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Delgado-Sanchez A, Brown C, Sivan M, Talmi D, Charalambous C, Jones AKP. Are We Any Closer to Understanding How Chronic Pain Develops? A Systematic Search and Critical Narrative Review of Existing Chronic Pain Vulnerability Models. J Pain Res 2023; 16:3145-3166. [PMID: 37727681 PMCID: PMC10506671 DOI: 10.2147/jpr.s411628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/27/2023] [Indexed: 09/21/2023] Open
Abstract
Identifying biopsychosocial factors underlying chronic pain vulnerability is essential for the design of preventative efforts. Multiple chronic pain vulnerability models exist, however, there is a lack of comprehensive evaluation of these models in the literature, potentially due to the lack of guidelines that specify the criteria by which these types of work should be assessed. In this work, we created evaluation criteria (based on the general goals of conceptual models), and we then used them to critically review the chronic pain vulnerability models available in the current peer-reviewed literature (identified through a systematic search). Particularly, we evaluated the models on the basis of conceptual clarity/specificity of measures, depth of description of aetiological and mechanistic factors, use of a whole system approach, and quality of the evidence associated with the models. We found nine conceptual models that have been explored in detail (eg, fear avoidance model, diathesis-stress model). These models excel at clarity and are supported mostly by self-report evidence of a psychological nature (anxiety sensitivity, pain catastrophizing, etc.), but provide little explanation of mechanistic and aetiological factors. In the future, models could be improved by complementing them with proposals from other models and exploring potential causal factors and mechanisms maintaining the condition. This task could be carried out through prospective cohort studies, and computational approaches, amongst others.
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Affiliation(s)
- Ariane Delgado-Sanchez
- Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, UK
| | - Christopher Brown
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Deborah Talmi
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Anthony K P Jones
- Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, UK
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2
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Tarantino S, Papetti L, Di Stefano A, Messina V, Ursitti F, Ferilli MAN, Sforza G, Moavero R, Vigevano F, Gentile S, Valeriani M. Anxiety, Depression, and Body Weight in Children and Adolescents With Migraine. Front Psychol 2020; 11:530911. [PMID: 33192771 PMCID: PMC7655930 DOI: 10.3389/fpsyg.2020.530911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
Background: There is a lack of studies that explore the possible association between body weight, psychological symptoms, and migraine severity in pediatric populations. The purpose of the study was to explore: (1) the association between body weight and the frequency of migraine attacks, (2) the possible differences in anxiety and depression symptoms according to the frequency of attacks and body weight, and (3) the possible mediating role of anxiety and/or depression in the association between body weight and frequency of migraine attacks in children. Methods: One hundred and eleven children/adolescents with migraine were included (47 boys and 64 girls; mean age 11.7; ±2.4 years). The patients were classified as: (1) high frequency patients, reporting from weekly to daily episodes and (2) low frequency patients, with ≤3 episodes per month. According to their body mass index percentiles, the patients were divided in “Normal weight” (from ≥5 to <85 percentile), “Overweight” (from ≥85 to <95 percentile), and “Obese” (≥95 percentile). Given the low number of obese patients, the overweight and obese groups were considered together in the “Overweight” group. Anxiety and depression symptoms were assessed by the Self-Administered Psychiatric Scales for Children and Adolescents (SAFA). Results: Fifty-four patients were normal in weight (49.6%), while 56 patients (50.4%) were overweight. The overweight patients showed a higher frequency of migraine attacks (64.7%; p < 0.05). Patients with a high frequency of attacks reported higher scores in all SAFA-Anxiety subscales (SAFA-A Tot: F = 15.107; p = 0.000). Overweight patients showed a significantly higher score in the “Separation anxiety” subscale (F = 7.855; p = 0.006). We found a mediating role between the overweight and high frequency for total anxiety (z = 2.11 ± 0.03; p < 0.05) and social anxiety (z = 2.04 ± 0.03; p < 0.05). Conclusions: Our results suggest that, among the children suffering from migraine, the overweight status is associated with a higher frequency of attacks and separation anxiety symptoms. In particular, our study provides the first evidence of the role of anxiety in linking overweight and the frequency of migraine attacks in children and adolescents.
