Longitudinal Impact of Parent Factors in Adolescents With Migraine and Tension‐Type Headache

Abstract

Objective To examine longitudinal associations between parent factors (parent headache frequency and disability, protective parenting behaviors, parent catastrophizing) with adolescent headache‐related disability and headache frequency over 6 months. Background Theoretical models propose bidirectional, longitudinal relationships between parent factors and adolescent headache. Few studies have examined this using prospective study designs. Design and Methods Participants were a cohort of 239 youth ages 11‐17 years with recurrent migraine (with and without aura; chronic migraine) or tension‐type headache (episodic and chronic) and their parents recruited from a pediatric neurology clinic and the community who completed assessments at baseline and 6‐month follow‐up. Results After controlling for demographic and clinical covariates, we found that every point increase in baseline protective parenting behavior corresponded with a 2.19‐point increase in adolescent headache frequency at follow‐up (P = .026, 95% CI [0.27, 4.10]). Similarly, every point increase in baseline parent catastrophizing corresponded with a 0.93‐point increase in adolescent headache‐related disability (P = .029, 95% CI [0.09, 1.77]) and a .13‐point increase in adolescent headache frequency (P = .042, 95% CI [0.01, 0.25]) at follow‐up. We also found support for the reverse association, where every point increase in baseline adolescent headache‐related disability predicted a 0.03‐point increase in parent catastrophizing (P = .016, 95% CI [0.01, 0.05]) and a 0.02‐point increase in protective parenting behavior (P = .009, 95% CI [0.01, 0.03]) at follow‐up. The remaining bidirectional, longitudinal associations tested between parent factors and adolescent headache were not statistically significant. Conclusion Findings suggest that family‐based psychological interventions targeting modifiable adolescent and parent factors may lead to improvements in adolescent headache‐related disability and reductions in adolescent headache frequency.

Outcomes of Migraine and Tension-Type Headache in Children and Adolescents

“…Only a few studies have addressed the long-term prognosis of childhood headache syndromes. Moreover, of these, most studies have focused on pediatric migraine [ 8 , 11 , 14 , 15 , 16 , 17 , 18 , 19 ], with very few evaluating TTH as well [ 7 , 20 , 21 ].…”

“…Finally, some argue that migraine and episodic TTH in childhood are both part of the same headache syndrome or, more precisely, two ends of the same continuum [ 8 , 24 , 25 ]. This “continuum theory” of headache is also supported by those children and adolescents who present clinically with “mixed headache syndrome,” meaning a combination of TTH and migraine (mostly without aura).…”

“…Headache in children and adolescents can cause impaired psychosocial functioning in different areas of life, including family, activities, and school tasks [ 7 ]. Adolescents with headache are at heightened risk of developing additional physical problems in adulthood, as well as mental difficulties such as anxiety and depression [ 7 , 8 ].…”

Examining Parent Adverse Childhood Experiences as a Distal Risk Factor in Pediatric Chronic Pain

“…Research has shown that parents' physical and mental health is integrally related to the functioning of youth with chronic pain. [1][2][3][4][5] This study extends the literature by examining the potential intergenerational cascade from parent ACEs to parent physical and mental health to child pain in a clinical sample of youth with chronic pain. As expected, parent ACEs significantly predicted parent chronic pain status and depressive symptoms.…”

Virtual issue: Kids (with headache disorders) are not just little adults (with headache disorders)

“…3 In this issue, we present the work that highlights the importance of the unique biopsychosocial factors that play a key role in the incidence and prognosis of pediatric headache disorders. From the importance of parental factors and early life stress in determining headache incidence and trajectories, [4][5][6] to considering the impact of societal policies on children and adolescents with headache disorders such as school start times, 7 we are starting to learn more about the biopsychosocial factors that are key to understand how pediatric headache disorders develop and how they are maintained.…”