The aim of the present study was to assess the distribution and characteristics of headache in children aged 7-14 years in Lower Saxony (Germany). For the survey, 8800 households with children were randomly drawn from community registers. Parents received comprehensive questionnaires regarding various aspects of their child's headache history and general health by mail. The response rate was 63.5%. The 6-month prevalence of paediatric headache was 53.2% and increased with age (39% at 7 years to 63% at age 14). Overall, recurrent headache (> or =1/week) was experienced by 6.5% of the total sample and was significantly more common among older girls (> or =11 years) than their male counterparts. Boys and girls did not differ markedly from one another regarding headache occurrence and frequency until the age of 11. Mean age of headache onset was 7.5 years, with onset occurring at a significantly younger age among boys than among girls. In accordance with International Classification of Headache Disorders-II criteria, migraine was diagnosed in 7.5% and tension-type headache in 18.5% of the cases, hence a large proportion of the children had unclassifiable headache. Of the headache disorders, migraine was rated the most disabling, with the highest average intensity, highest frequency, duration of headache often exceeding 2 h and more frequent use of medication. In general, aura symptoms were rare except for visual disturbances (17%). Paediatric headache was strongly associated with other health problems, including other pain symptoms. Paediatric headache was also associated with a history of parental headache.

Internet-based prevention is effective and can be successfully adapted to a different culture.

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.

The examined potential moderator variables did not elucidate processes underlying the differences in child and parent agreement. There is no convincing evidence that the children's appraisal is less valid than their parents'. In summary, parents' reports cannot be viewed as a substitute for children's reports in pediatric pain and health assessment. Instead, each perspective represents a unique subjective reality and as such, both are of importance for research on pediatric pain and other health variables.

The aim of this study was to estimate prevalence rates of different types of primary headache in 9- to 14-year-old children in a population-based sample. Case definition was based on International Classification of Headache Disorders (ICHD) criteria. The possibility of implementing these criteria within a questionnaire format, which has been regarded as problematic by some authors, was the main focus of the study. A questionnaire was sent to children and adolescents in 6400 randomly drawn families in southern Lower Saxony. Valid questionnaires were returned by 61.1% of the sample. The overall prevalence rate for tension-type headache (TTH) (criteria C and D) was 17.6% and for migraine (criteria B, C and D) 13.1%. Despite the use of abridged criteria for headache classification, 35.5% of all children reported headache that could not be classified using the ICHD criteria. The response behaviour of these children indicated that they had difficulties reporting symptoms that were defining for migraine or TTH. The classifiability of headache does not seem to be dependent on age or frequency of headache, but rather on the number of 'I don't know' answers given regarding headache characteristics. It is likely that studies reporting prevalence rates that are limited to migraine and or TTH diagnoses underestimate the true prevalence of headache in children and adolescents.

The aims of the present study were the assessment of headache (HA) prevalence in German children and adolescents in the second year of a 4-year longitudinal study and the analysis of headache status change from year 1 to year 2. The original sample consisted of 8800 households with a child aged 7-14 years. A total of 4159 households responded in both year 1 and year 2, yielding 3984 valid parent questionnaires. Data regarding various aspects of the child's HA history and general health were gathered via mailed questionnaires from the parents. Of the households returning valid parent questionnaires at survey 2, 48.9% reported their child to have experienced headaches during the previous 6 months (53% at survey 1). Weekly HA was reported for 6.5% of the children, monthly or less frequent HA for 16.5% and 25.9%, respectively. With regard to headache diagnosis, 55.0% of the children and adolescents with HA experienced tension-type HA (TTH) and 11.3% migraine with or without aura (M). For more than half of the children and adolescents with HA (57.0%) the frequency of head pain remained stable over the period of 1 year (i.e. same frequency category in years 1 and 2). Improved and worsened HA status regarding frequency of occurrence was found in 22.3% and 20.7% of the subjects, respectively. Thus, there was no definite trend towards an increase of HA episodes over the course of 1 year regarding the individual child or adolescent. The most stable type of HA was TTH.

Zusammenfassung. Theoretischer Hintergrund: Ausgangspunkt der beiden vorgestellten Studien ist die Forschung zu der Bedeutung von Selbstöffnung beim gefühlsbetonten Schreiben über belastende Ereignisse, die von Pennebaker und Mitarbeitern initiiert wurde. Nach Pennebaker belegen die Studien den langfristigen gesundheitsfördernden Effekt dieser kurzen und unaufwendigen Intervention. Methode: Die erste Studie versuchte im wesentlichen eine Replikation der Studie von Pennebaker und Beall (1986) mit der Erwartung, die von den Autoren beschriebenen Effekte bestätigen zu können. Neben den in der Originalstudie verwandten Erhebungsinstrumenten wurden verschiedene Essayvariablen extrahiert und eine Reihe von Persönlichkeitsmerkmalen erhoben, für die eine Moderatorfunktion bezüglich der Ergebnisvariablen angenommen wurde. Die zweite Studie variierte die Bedingung der Selbstöffnung, indem zusätzlich zur Ursprungsbedingung eine sogenannte “Coping“- bzw. “Helping“-Instruktion gegeben wurde, die über Aktivierung von Ressourcen deutlichere Wirkung im Sinne der Hypothesen zeigen sollte. Ergebnisse: In der ersten und zweiten Studie wurden keine langfristigen positiven Effekte auf die erhobenen Gesundheitsvariablen (z.B. Arztbesuche) gefunden. Die Essaymerkmale sowie die Persönlichkeitsmerkmale erklären fast keine Varianz in den Ergebnisvariablen. Es wurden Veränderungen in Parametern der Belastungsreaktion (z.B. Intrusion) gefunden. Diese waren besonders ausgeprägt bei der Aktivierung prosozialer Motivation (“Helping“-Bedingung). Schlussfolgerung: Das mehrmalige (aber kurzzeitige) gefühlsaktivierende Schreiben über belastende Ereignisse der Vergangenheit erzielt keine gesundheitlich positiven Konsequenzen. Es fördert aber eine bessere Belastungsverarbeitung.

Zusammenfassung. Eine erhöhte Bedeutsamkeit von Figur und Gewicht sowie Diätverhalten gehören zu den am besten bestätigten und bedeutungsvollsten Risikofaktoren, die bei jungen Frauen zu einem erhöhten Risiko für spätere Essstörungssymptome oder -syndrome führen. Präventive Interventionen sollten daher versuchen, diese Faktoren zu reduzieren, um die Wahrscheinlichkeit der Entwicklung einer Essstörung zu verringern. Die vorliegende Untersuchung beschreibt die Überprüfung der Wirksamkeit eines für den deutschen Sprachraum adaptierten Internet-gestützten Präventionsprogramms (“Student Bodies“) zur Reduktion von Risikofaktoren für gestörtes Essverhalten bzw. Essstörungen. 100 Studentinnen von zwei Universitäten wurden per Zufall entweder einer Interventionsgruppe oder einer Wartekontrollgruppe zugewiesen. Die Dauer der Intervention betrug 8 Wochen. Zum Post-Zeitpunkt konnte die Wirksamkeit des adaptierten Programms im Vergleich zur Kontrollgruppe gut bestätigt werden. Die Effekte waren deutlich höher für eine Subgruppe von Frauen mit erhöhtem Risiko für Essstörungen.