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Affiliation(s)
- Samuela Tarantino
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Laura Papetti
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Alessandra Di Stefano
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Valeria Messina
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabiana Ursitti
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giorgia Sforza
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Romina Moavero
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Federico Vigevano
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Massimiliano Valeriani
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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When a Head Is about to Burst: Attachment Mediates the Relationship Between Childhood Trauma and Migraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124579. [PMID: 32630556 PMCID: PMC7344657 DOI: 10.3390/ijerph17124579] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022]
Abstract
Background: People exposed to childhood trauma show insecure attachment patterns and are more prone to chronic and pain-related conditions, including migraine. The aim of this study was to explore the mediating role of attachment in the association between childhood trauma and adulthood chronic health conditions, with a focus on migraine. Methods: Respondents from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male) were asked to report various chronic and pain-related conditions, childhood trauma (The Childhood Trauma Questionnaire, CTQ), and attachment anxiety and avoidance (The Experience in Close Relationships Revised, ECR-R) in a cross-sectional, questionnaire-based survey conducted in 2016. Structural equation models (SEM) adjusted for sociodemographic variables were used to assess the relationship between childhood trauma, adulthood attachment, and adulthood chronic health conditions (migraine, other pain-related conditions, chronic health conditions other than pain, no chronic health complaints). Results: After adjusting for sociodemographic variables, SEM confirmed a significant mediation of the relationship between childhood trauma and migraine through adulthood attachment. There was no mediation effect of adulthood attachment found in other health complaints. Conclusion: This study highlights the mediation effect of attachment in the link between childhood trauma and migraine. Attachment-based therapeutic interventions can be useful in the treatment of patients with migraine.
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Coutinho VM, Queiroga BAMD, Souza RCD. ATTACHMENT STYLE IN CHILDREN WITH CHRONIC DISEASES: A COMPREHENSIVE REVIEW. ACTA ACUST UNITED AC 2020; 38:e2018308. [PMID: 32401946 PMCID: PMC7212585 DOI: 10.1590/1984-0462/2020/38/2018308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/17/2019] [Indexed: 12/03/2022]
Abstract
Objective: To investigate how attachment style has been studied in children with
chronic disease in the scientific literature, and what repercussions this
attachment has on this population. Data sources: An integrative review of the literature was carried out from a survey in the
LILACS, MEDLINE and SciELO databases, including original national and
international publications in Portuguese, Spanish and English from 2007 to
2018, using the descriptors “apego” and
“criança” in the Health Sciences Descriptors (DeCS),
and “attachment” and “children” for the Medical Subject Headings (MeSH).
Sixteen (16 articles) were obtained for the sample analysis. Data synthesis: The chronic diseases found in the research were neurobehavioral disorders
such as attention deficit hyperactivity disorder (ADHD) and autism,
childhood obesity, and chronic migraine. The predominant attachment style
was insecurity, which could compromise the biopsychosocial development of
the child. Conclusions: The type of attachment between child and primary caregiver may be considered
a protective or risk factor for child development. Considering this premise,
it is important to equip/inform families based on dialogic educational
practices, in which professionals create opportunities and means for
families to develop their skills and competencies, and acquire resources
which meet the child’s needs. It is important that this professional helps
the family to build secure bases for their child with chronic disease,
understanding that the main focus for promoting child development is in the
family unit.
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Failo A, Giannotti M, Venuti P. Associations between attachment and pain: From infant to adolescent. SAGE Open Med 2019; 7:2050312119877771. [PMID: 31555442 PMCID: PMC6753515 DOI: 10.1177/2050312119877771] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/23/2019] [Indexed: 12/15/2022] Open
Abstract
Pain experience is a negative complex phenomenon influenced by several mechanisms. Attachment processes may affect the way in which individuals experience and signal pain. Hence, in the last two decades, the role of attachment quality has drawn attention in pain research and practice. However, previous reviews on this topic focused on adulthood and/or specific types or pain. We conducted a narrative review examining the association between attachment and different pain conditions from infancy to adolescence. Two independent researchers searched scientific databases for relevant papers. A total of 17 articles were included. Results highlight the following: (a) children and adolescents with chronic idiopathic pain showed low rates of attachment security compared to control groups; (b) pain conditions are consistently associated with elevated rates of at-risk pattern of attachment and information processing; and (c) the presence of unresolved trauma or loss is higher in children and adolescent who experienced pain compared to healthy controls. Despite the significance of these empirical evidences, the impact of caregiving environment and interpersonal context on pain experience in infancy and preschool age is poorly investigated compared to adulthood. Research on pain and attachment needs to be extended since the majority of the studies are limited to specific pain conditions. Future research should investigate the role of anxious attachment on procedural pain and transition from acute to chronic pain, testing new conceptual models. These findings shed light on the importance of relational factors and psychosocial vulnerabilities in pain clinical practice. An attachment-informed approach to pain will help health professionals to offer adequate support during procedures and to increase effectiveness of interventions. A developmental perspective is needed to integrate familial and relational contribution into a multimodal assessment and treatment of pain. Longitudinal studies are recommended.
