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

Objectives: 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.