Primary Headache in Children and Adolescents: Therapy Outcome and Changes in Family Interaction Patterns.

Abstract

The present study, a qualitative case series report with a quantitative component, explores the relation between changes in family interaction patterns and therapy outcome at 9-month follow-up in a child-and familyoriented psychosocial treatment program developed to treat pediatric primary headache. Changes in the family interaction patterns of 38 children and adolescents diagnosed according to International Headache Society criteria were examined via qualitative methods. Therapy outcome was assessed on an 11-point numeric rating scale measuring the reduction of subjectively experienced global headache burden. At follow-up, 1 subgroup of families showed positive change, and a 2nd subgroup displayed either unchanged or worsened headache-associated interaction patterns. Participants from families with a positive change in headache-associated interaction patterns showed a 64% reduction (p ϭ .00) of global headache burden; participants with unchanged or worsened family interaction patterns showed only a 17% reduction. The findings are illustrated by case histories and discussed in the context of dynamic systems theory.

El Papel Funcionamiento y la Comunicación Familiar en los Síntomas Psicosomáticos

“…Psychosomatic symptoms can be explained by a number of different factors, such as psychological factors (anxiety, stress coping and optimism) (Davidsdottir, 2006;Holahan & Moos, 1986), attribution style (Peterson, Vaillant & Seligman, 1988), lifestyle (Davidsdottir, 2006), gender differences (Barsky, Peekna & Borus, 2001;Tamada, 2005) and psychosocial factors, such as family interactions (Segrin, 2006), specifically family communication and family functioning (Ochs et al, 2005;Sayre, 2001;Terre & Ghiselli, 1997) and family satisfaction (Horner, 2001;Segrin, 2006).…”

“…En investigaciones más recientes, se ha observado la relación entre los patrones de interacción familiar y algunas enfermedades (Sayre, 2001) o diversos dolores (Ochs et al, 2005); además, las personas que utilizan habilidades positivas de comunicación y que mantienen relaciones familiares de armonía son más saludables que aquéllas con relaciones problemáticas (Segrin, 2006). Los miembros de las familias que con mayor frecuencia manifiestan enfermedades somáticas, provienen de familias con interacciones en las que predomina una comunicación evitativa y negativa (Sayre, 2001).…”

Broadening Parental Involvement in Family-based Interventions for Pediatric Overweight

“…31 Systemic family counseling, which seeks to attribute positive meaning to stressful circumstances, has been used effectively as part of the comprehensive treatment of primary headache. 32 Efforts continue to determine the best methods for incorporating family systems ideas in the treatment of pediatric illnesses. The promise of taking a broader family systems approach in treating pediatric illnesses is reflected by a special issue of Journal of Pediatric Psychology that examined the strengths of family-based interventions in treating pediatric illnesses, as well as obstacles faced by family-based approaches.…”

There's a Family in This Headache: A Commentary on Ochs et al. (2005).

“…The symptoms dissipated when the patterns changed in response to the study interventions. Ochs et al (2005) stated, "The aim of the present study is not to provide experimental proof for a causal relationship between the reduction of headache burden and changes in family interaction patterns" (p. xx). They distinguished between the "outset approach" (the fiction I labored under as a young resident) and the "cofluctuation approach" (p. xx).…”