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Affiliation(s)
- Alessandro Failo
- Department of Psychology and Cognitive Science,
University of Trento, Rovereto, Italy
| | - Michele Giannotti
- Department of Psychology and Cognitive Science,
University of Trento, Rovereto, Italy
| | - Paola Venuti
- Department of Psychology and Cognitive Science,
University of Trento, Rovereto, Italy
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Faedda N, Natalucci G, Piscitelli S, Alunni Fegatelli D, Verdecchia P, Guidetti V. Migraine and attachment type in children and adolescents: what is the role of trauma exposure? Neurol Sci 2018; 39:109-110. [PMID: 29904855 DOI: 10.1007/s10072-018-3368-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Noemi Faedda
- Behavioural Neuroscience, Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Giulia Natalucci
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Silvia Piscitelli
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Paola Verdecchia
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Guidetti
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
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Defense mechanism is predicted by attachment and mediates the maladaptive influence of insecure attachment on adolescent mental health. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9839-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Ning Y, Zheng R, Li K, Zhang Y, Lyu D, Jia H, Ren Y, Zou Y. The altered Granger causality connection among pain-related brain networks in migraine. Medicine (Baltimore) 2018; 97:e0102. [PMID: 29517685 PMCID: PMC5882438 DOI: 10.1097/md.0000000000010102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Numerous fMRI studies have confirmed functional abnormalities in resting-state brain networks in migraine patients. However, few studies focusing on causal relationships of pain-related brain networks in migraine have been conducted. This study aims to explore the difference of Granger causality connection among pain-related brain networks in migraine without aura (MWoA) patients.Twenty two MWoA patients and 17 matched healthy subjects were recruited to undergo resting-state fMRI scanning. Independent component analysis was used to extract pain-related brain networks, and Granger causality analysis to characterize the difference of Granger causality connection among pain-related brain networks was employed.Seven pain-related brain networks were identified, and MwoA patients showed more complex Granger causality connections in comparison with healthy subjects. Two-sample t test results displayed that there was the significant difference between right-frontoparietal network (RFPN) and executive control network (ECN).This study indicates that the specific intrinsic brain Granger causality connectivity among pain-related networks in MwoA patients are affected after long-term migraine attacks.
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Affiliation(s)
- Yanzhe Ning
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University
| | - Ruwen Zheng
- Department of Acupuncture and Moxibustion, Dongfang Hospital, The Second Affiliated Hospital of Beijing University of Chinese Medicine
| | - Kuangshi Li
- Department of Internal Medicine, Gulou Hospital of Traditional Chinese Medicine of Beijing
| | - Yong Zhang
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Diyang Lyu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University
| | - Hongxiao Jia
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University
| | - Yi Ren
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Yihuai Zou
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine
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9
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Natalucci G, Faedda N, Calderoni D, Cerutti R, Verdecchia P, Guidetti V. Headache and Alexithymia in Children and Adolescents: What Is the Connection? Front Psychol 2018; 9:48. [PMID: 29449820 PMCID: PMC5799825 DOI: 10.3389/fpsyg.2018.00048] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/12/2018] [Indexed: 01/14/2023] Open
Abstract
Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were "alexithymia" combined with the "primary headache," "migraine," "tension type headache," "children," and "adolescents." Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness.
