Parental attitudes, particularly maternal ones, may increase symptoms of depression and anxiety in children with episodic or chronic migraine or tension-type headache and increase their child’s perception of pain intensity, resulting in the chronification of headache, according to a study published in Clinical Child Psychology and Psychiatry.

A total of 195 children aged 9 to 16 with chronic migraine (n=25), episodic migraine (n=90), and tension-type headache (n=80) and 43 children without headache were included in the study. Questionnaires were administered to gather data on sociodemographic variables, and children were asked to report their pain intensity with the visual analog scale (VAS), and to complete the Social Anxiety Scale for Adolescents and the Children’s Depression Inventory. Parents completed the Parental Attitudes Determining Scale, designed to evaluate psychological adjustment.

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Anxiety and depression in children, as well as their father’s attitude scale scores were comparable between healthy study participants and those with migraine or headache, but VAS scores and mean mothers’ attitude scale scores were worse in the headache vs healthy group (P =.000 and P =.002, respectively). Mothers of children with chronic migraine had higher mean oppressive-authoritarian attitude subscale scores (P =.000). A relationship between VAS scores and depression was identified for all participants (P =.000), and in children with chronic migraine, there was a positive correlation between VAS and anxiety and depression scores (r=0.482; P =.015 and r=0.379; P =.042, respectively).

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“The findings support [the notion] that protective parenting has several effects on migraine in children. Parental attitudes may elevate psychiatric symptoms and influence children’s perception of pain negatively. Our study may be improved by assessing parents’ response to their child’s pain experience in future research,” concluded the study authors.


Ertem DH, Bingol A, Ugurcan B, et al. The impact of parental attitudes toward children with primary headaches [published online March 21, 2019]. Clin Child Psychol Psychiatry. doi: 10.1177/1359104519838571

This article originally appeared on Clinical Pain Advisor