The aim of this study is to investigate the correlational processes and possible mediation mechanisms between internalizing problems and significant indicators of headache (pain frequency, duration, and intensity) and pain coping strategies among adolescents diagnosed with episodic migraine. Methods: The study sample included 143 adolescents diagnosed with episodic migraine in compliance with the diagnostic criteria specified in ICHD-3. In collecting data, Sociodemographic Information Form, Headache Questionnaire Form, Pain Coping Questionnaire, Children's Depression Questionnaire, and Screen for Child Anxiety-Related Disorders: Child Form were used. Statistical analyses of the study were carried out using the "SPSS for Windows Package Program. " Results: The findings of the study indicate that adolescents suffer from a higher headache frequency per month in parallel with higher levels of depression (r=0.28, p<0.05), total anxiety (r=0.19, p<0.05), panic disorder/somatic symptoms (r=0.22, p<0.05), and school avoidance (r=0.21, p<0.05). In addition, the higher the levels of internalizing problems among adolescents are, the more common is the use of coping strategies that give rise to feelings of helplessness in the face of pain (r=0.27, p<0.01). On the other hand, the study findings concerning mediation mechanisms show that the level of depression is a full mediator in correlations between the levels of panic disorders/somatic symptoms and school avoidance and both monthly headache frequency and use of coping strategies that give rise to feelings of helplessness in the face of pain among adolescents. Conclusion:The results of the study also offer an insight into the age-related phenotypic variation and chronicity of migraine.

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ObjectiveThis study aimed to examine the mediating role of early maladaptive schemas on the relationship between illness-related perceptions and pain coping strategies among adolescents diagnosed with migraine.Material and methodsA total of 134 adolescents (aged 12–18 years) diagnosed with migraine with and without aura participated in the study. The Illness Perception Questionnaire, the Pain Coping Questionnaire, and the Early Maladaptive Schema Questionnaires Set for Children and Adolescents were used.ResultsThe intensity of using desperate ways of coping with pain was higher among adolescents who perceive migraine as a chronic disease (β = 0.199, p &lt; 0.05) even if they have episodic attacks and who have higher levels of coherency in understanding the illness (β = 0.256, p &lt; 0.01). First, full mediations of over-vigilance/inhibition and impaired autonomy/performance schema domains on these relations were observed. Second, the increases in negative cognitive (β = 0.199, p &lt; 0.05) and emotional (β = 0.280, p &lt; 0.01) representations related to the consequences of the illness lead to an increase in the uncontrolled and frequent use of analgesic drugs where the partial mediating role of over-vigilance/inhibition schema domain on this correlation is observed. The perceptions about the negative as well as serious consequences of migraine are related to both the self-active behaviors (β = 0.181, p &lt; 0.05) and the conscious cognitive attempts (β = 0.207, p &lt; 0.05) as effective coping strategies, which is an unexpected finding. The disconnection/rejection schema domain had a full mediation role on both relations.ConclusionThe results suggest that early maladaptive schemas are essential factors that affect the migraine coping processes of adolescents.

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