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Affiliation(s)
- Giulia Natalucci
- Department of Paediatric and Child and Adolescent Neuropsychiatry, “Sapienza” University of Rome, Rome, Italy
| | - Noemi Faedda
- Behavioural Neuroscience, Department of Paediatric and Child and Adolescent Neuropsychiatry, “Sapienza” University of Rome, Rome, Italy
| | - Dario Calderoni
- Department of Paediatric and Child and Adolescent Neuropsychiatry, “Sapienza” University of Rome, Rome, Italy
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Paola Verdecchia
- Department of Paediatric and Child and Adolescent Neuropsychiatry, “Sapienza” University of Rome, Rome, Italy
| | - Vincenzo Guidetti
- Department of Paediatric and Child and Adolescent Neuropsychiatry, “Sapienza” University of Rome, Rome, Italy
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Tarantino S, Papetti L, De Ranieri C, Boldrini F, Rocco AM, D’Ambrosio M, Valeriano V, Battan B, Paniccia MF, Vigevano F, Gentile S, Valeriani M. Maternal Alexithymia and Attachment Style: Which Relationship with Their Children's Headache Features and Psychological Profile? Front Neurol 2018; 8:751. [PMID: 29403425 PMCID: PMC5786507 DOI: 10.3389/fneur.2017.00751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/28/2017] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION A growing body of literature has shown an association between somatic symptoms and insecure "attachment style." In a recent study, we found a relationship between migraine severity, ambivalent attachment style, and psychological symptoms in children/adolescents. There is evidence that caregivers' attachment styles and their way of management/expression of emotions can influence children's psychological profile and pain expression. To date, data dealing with headache are scarce. Our aim was to study the role of maternal alexithymia and attachment style on their children's migraine severity, attachment style, and psychological profile. MATERIALS AND METHODS We enrolled 84 consecutive patients suffering from migraine without aura (female: 45, male: 39; mean age 11.8 ± 2.4 years). According to headache frequency, children/adolescents were divided into two groups: (1) high frequency (patients reporting from weekly to daily attacks), and (2) low frequency (patients having ≤3 episodes per month). We divided headache attacks intensity into two groups (mild and severe pain). SAFA "Anxiety," "Depression," and "Somatization" scales were used to explore children's psychological profile. To evaluate attachment style, the semi-projective test SAT for patients and ASQ Questionnaire for mothers were employed. Maternal alexithymia traits were assessed by TAS-20. RESULTS We found a significant higher score in maternal alexithymia levels in children classified as "ambivalent," compared to those classified as "avoiding" (Total scale: p = 0.011). A positive correlation has been identified between mother's TAS-20 Total score and the children's SAFA-A Total score (p = 0.026). In particular, positive correlations were found between maternal alexithymia and children's "Separation anxiety" (p = 0.009) and "School anxiety" (p = 0.015) subscales. Maternal "Externally-oriented thinking" subscale correlated with children's school anxiety (p = 0.050). Moreover, we found a correlation between TAS-20 Total score and SAFA-D "Feeling of guilt" subscale (p = 0.014). Our data showed no relationship between TAS-20 and ASQ questionnaires and children's migraine intensity and frequency. CONCLUSION Maternal alexithymia and attachment style have no impact on children's migraine severity. However, our results suggest that, although maternal alexithymic traits have no causative roles on children's migraine severity, they show a relationship with patients' attachment style and psychological symptoms, which in turn may impact on migraine severity.
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Affiliation(s)
- Samuela Tarantino
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | - Laura Papetti
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | - Cristiana De Ranieri
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Francesca Boldrini
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Angela Maria Rocco
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Monica D’Ambrosio
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Valeria Valeriano
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Barbara Battan
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | | | - Federico Vigevano
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Massimiliano Valeriani
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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11
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Esposito M, Messina A, Monda V, Bitetti I, Salerno F, Precenzano F, Pisano S, Salvati T, Gritti A, Marotta R, Lavano SM, Lavano F, Maltese A, Parisi L, Salerno M, Tripi G, Gallai B, Roccella M, Bove D, Ruberto M, Toraldo R, Messina G, Carotenuto M. The Rorschach Test Evaluation in Chronic Childhood Migraine: A Preliminary Multicenter Case-Control Study. Front Neurol 2017; 8:680. [PMID: 29312117 PMCID: PMC5733029 DOI: 10.3389/fneur.2017.00680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/29/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECT About 1.2-3.2% of children at 7 years of age with increasing age up to 4-19% in adolescents are suffering from migraine without aura (MwA). The aim of the present study is investigating the personality style associated with children and adolescents affected by MwA, administrating the Rorschach test, and comparing with typical developing healthy controls (TD). METHODS 137 patients (74 males), aged 7.3-17.4 years (mean age 11.4, SD 3.02 years), affected by MwA according to the IHs-3 criteria. The Rorschach variables were treated as numerical variables and statistically tested with t-Student's analysis. RESULTS No statistical differences were found between the MwA and TD for age (p = 0.55), and gender (p = 0.804). From the comparison between the two samples, MwA group shows lower W responses (p < 0.001), good quality W responses (p < 0.001), high frequency of detailed responses (p < 0.001), the presence of even minor form of good quality responses (p < 0.001), increased presence of animals answers (A%) (p < 0.001), more frequent trivial answers (Ban%) (p < 0.001). DISCUSSION Rorschach interpretation pinpointed many interesting and, perhaps, peculiar aspects in our MwA population such as a trend predisposition for: analytical reasoning rather than synthetic, ease/practicality rather than creativity, oppositionality rather than external adaptation to the environment that may be interpreted as effect of general maladaptivity.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ilaria Bitetti
