components originally proposed suggests that considerable caution is warranted with respect to using the 'sensory-evaluative-affective' method of scoring this test. Considered in relation to previous research, the present findings are consistent with the conclusion that social influences affect fundamental components of subjective reactions to pain.

Electroshock↗
PubMed1986

Observer judgments of acute pain: facial action determinants.

We provided a microanalytic description of facial reactions to a series of painful and nonpainful electric shocks and examined the impact of these as discrete facial cues for observer judgments of acute pain. Thirty female volunteers were videotaped and reported their discomfort in response to electric shocks after earlier exposure to one of three social influence conditions: a tolerant model, an intolerant model, or neutral peer presence. We coded the videotapes for facial activity using the Facial Action Coding System (Ekman & Friesen, 1978b), and peer judges rated them for painful discomfort. Subjects exposed to a tolerant model reported no more discomfort than did subjects exposed to an intolerant model, despite receiving more intense levels of shock, but were judged by observers to be in more pain. Analyses of facial activity yielded consistent findings: Tolerant-model subjects, though reporting discomfort equivalent to that reported in other groups, displayed more pain-related facial activity (brow lowering, narrowing of the eye aperture from below, raising the upper lip, and blinking). There was a substantial direct relation between observer judgments of distress and discrete, pain-related facial actions (mean multiple R = .74 for the various shock levels rated). These data indicate that nonverbal expression yields information about the response to noxious stimulation that is non-redundant with self-report.

Acute Disease↗
PubMed1985

Facial expression during induced pain.

Facial expressions contribute substantially to judgments of sufferer's pain but have not been rigorously described. We obtained a detailed description of 72 female volunteers' facial reactions to the cold pressor experience, using Ekman and Friesen's (1978a) objective, anatomically based Facial Action Coding System. In addition, we examined the impact of exposure to social models tolerant or intolerant to pain. The facial actions systematically provoked by cold pressor exposure comprised a narrowing of the eye aperture from below, raising the upper lip, pulling the lip corners, parting of the lips, or dropping the jaw, and eyes closing or frequently blinking; however, there was rich individual variation in the facial displays. The reactions were most salient at onset, indicating blends of startle, adaptive reaction, emotional expression, and pain, but they declined in vigor over time, although self-report of pain continued to mount. The relation between subjective distress and facial expression was greatest at the beginning of noxious stimulation. The social models had a potent impact on verbal report and pain tolerance but not on facial expression, indicating relative independence of components within the rich range of expressive reactions of painful experience.

Adolescent↗
PubMed1984

Developmental changes in infant pain expression during immunization injections.

Developmental changes in pain expression provoked by routine immunization injections during the first 2 years of life were examined. An interval-sampling, behavioral observation system was developed to code categories of expressive behavior in infants, their mothers and the nurse responsible for the injection. Qualitative changes were observed in the infants' behavior, with those less than 12 months of age responding in a more spontaneous, diffuse manner, whereas the older infants displayed more anticipatory distress, descriptive language and goal-directed movement. Mothers and the nurse actively interacted with each other and the infant with a range of vocal and nonvocal actions. The findings justified the use of unobtrusive, naturalistic observation as a means of assisting practitioners who suffer from an inadequate knowledge-base on pain in children.

Age Factors↗
PubMed1978

Social modeling influences on sensory decision theory and psychophysiological indexes of pain.

Subjects exposed to social models dissimulating tolerance or intolerance generally exhibit matching behavior in their verbal ratings of painful stimulation. It has been unclear, however, whether these changes reflect voluntary alteration of evidence or genuine changes in distress. This study used alternative measures and controlled for methodological limitations of earlier studies by examining nonpalmar skin potential in addition to palmar skin conductance and heart rate indexes of psychophysiological response to electric shock, and by evaluating verbal expressions of pain with sensory decision theory methodology. Of 20 female volunteer subjects, half served as controls, and half were exposed to a tolerant female model. Both the subject and the model verbalized ratings of discomfort provoked by a series of electric shocks of increasing intensity. Subjects then underwent a series of preselected random shocks. Sensory decision theory analyses revealed lower discriminability of the shocks among subjects exposed to a tolerant model. Several indexes of nonpalmar skin potential and heart rate reactivity exhibited lower reactivity in the tolerant group. Tolerant modeling was also associated with decreases in subjective stress. The results were consistent with the position that changes in pain indexes associated with exposure to a tolerant model represented variations in fundamental characteristics of painful experiences as opposed to suppression of information.

Decision Making↗