Attributions and coping in children's pain experiences.

OBJECTIVE To examine how children's injury attributions and coping strategies relate to procedure-related distress during unplanned medical procedures (laceration repair). METHODS Children (N = 50) with minor lacerations were assessed from emergency department admittance until discharge. Children's attributions of causes regarding their injury were assessed, and the Procedural Behavior Checklist was administered to each child (to assess coping strategies and procedure-related distress). RESULTS Internally focused attributions of blame correlated with higher distress. Overall, children who reported primary-control coping, as opposed to secondary-control coping and relinquished-control coping, exhibited more pain during the procedure. Children who reported secondary-control coping, as opposed to relinquished-control coping, reported less pain after the procedure. CONCLUSIONS Injury attributions and coping style are significant factors in children's pain experiences. These results suggest that self-blame may heighten subsequent pain experiences. In addition, similar coping strategies appear to be adaptive for unplanned medical procedures as have been found for planned medical procedures.