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Filomena Salerno
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Precenzano
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simone Pisano
- Department of Child and Adolescent Neuropsychiatry, University of Salerno, Salerno, Italy
| | - Tiziana Salvati
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Antonella Gritti
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Rosa Marotta
- Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, Italy
| | | | - Francesco Lavano
- Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Agata Maltese
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Margherita Salerno
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Tripi
- Department PROSAMI, University of Palermo, Palermo, Italy
- Childhood Psychiatric Service for Neurodevelopmentals Disorders, Chinon, France
| | - Beatrice Gallai
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Domenico Bove
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Maria Ruberto
- Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Roberto Toraldo
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
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12
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The role of attachment insecurity in the emergence of anxiety symptoms in children and adolescents with migraine: an empirical study. J Headache Pain 2017; 18:62. [PMID: 28560542 PMCID: PMC5449355 DOI: 10.1186/s10194-017-0769-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/22/2017] [Indexed: 01/03/2023] Open
Abstract
Background It is widely recognised that there are associations between headache, psychiatric comorbidity and attachment insecurity in both adults and children. The aims of this study were: 1) to compare perceived attachment security and anxiety in children and adolescents with migraine without aura and a healthy control group; 2) to test whether the child’s perceived security of attachment to the mother and the father mediated the association between migraine and anxiety. Methods One hundred children and adolescents with Migraine without Aura were compared with a control group of 100 children without headache. The Security Scale (measures perceived security of attachments) and the Self-Administered Psychiatric Scales for Children and Adolescents, a measure of anxiety symptoms, were administered to all participants. Results The clinical group had lower attachment security than the control group and higher scores on all anxiety scales. Anxiety was negatively correlated with attachment. Children’s attachment to their mother mediated the increase in global anxiety in the clinical group. Insecure paternal attachment was associated with greater insecurity in maternal attachment, suggesting that there is a complex pathway from migraine to anxiety symptoms mediated by perceived insecurity of paternal attachment and hence also by perceived insecurity of maternal attachment. Conclusion These results suggest that insecure parental attachment may exacerbate anxiety in children and adolescents with migraine and point to the importance of multimodal interventions, perhaps taking account of family relationships, for children and adolescents with migraine.
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Precenzano F, Ruberto M, Parisi L, Salerno M, Maltese A, Gallai B, Marotta R, Lavano SM, Lavano F, Roccella M. Visual-spatial training efficacy in children affected by migraine without aura: a multicenter study. Neuropsychiatr Dis Treat 2017; 13:253-258. [PMID: 28184165 PMCID: PMC5291325 DOI: 10.2147/ndt.s119648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Routinely in the clinical practice, children affected by migraine without aura (MwA) tend to exhibit severe and persistent difficulties within cognitive processes such as attention, memory, and visual-motor integration (VMI) skills. The aim of this study was to assess the visual-spatial and visual-motor abilities among a sample of children with MwA and the effects of a specific computerized training. The study population was composed of 84 patients affected by MwA (39 girls and 45 boys; mean age: 8.91±2.46 years), and they were randomly divided into two groups (group A and group B) comparable for age (P=0.581), gender (P=0.826), socioeconomic status (SES), migraine frequency (P=0.415), and intensity (P=0.323). At baseline (T0), the two groups were comparable for movement assessment battery for children (M-ABC) and VMI performances. After 6 months of treatment (T1), group A showed lower scores in the dexterity item of M-ABC test (P<0.001) and higher scores in M-ABC global performance centile (P<0.001) and total (P<0.001), visual (P=0.017), and motor (P<0.001) tasks of VMI test than group B. Moreover, at T1, group A showed higher scores in total (P<0.001) and motor (P<0.001) tasks of VMI test and in M-ABC global performance centile (P<0.001) and lower scores in the dexterity item of M-ABC test (P<0.001) than at T0. Group B showed, at T1, performances comparable to T0 for all evaluations. As reported by recent studies about alteration MwA among children in motor abilities, our study confirmed these difficulties and the efficacy of a specific software training, suggesting a new rehabilitative proposal in childhood.
