Academic article summaries from Module III

Amanda Bills
Comp 106
November 16, 2008
Module III
Effects of Headaches on Children and Adults

The first article I read, entitled “Temperament and haracter Profiles of Patients with Tension-Type Headache and Migraine,” was regarding whether temperaments and character profiles differed between people who experience headaches (migraines and tension type headaches, or TTH) and those who don’t. The article supports the idea that these types of headaches are related to depression and some personality disorders. Some researchers of this topic have used the Minnesota Multiphasic Personality Inventory (MMPI) to study the personalities of people who experience these headache types. Some have found that MMPI scores of migraine sufferers were within normal limits, according to the results of the healthy controls, but those of TTH sufferers were not. Mentioned in the article are Cloninger et al, who developed the Psychobiological Model of Personality approach. This approach examines seven personality traits, four of which considered dimensions of temperament; the other three dimensions of character. These dimensions reflected various responses depending on sex, age, level of education, and BDI (Beck Depression Inventory, which verified validity and reliability of depressive symptomatology) in relation to both types of headache. At the end of the article, the authors inform the reader that their presumptions about the effect serotonin levels have on tension type headaches, if any, were indirect interpretations because they were based on self-administered questions and no physiological variables were actually assessed.
The second article, “Sleep, Sleepiness, and Behavior Problems in Children with Headache,” also looks into migraine and tension-type headaches. Like in the first article, the authors found that headaches affect temperament and behavior and, not surprisingly, temperament and behavior can be indicators of headaches in young children. For example, changes in sleep patterns and difficulty sleeping are correlated with headaches in children, in that children who suffer from headache have a high rate of sleep difficulties. In addition, headaches have been linked to specific sleep disorders and snoring. Also, sleep problems in early childhood predict headaches in children who are of school entry age. Bruni et al conducted a study of frequency, duration, and intensity of headaches and found no differences in children with sleep difficulties versus those without. On the other hand, they did find that children with headaches had higher rates of sleep difficulties. Bruni and colleagues also found that migraines were associated with less sleep, fear of falling asleep, and bedtime refusal in children aged two years to twelve years. Related too are headaches and psychopathology, with some gender differences. For instance, girls who were found to have anxiety and depression showed higher rates of headaches than girls without these internalizing disorders, and boys’ behaviors were connected to externalizing disorders such as Attention Deficit Hyperactivity Disorder (ADHD). Furthermore, sleep disorders and headaches have been associated with stress in children. In terms of sleep and sleepiness, to paraphrase the article: boys with headaches fell asleep earlier than boys without headaches, while girls with headaches fell asleep later than girls without headaches. Also, to paraphrase again: boys with headaches slept more and spent more time in true sleep, while girls with headaches slept less and spent less time in true sleep than the children in the control group. Earlier (morning) rise time was proven to have a correlation to the severity of headaches. One factor that is not considered in this article is the children’s sleep needs, which in some cases could have been high.
Lastly, in the third article, “Serial Headache Drawings by Children with Migraine: Correlation with Clinical Headache Status,” a previous study, done by the authors, was described in which children were asked to draw a picture of what their headaches felt like. Because children aren’t always able to report headache pain and auras, the authors of this article studied the pictures drawn by children suffering from headaches, and whether those pictures could be used to diagnose migraines. In 90% of the cases, drawings predicted the diagnosis of migraine versus non-migraine headaches. Their next study is discussed in this article. Its purpose was to analyze the drawings made by children who received treatment for migraine headaches. The drawings made after treatment were compared to those made before treatment and evaluated to see if they showed improvement. Out of 111 children in the study, only 12 of the patients’ drawings were considered not to show improvement due to disagreement among the raters.