Biopsychosocial Correlates of Headache: What Predicts Pediatric Headache Occurrence?

Authors

  • Birgit Kröner-Herwig PhD,

    1. From the Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Göttingen, Göttingen, Germany.
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  • Lisette Morris PhD,

    1. From the Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Göttingen, Göttingen, Germany.
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  • Marion Heinrich PhD

    1. From the Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Göttingen, Göttingen, Germany.
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  • Conflict of Interest: None

Dr. Birgit Kröner-Herwig, Georg-August-University Göttingen, Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Gosslerstr. 14. 37073 Göttingen, Germany.

Abstract

Objective.— The study aims at identifying biopsychosocial risk factors for headache in children and adolescents aged 9 to 14.

Methods.— An epidemiological survey was conducted in a randomly drawn population sample of families with children in the above age group. Questionnaires were mailed to parents and children (n = 6400), on whose data this report is based. The objective of the study was to establish a profile of risk factors regarding the occurrence of headache. Headache, as the criterion variable, was ranked according to its frequency in the last 6 months (no, rare, monthly, weekly). Independent variables came from 6 domains: health, socioeconomic, family, school, leisure/peers, and psychological factors. Data analysis was conducted via multinomial regression analyses in a 4-step strategy: (1) analysis of age and sex as control variables; (2) analysis of single variables from each of the 6 domains (controlled for age and sex); (3) domain analyses; and (4) comprehensive analysis including all significant variables from the domain analyses.

Results.— Age and sex explained a small but significant proportion of the variance in headache frequency (3.5%). All health variables, several socioeconomic, and most family- and school-related as well as the psychological variables demonstrated a significant association with the criterion in the single variable models. However, only a few of the variables related to leisure/peer activities reached significance. The domain model comprising health variables explained 27% of the variance, achieving the best model fit, followed by the psychological model with 13%.

Conclusions.— The comprehensive model was able to explain one third of the total variance in headache occurrence. Contrary to our hypothesis, the addition of psychosocial variables to health-related predictors did not markedly improve model fit.

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