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Affiliation(s)
- Francesco Precenzano
- Clinic of Child and Adolescent Neuropsychiatry, Headache Center for Children and Adolescent. Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania Luigi Vanvitelli
| | - Maria Ruberto
- Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - Lucia Parisi
- Department of Psychological, Pedagogical and Educational Sciences
| | - Margherita Salerno
- Sciences for Mother and Child Health Promotion, University of Palermo, Palermo
| | - Agata Maltese
- Department of Psychological, Pedagogical and Educational Sciences
| | - Beatrice Gallai
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia
| | | | | | | | - Michele Roccella
- Department of Psychological, Pedagogical and Educational Sciences
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14
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Donnelly TJ, Jaaniste T. Attachment and Chronic Pain in Children and Adolescents. CHILDREN-BASEL 2016; 3:children3040021. [PMID: 27792141 PMCID: PMC5184796 DOI: 10.3390/children3040021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 11/16/2022]
Abstract
Although attachment theory is not new, its theoretical implications for the pediatric chronic pain context have not been thoroughly considered, and the empirical implications and potential clinical applications are worth exploring. The attachment framework broadly focuses on interactions between a child’s developing self-regulatory systems and their caregiver’s responses. These interactions are believed to create a template for how individuals will relate to others in the future, and may help account for normative and pathological patterns of emotions and behavior throughout life. This review outlines relevant aspects of the attachment framework to the pediatric chronic pain context. The theoretical and empirical literature is reviewed regarding the potential role of attachment-based constructs such as vulnerability and maintaining factors of pediatric chronic pain. The nature and targets of attachment-based pediatric interventions are considered, with particular focus on relevance for the pediatric chronic pain context. The potential role of attachment style in the transition from acute to chronic pain is considered, with further research directions outlined.
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Affiliation(s)
- Theresa J Donnelly
- Department of Pain & Palliative Care, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
| | - Tiina Jaaniste
- Department of Pain & Palliative Care, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
- School of Women's and Children's Health, University of New South Wales, Kensington, NSW 2052, Australia.
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15
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Gatta M, Spitaleri C, Balottin U, Spoto A, Balottin L, Mangano S, Battistella PA. Alexithymic characteristics in pediatric patients with primary headache: a comparison between migraine and tension-type headache. J Headache Pain 2015; 16:98. [PMID: 26607363 PMCID: PMC4659793 DOI: 10.1186/s10194-015-0572-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/06/2015] [Indexed: 01/03/2023] Open
Abstract
Background Alexithymia is a personality construct characterized by difficulties in verbal emotional expression and a limited ability to use one’s imagination. Evidence of alexithymic characteristics was found in adults suffering from headache, while little is known about children. The aim of this study was to establish the prevalence of alexithymia in two different subgroups of children and adolescents suffering from primary headache. We also looked for correlation between alexithymia in children and in their mothers. Methods This study involved 89 participants: 47 (11 males, 36 females, aged 8 to 17 years) suffering from tension-type headache (TTH), and 42 (18 males, 24 females, aged 8 to 17 years) suffering from migraine (M), based on the International Classification of Headache Disorders (ICHD 2013). A control group of 32 headache-free subjects (26 females and 6 males, aged 8 to17 years) was also considered. Two questionnaires were administered to measure alexithymia: the Alexithymia Questionnaire for Children to young patients and controls, and the Toronto Alexithymia Scale (TAS-20) to the mothers. Results Higher rates of alexithymia emerged in the TTH group compared to the M group. In particular, TTH sufferers had difficulty identifying their feelings. The mothers of children with headaches didn’t score higher in alexithymia compared to other mothers. In the M and in the control group, there was a significant correlation between the rates of alexithymia in young people and in their mothers. Conclusions To date no other study has investigated alexithymia in subgroups of primary headaches in developmental age. Our results suggest that patients suffering from TTH are more alexithymic than M patients. This pave the way to etiopathogenetic and clinical considerations, calling for a comprehensive and multidisciplinary approach to tackle the problem of headache.
