Sensitivity to pain in autistic spectrum disorders: Its links with self-gressivity
Keywords:
autism, self-injurious behavior, pain sensitivity, risk factorsAbstract
Objectives: To investigate the link between pain sensitivity in autism spectrum disorders (ASD) and self-aggressive behavior.
Methods: we performed a cross-sectional study which involved 50 children fulfilling DSM-V criteria for ASD; confirmed by the Autism Diagnostic Interview Revised. The severity of autism was determined using the Childhood Autism Rating Scale (CARS).The psycho-educational profile (PEP-R) was used to assess the age of development and perception. Sensitivity to pain was assessed with item IX of the CARS. Self-aggressive behavior was assessed by the Behavior Problems Inventory.
Results: Pain sensitivity was lowered in 40% and elevated in 4% of children. In the univariate analysis, no statistically significant association was found between normal sensitivity or hyper sensitivity to pain and the presence of auto-aggressiveness. A significant association was found between the presence of hypo-sensitivity to pain and the following variables: auto-aggression (p = 0.007, OR = 5.8, 95% CI = 1.5-21) , frequency of self-aggression (p = 0.001), intensity of self-aggression (p = 0.05), location of auto-aggressiveness at head and (P = 0.007, OR = 7.6, 95% CI = 1.8-14), higher score at CARS, and lower perception score at PEP-R (p = 0.012). Multiple-varied analysis identified risk factors for hypo-sensitivity to pain: lower perceptual score (p = 0.003, adjusted OR = 4.3, 95% CI = 1.9-54) and location of self-aggression at head and hands (p = 0.001, adjusted OR = 1.09, 95% CI = 1.02-1.09).
Conclusion: It would be interesting to develop tools allowing a fine and precise evaluation of the painful sensation.
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References
Allely CS. Pain sensitivity and observer perception of pain in individuals with autistic spectrum disorder. ScientificWorldJournal. 2013;9:161-78.
Dubois A, Rattaz C, Pry R, Baghdadli A. Autism and pain a literature review. Pain Res Manag. 2010;15(4):245-53.
Moore DJ. Acute pain experience in individuals with autism spectrum disorders: a review. Autism 2015;19(4):387-99.
Panksepp J. A neurochemical theory of autism. Trends Neurosci. 1979;2:174-7.
Pernon E, Rattaz C. Les modes d'expression de la douleur chez l'enfant autiste : étude comparée. Devenir. 2003;15:263-77.
Rogers SJ, Ozonoff S. Annotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidence. J Child Psychol Psychiatry. 2005;46:1255-68.
Rojahn J, Matson JL, Lott D, Esbensen AJ, Smalls Y. The Behavior Problems Inventory: an instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. J Autism Dev Disord. 2001;31(6):577-88.
Sahnouna L, Saravane D. Autisme et douleur : état des connaissances et conséquence pratique. Douleurs: Évaluation - Diagnostic -Traitement.2015;16: 21-5.
Symons FJ, Thompson T. Self-injurious behaviour and body site preference. J Intellect Disabil Res. 1997;41(6):456-68.
Tordjman S, Antoine C, Cohen DJ, Gauvain-Piquard A, Carlier M, Rouber-Toux P, et al. Study of the relationships between self-injurious behavior and pain reactivity in infantile autism. Encephale 1999;25:122-34.
Tomchek SD, Dunn W. Sensory processing in children with and without autism: A comparative study using the short sensory profile. Am J OccupTher 2007;61:190-200.
