Background & Aims
Pediatric chronic headache experiences and associated functional disability are determined, at least in part, by specific psychological factors. Among these, anxiety, depression and pain catastrophizing may be targets for psychological interventions. Prior analyses have determined that comorbid mental health symptoms and catastrophic thinking patterns about pain impact function, quality of life, and avoidance of school and other activities. However, how these factors impact disability for individual patient groups is not well understood. While prior research has demonstrated gender differences in headache prevalence and characteristics among children and adolescents, no previous studies have investigated differences in psychosocial factors and profiles between male and female youth with headaches.
Methods
Data was collected from two samples of children, ages 4 to 17, with persistent headaches presenting to an interdisciplinary pediatric headache clinic at an academic medical center (1059 from years 2018-2021; 139 inclusive of Jan-Dec 2022). 61% female and 37% male; mean age 12.37 years. Parents and youth 12 years of age and older completed questionnaires screening for headache-related disability, functional disability, pain catastrophizing, and mental health-associated symptoms (attention, externalizing and internalizing, sleep disturbance). Independent samples t-tests were utilized to determine whether there were differences between headache-related disability, functional disability, mental health symptoms, and pain catastrophizing between male and female participants.
Results
Analyses indicated that there was not a significant difference between males and females in headache-related disability, sleep difficulties, or functional disability. There was a significant difference between males and females in pain catastrophizing, with female participants reporting significantly higher levels of pain catastrophizing (t[579] = -3.83, p < 0.01; females: M=26.29, SD = 10.70; males: M=22.67, SD = 11.09). There was a significant difference between males and females in mental health symptoms, with male participants exhibiting significantly higher levels of overall mental health symptoms (t[380] = 1.79, p < 0.05; males: M=10.32, SD = 5.78; females: M=9.27, SD = 5.67); however, female participants exhibited significantly higher levels of internalizing symptoms (t[116] = -1.52, p < 0.10; females: M=4.09, SD = 2.88; males: M=3.24, SD = 3.06).
Conclusions
Although headache-related functional disability is equally prevalent in males and females, there are subtle gender distinctions in cognitive and mental health factors associated with greater disability. Catastrophic thinking (helplessness, pain anxiety, overfocus) is more prominent in females and can be targeted for biopsychosocial intervention, in addition to pain and mood management.
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Presenting Author
Deirdre Caplin
Poster Authors
Topics
- Pain in Special Populations: Adolescents