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Affiliation(s)
- M Gatta
- Department of Woman and Child Health, University of Padova, Padova, Italy.
| | - C Spitaleri
- Department of Child and Adolescent Neuropsychiatry, University of Palermo, Palermo, Italy.
| | - U Balottin
- Child Neuropsychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy. .,Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - A Spoto
- Department of General Psychology, University of Padova, Padova, Italy.
| | - L Balottin
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy.
| | - S Mangano
- Department of Child and Adolescent Neuropsychiatry, University of Palermo, Palermo, Italy.
| | - P A Battistella
- Department of Woman and Child Health, University of Padova, Padova, Italy.
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16
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Perillo L, Esposito M, Caprioglio A, Attanasio S, Santini AC, Carotenuto M. Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept. Patient Prefer Adherence 2014; 8:353-9. [PMID: 24672229 PMCID: PMC3964173 DOI: 10.2147/ppa.s58971] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dental malocclusions can be considered not only as an oral health problem, because they are linked to quality of life perception. Many factors related to malocclusion have strong influences on the perception of facial esthetics (eg, anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, and overjet). Many reports have shown that the perception of facial esthetics can influence psychological development from early childhood to adulthood. The aim of this study is to investigate the effect of dental malocclusion on self-esteem in a sample of adolescents. MATERIALS AND METHODS The study population was composed of 516 orthodontically untreated subjects (256 males) mean ages 13.75±1.977 years recruited from schools in the Campania region of Italy between January 2011 and July 2011. To evaluate the self-esteem grade in our population, all subjects filled out the Multidimensional Self Concept Scale questionnaire and attended an orthodontic clinical evaluation to estimate dental occlusal aspects. RESULTS Pearson's analysis shows the relationship in our sample between some occlusal characteristics (crossbite and dental crowding) and aspects of self-concept evaluation (social, competence, academic, physical, and global score) of the Multidimensional Self Concept Scale questionnaire. Moreover, logistic regression analysis shows the potential role of dental crowding (odds ratio 5.359; 95% confidence interval 3.492-8.225) and crossbite (odds ratio 6.153; 95% confidence interval 3.545-10.678) as risk factors for development of global self-concept score abnormalities. CONCLUSION Our findings confirm the relationship between psychosocial well-being, self-esteem, and dental malocclusion among adolescents.
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Affiliation(s)
- Letizia Perillo
- Department of Orthodontics, Second University of Naples, Naples, Italy
| | - Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | | | | | - Annamaria Chiara Santini
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
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Esposito M, Gallai B, Roccella M, Marotta R, Lavano F, Lavano SM, Mazzotta G, Bove D, Sorrentino M, Precenzano F, Carotenuto M. Anxiety and depression levels in prepubertal obese children: a case-control study. Neuropsychiatr Dis Treat 2014; 10:1897-902. [PMID: 25336955 PMCID: PMC4200069 DOI: 10.2147/ndt.s69795] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Childhood obesity has become a worldwide epidemic in Western and in developing countries and has been accompanied by many serious and severe comorbidities, such as diabetes, hypertension, sleep apnea syndrome, depression, dyslipidemia, impaired glucose homeostasis, steatohepatitis, and intracranial hypertension, as well as medical concerns unique to youth, such as accelerated pubertal and skeletal development and orthopedic disorders. To date, no specific studies about the psychological assessment in pediatric obesity are present. Therefore, the aim of this study was to evaluate the putative relationship between psychological troubles and obesity in a sample of school-aged children. MATERIALS AND METHODS The study population consists of 148 obese subjects (body mass index [BMI] >95th percentile) (69 males, mean age 8.9±1.23 years) consecutively referred from clinical pediatricians to the Child and Adolescent Neuropsychiatry department at the Second University of Naples. In all subjects, weight, height, and BMI z-score were evaluated. In order to assess the anxiety levels and the presence of depressive symptoms, the Children Depression Inventory (CDI) and the Italian Self-Administered Psychiatric Scales for Children and Adolescents (SAFA) were administered. The control group consisted of 273 healthy children (129 males and 144 females) (mean age 9.1±1.8 years), enrolled in schools within the Campania region of Italy. RESULTS No significant differences between the two study groups were found for age (8.9±1.23 years in the obese sample and 9.1±1.8 years in the control group) (P=0.228) or sex (ratio male/female: 69/79 in the obese group versus 129/144 in the control group) (P=0.983). Obviously, significant difference was found for the BMI z-score (2.46±0.31 in the obese group vs 0.73±0.51 in the control group) (P<0.001). The obese subjects showed significant higher level of depressive symptoms (CDI total score) (16.82±7.73 vs 8.2±2.9) (P<0.001) and anxiety (SAFA - Anxiety [SAFA-A]) scale score (58.71±11.84 vs 27.75±11.5) (P<0.001) compared with the control group. Moreover, the Pearson's correlation analysis showed a significantly positive relationship between the BMI z-score and both the CDI (r=0.677; P<0.001) and SAFA-A scores (r=0.591; P<0.001). CONCLUSION Our findings highlighted the importance of assessing the presence of internalizing problems, such as anxiety and depression, in the common management of childhood obesity.
