Autism & Pain

Post Reply New Topic

[url=http://web.ebscohost.com/ehost/detail?sid=a558b818-5337-4684-a0ef-d9b318e0d405@sessionmgr10&vid=1&hid=8&#db=mnh&AN=19707566#db=mnh&AN=19707566]Pain reactivity and plasma beta-endorphin in children and adolescents with autistic disorder.[/url]

Somebody who does not have MEDLINE access: Tell me if you can get to the full text of this? Thanks.

(If you are wondering, the painful stimulus they used was drawing blood from autistic and control children.)

So what do you think? Increased sensitivity, coupled with decreased social expression of pain, might lead to some interesting effects... consider especially the effect of sensory stimuli, which can be painful to many of us. I wonder if it is actually possible for a person to be in pain and not realize it? I would wager that for autistic people, this is very possible, especially if one is taught to judge "pain" by how much one expresses the outward signs of it...

Of course, the behavioral analysis does hinge on whether or not it was obvious to observers that the children were autistic. It's kind of hard to blind your researchers when the subject is particularly stereotypical. Whether that could actually account for such a huge effect, though... Hmm. And it shouldn't do much for the biological stuff like heart rate and endorphin measurements; those depend a lot less on subjective interpretation. It did annoy me that they didn't survey the parents to try to figure out how often the kids in both groups had had blood drawn before. Being used to it can lead to different behavior.

Should note that these were very autistic kids; not borderline cases. They like to look at the very autistic kids so they will get a stronger effect, I suppose. Another interesting thing: A significant number of kids were hyper-reactive; they reacted to getting their blood drawn to a more intense degree than the controls.

Thoughts?

This doesn't surprise me at all.. it seems to be a common theme in autism that reactions don't match actual experience. It's a large part of the never-being-believed issue. I say something, but my expressions don't match what someone would expect my expressions to be, so they figure I'm lying. Then I end up wondering if I should attempt to "fake" reactions that actually match how I actually feel. It seems to me like if I did that, then I actually would be lying.. But of course, I guess there's more actual deception going on when I don't seem to feel how I actually feel than there would be if I was faking the "correct" reactions to my actual feelings. Wow.. that just tied my brain in knots. I'm not exactly sure how to say it in a less tangled way, though. Can one of the wonderful rephrasers around here come along and translate what I just said into something that actually makes sense?

Tell me if this metaphor helps you: Say someone's first language is Chinese. Even though speaking English isn't natural for them, they have to in order to be understood. Instead of thinking of your reactions as "faking", think of it as translating.

It could just be pointing out that the children with AD were stressed about the environment and the strange nurse (all of that white lighting and paint; noise, going out, and blah), rather than a psychological response to the punctured vain. Or, displaying pain differently; it's possible to feel immense pain but lack the ability to show it verbally and nonverbally (if you can't show anger nonverbally, why do they assume you can display pain?).

In my case, as a child, I wouldn't let nurses give me needles (as per my mother); I'd Hulk Smash out until they attempted to and failed at sedating me.

I don't know if that works or not.. because it's more than that. They're expressions that are supposed to be automatic.. so wouldn't faking those expressions make it so I'd be not only in-congruent with my feelings, but also obviously faking expressions? Or would it just not matter because they were already figuring that I was being dishonest anyway? It seems weird to me to think that the way to deal with someone thinking something was fake would be to actually be fake. If not faking anything, it seems like at least then I have truth on my side. But then if I go trying to fake feeling the way I actually genuinely feel anyways, then that brings untruth into the equation that just makes it more complicated.

If you read the study design, they did try to make the environment as comfortable as possible for the autie kids--no white coats, a playroom to relax in beforehand, parents present, and a nurse who had experience with special needs kids--but I definitely agree that this could have been part of it. The element I thought of most, rather than the strangeness of the experience, was the fact that you have to have people hold your arm still to get blood out of it, and that can be extremely frightening especially to kids who are touch sensitive or have bad experiences with being restrained. (Or both. Otherwise known as "autistic hell on earth".)

I can really relate to this.

I was supposed to have a blood test about a week ago and didn't go through with it because my nervous system went into overdrive the minute they put that thing around my arm.

The sensation lingered and my arms and hands were numb for two hours afterwards.

Also my AS dad is super-squeamish about all this kinda stuff and my Mum didn't have half the tests she was meant to during pregnancy because of this problem.