The role of internalizing problems on headache characteristics and pain coping strategies among adolescents diagnosed with episodic migraine

Abstract

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.

The mediating role of early maladaptive schemas on the relationship between illness perception and pain coping strategies among adolescents diagnosed with migraine

“…These high standards usually come from oppressive and intolerant family attitudes (22,34). Those core beliefs combined with the wishes to be accepted by others might increase the use of uncontrolled and frequent use of analgesic drugs by adolescents as easily obtained over-the-counter pills would give temporary relief (5). Bearing in mind that frequent use of these pills might help adolescents to suppress their emotions about their illnesses, they tend to think that they have no medical problems at all.…”

“…but they do not tend to empathize with the negative feelings. Therefore, adolescents may choose not to express their emotions (22, 34) while communicating through analgesic drugs might be considered as a cry for help for emotional support (5).…”

“…Within families where disconnection/rejection schemas have developed, a lack of social and emotional support is frequently seen (34). Children and adolescents who experience helplessness in coping with their headaches may express their pain more often by seeking social support and empathy from others (5,38). In a recent study, the effects of parental attitudes toward patients migraine on their adolescent children were investigated (39).…”

“…The part of coping with pain through ineffective medical remedies of the scale evaluates uncontrolled and unconscious use of analgesic drugs which do not belong to the treatment protocol of pain attacks ( 5 ). Negativity/pessimism and emotional inhibition schemas of the over-vigilance/inhibition domain and some maladaptive coping methods used to manage these schemas may have a role in ineffective coping strategies.…”

“…The highest prevalence of migraine is observed during adolescence as discussed in earlier studies (1)(2)(3). Migraine is not only physical pain but also is one of the common causes that affects the family, school, and social lives of adolescents (4)(5)(6). If the migraine has a chronic course, it has been reported that the functionality of the adolescents in the abovementioned areas is more disrupted, and comorbid psychiatric disorders are encountered much more frequently (7,8).…”