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Contemporary Use of the Cold Pressor Task in Pediatric Pain Research: A Systematic Review of Methods

  • Kathryn A. Birnie
    Correspondence
    Address reprint requests to Kathryn A. Birnie, Centre for Pediatric Pain Research, K8536 (8th floor, Children’s site), IWK Health Centre, 5850/5980 University Ave, Halifax, Nova Scotia, Canada B3K 6R8.
    Affiliations
    Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada

    Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
    Search for articles by this author
  • Mark Petter
    Affiliations
    Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada

    Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
    Search for articles by this author
  • Katelynn E. Boerner
    Affiliations
    Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada

    Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
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  • Melanie Noel
    Affiliations
    Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada

    Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
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  • Christine T. Chambers
    Affiliations
    Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada

    Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada

    Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
    Search for articles by this author

      Abstract

      The cold pressor task (CPT) is an ethical experimental pain task widely used by pediatric pain researchers to examine a variety of important theoretical and clinical questions. The purpose of this systematic review was to describe contemporary use of the CPT in pediatric pain research to identify possible methodological and procedural inconsistencies and inform future research. All papers using the CPT to examine pain-related outcomes in children ≤18 years old published after 2005 were identified, 2005 being when published pediatric CPT studies were last reviewed and guidelines for pediatric use of the CPT were published. Information related to samples, CPT methodology, and pain outcomes was recorded. Thirty-six published papers, involving 2,242 children (aged 3–18 years) from both healthy and clinical samples, met review inclusion criteria. Several aspects of CPT methodology with significant potential to impact pain outcomes were found to be inconsistently implemented and reported, including water temperature, use of informed versus uninformed ceilings, and the presence of observers during the CPT. Self-report child pain intensity and pain tolerance were common outcomes. A number of refinements for use of the CPT in pediatric pain research are suggested.

      Perspective

      The cold pressor task is a commonly used experimental method in pediatric pain research. This systematic review reveals important methodological inconsistencies in its use and suggestions for improvements to previously published guidelines.

      Key words

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