Sensitivity to Pain in Children With Acute Lymphoblastic Leukemia (ALL)

Background: There are many physiological and psychological factors, which affect sensitivity to pain in children afflicted with ALL. The main purpose of this study was to evaluate the relation between salivary cortisol and sensitivity to pain, and also study the role of age and gender. Methods: Seventy eight children (33 girls and 45 boys, aged 3 to 12 years) with ALL participated in this study. Morning salivary cortisol was measured and Behavior Scales of Sensitivity to Pain for Children (BSSPC) and Pre-Linguistic Behavioral Pain Reactivity Scale (PL-BPRS) were applied. Results: The results showed a high significant correlation between cortisol levels and pain sensitivity. Cortisol suppression was observed in some participants. The roles of gender and age in relation between cortisol levels and sensitivity to pain were assessed by using moderated regression. Gender and age moderated the relation between sensitivity to pain and cortisol level. Conclusion: Conditional fear can explain for high sensitivity to pain amongst the participants; chemotherapy drugs might play a role in cortisol suppression and parenthood style perhaps determines sex difference in reaction to pain.