4.6 Article

Longitudinal and concurrent relationships between caregiver-child behaviours in the vaccination context and preschool attachment

Journal

PAIN
Volume 162, Issue 3, Pages 823-834

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002091

Keywords

Infant pain; Child pain; Caregiver sensitivity; Preschool attachment

Funding

  1. Canadian Institutes of Health Research (CIHR) [MOP-111140, MOP-84511]
  2. Ontario Ministry of Research and Innovation (OMRI) [532653]
  3. Canada Foundation for Innovation (CFI) [29908]
  4. Social Sciences and Humanities Research Council (SSHRC) [P2016-1674]
  5. Natural Sciences and Engineering Research Council (NSERC) [RGPIN-2015-06813]
  6. SSHRC [410-2009-0724, 435-2013-0230]
  7. SSHRC through a Joseph-Armand Bombardier Canada Graduate Scholarship [752-2017-1866]
  8. CIHR [GSD-134896]
  9. Pain in Child Health Strategic Training Program
  10. Lillian Meighen Wright Maternal-Child Health Graduate Scholarship
  11. LaMarsh Centre for Child and Youth Research

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This study consists of two independent researches that investigate the relationships between caregiver-child behaviors in the vaccination context and preschool attachment outcomes. The results suggest that caregiver sensitivity and soothing behaviors towards infant pain are related to preschool attachment outcomes.
This article consists of 2 separate studies in which the overarching aim was to examine the relationships between caregiver-child behaviours in the vaccination context (infant and preschool) and preschool attachment outcomes. It provides for the first time an examination of acute pain behaviours during early childhood and how it relates to a critical aspect of child development (ie, attachment status) at the end of early childhood. Study 1 examined the longitudinal relationships between caregiver-infant behaviours during infants' first routine vaccination (2 months) and preschool attachment (n = 84). Study 2 examined the concurrent relationships between caregiver-preschooler behaviours during the last routine vaccination of preschool (4-5 years) and preschool attachment (n = 117). Hierarchical multiple regression analyses were used. Although there were several nonsignificant findings, the results revealed that higher caregiver sensitivity and higher proximal soothing 1 minute before the needle during infants' 2-month vaccinations predicted higher levels of preschooler avoidance and lower levels of preschooler ambivalence, respectively. In addition, higher infant pain-related distress at 2 minutes after the needle was related to higher preschooler security and lower preschooler disorganization and controlling-punitive attachments. In terms of concurrent relationships, only caregiver sensitivity was significantly related to preschool attachment outcomes. Specifically, higher caregiver sensitivity at preschoolers' 4- to 5-year vaccinations was related to higher preschooler attachment security. The study findings provide evidence that child-caregiver behavioural patterns during the infant and preschool routine vaccination relate to preschoolers' patterns of attachment. Moreover, it underscores the potential importance of health professionals teaching and supporting attuned caregiving to the child in pain.

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