Conflict of Interest: The authors report no conflict of interest.
Headache Disorders in Children and Adolescents: Their Association With Psychological, Behavioral, and Socio-Environmental Factors
Article first published online: 12 JUL 2012
© 2012 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 52, Issue 9, pages 1387–1401, October 2012
How to Cite
Kröner-Herwig, B. and Gassmann, J. (2012), Headache Disorders in Children and Adolescents: Their Association With Psychological, Behavioral, and Socio-Environmental Factors. Headache: The Journal of Head and Face Pain, 52: 1387–1401. doi: 10.1111/j.1526-4610.2012.02210.x
Funding: The research has been funded by a grant from the German Federal Ministry of Education, Research and Science within the German Headache Consortium.
- Issue published online: 3 OCT 2012
- Article first published online: 12 JUL 2012
- Accepted for publication June 5, 2012.
- headache disorder;
- psychosocial associations;
- behavioral factors;
- socio-environmental factors;
Objective.— This cross-sectional study on a randomly drawn population sample of children and adolescents (n = 3399; aged 9 to 15) aimed at the assessment of patterns of associations between psychosocial variables and primary headache disorders like migraine (MIG) or tension-type headache. A headache-free group served as a control.
Methods.— Data on headache and psychological trait variables (eg, internalizing symptoms), behavioral factors (eg, physical activities), and socio-environmental factors (eg, life events) were gathered by questionnaire. Logistic regression analyses were conducted with headache types (MIG, tension-type, and non-classifiable headache) as dependent variables.
Results.— The pattern of correlations was largely congruent between the headache disorders. Associations were closest regarding maladaptive psychological traits (in particular internalizing symptoms with an odds ratio > 4 regarding MIG) compared with socio-environmental factors and particularly the behavioral factors. Unfavorable psychological traits and socio-environmental strains demonstrated distinctly stronger associations with MIG than tension-type headache and explained more variance in the occurrence of pediatric headache disorders than parental headache. Sex-specific analyses showed similarities as well as differences regarding the correlations, and in general, the associations were stronger in girls than boys.
Conclusions.— A common path model as posited by several researchers in the field may explain the parallelism in biopsychosocial vulnerability regarding the different headache disorders.