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Affiliation(s)
- Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Beatrice Gallai
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | - Rosa Marotta
- Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Francesco Lavano
- Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | | | - Giovanni Mazzotta
- Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy
| | - Domenico Bove
- Centro per la Diagnosi e Cura dei Disturbi dell'apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Michele Sorrentino
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Francesco Precenzano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
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Esposito M, Ruberto M, Gimigliano F, Marotta R, Gallai B, Parisi L, Lavano SM, Roccella M, Carotenuto M. Effectiveness and safety of Nintendo Wii Fit Plus™ training in children with migraine without aura: a preliminary study. Neuropsychiatr Dis Treat 2013; 9:1803-10. [PMID: 24453490 PMCID: PMC3890965 DOI: 10.2147/ndt.s53853] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Migraine without aura (MoA) is a painful syndrome, particularly in childhood; it is often accompanied by severe impairments, including emotional dysfunction, absenteeism from school, and poor academic performance, as well as issues relating to poor cognitive function, sleep habits, and motor coordination. MATERIALS AND METHODS The study population consisted of 71 patients affected by MoA (32 females, 39 males) (mean age: 9.13±1.94 years); the control group consisted of 93 normally developing children (44 females, 49 males) (mean age: 8.97±2.03 years) recruited in the Campania school region. The entire population underwent a clinical evaluation to assess total intelligence quotient level, visual-motor integration (VMI) skills, and motor coordination performance, the later using the Movement Assessment Battery for Children (M-ABC). Children underwent training using the Wii-balance board and Nintendo Wii Fit Plus™ software (Nintendo Co, Ltd, Kyoto, Japan); training lasted for 12 weeks and consisted of three 30-minute sessions per week at their home. RESULTS The two starting populations (MoA and controls) were not significantly different for age (P=0.899) and sex (P=0.611). M-ABC and VMI performances at baseline (T0) were significantly different in dexterity, balance, and total score for M-ABC (P<0.001) and visual (P=0.003) and motor (P<0.001) tasks for VMI. After 3 months of Wii training (T1), MoA children showed a significant improvement in M-ABC global performance (P<0.001), M-ABC dexterity (P<0.001), M-ABC balance (P<0.001), and VMI motor task (P<0.001). CONCLUSION Our study reported the positive effects of the Nintendo Wii Fit Plus™ system as a rehabilitative device for the visuomotor and balance skills impairments among children affected by MoA, even if further research and longer follow-up are needed.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Child and Adolescent Neuropsychiatry Clinic, Department of Mental Health, Physical and Preventive Medicine, Naples, Italy
| | - Maria Ruberto
- Department of Odonto-Stomathologic Disciplines, Pathology - Orthopedic Sciences, Second University of Naples, Naples, Italy
| | - Francesca Gimigliano
- Center for Childhood Headache, Child and Adolescent Neuropsychiatry Clinic, Department of Mental Health, Physical and Preventive Medicine, Naples, Italy ; Department of Odonto-Stomathologic Disciplines, Pathology - Orthopedic Sciences, Second University of Naples, Naples, Italy
| | - Rosa Marotta
- Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Beatrice Gallai
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | | | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Child and Adolescent Neuropsychiatry Clinic, Department of Mental Health, Physical and Preventive Medicine, Naples, Italy
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