A Pilot Test of an Intervention for Teens with Chronic Daily Headaches

描述(申请人提供)：目前估计美国有近500,000名青少年患有慢性日常头痛(CDH)。青少年慢性日常头痛(CDH)的治疗是医疗保健提供者面临的最大挑战之一，因为如果不及时和有效地治疗，这些疾病会在青少年中造成严重的发病率。由于慢性日常头痛的负担，青少年经常耗尽他们的情绪和功能应对能力，并经历抑郁症状、焦虑和退学和其他社会活动的增加。此外，与没有头痛病史的青少年相比，患有CDH的青少年自杀的风险明显更大。尽管与CDH相关的发病率和死亡率很高，但在这一青少年高危人群中，改善预后的干预研究很少。因此，迫切需要专门针对患有CDH的青少年进行基于理论的干预研究，以改善他们的情绪和功能性应对结果，包括他们头痛、头痛残疾以及抑郁和焦虑症状的频率和严重程度。认知行为理论补充了压力和应对的心理学理论，作为拟议的可重复干预的理论基础，包括7个旨在提高CDH青少年应对结果的教育和认知行为技能培养会议。这项针对50名患有CDH和轻中度抑郁症状的青少年的初步研究的目的是：1)评估对患有CDH的青少年进行教育认知行为技能培养干预的可行性和可接受性；2)测试教育认知技能培养干预对头痛残疾、情绪应对(即抑郁和焦虑症状)、功能性应对(即参与学校、工作和其他适龄活动)的初步效果；以及3)描述研究变量之间的关系。这是旨在改善CDH青少年健康结局的研究计划中的第一项研究。 公共卫生相关性：青少年慢性日常头痛的治疗是医疗保健提供者面临的最大挑战之一，对青少年来说是一种负担，因为如果不及时有效地治疗，这些头痛会导致严重的发病率。由于慢性日常头痛的负担，青少年往往会耗尽他们的情绪和功能应对能力，并可能出现抑郁症状、焦虑、退学和其他社会活动。及时和有效地管理青少年的慢性日常头痛，特别是那些有抑郁症状的青少年，对于减少包括抑郁、焦虑、自杀和其他行为表现在内的多种不良后果的风险至关重要。

DESCRIPTION (provided by applicant): It is currently estimated that nearly 500,000 adolescents in the United States suffer with chronic daily headaches (CDH). Treatment of chronic daily headaches (CDH) in adolescents is one of the biggest challenges for healthcare providers as they cause significant morbidity in adolescents if not treated timely and effectively. Because of the burden of chronic daily headaches, adolescents frequently exhaust their emotional and functional coping abilities and experience elevated depressive symptoms, anxiety, and withdrawal from school and other social activities. Furthermore, the risk of suicide is significantly greater in adolescents with CDH compared to teens with no headache history. Despite the substantial morbidities and mortality associated with CDH, there is a paucity of intervention studies to improve outcome in this high-risk population of teens. Thus, there is an urgent need for theory-based intervention studies that focus exclusively on adolescents with CDH to improve their emotional and functional coping outcomes, including frequency and severity of their headaches, headache disability, and depressive and anxiety symptoms. Cognitive Behavior Theory complements the Psychological Theory of Stress and Coping as theoretical underpinnings for the proposed reproducible intervention, comprised of 7 education and cognitive-behavioral skills building sessions designed to enhance coping outcomes in adolescents with CDH. The aims of the proposed pilot study with 50 adolescents who have CDH and mild to moderate depressive symptoms are to: 1) assess the feasibility and acceptability of an educational cognitive behavioral skills building intervention with teens who have CDH, 2) test the preliminary effects of an educational cognitive skills building intervention on headache disability, emotional coping (i.e. depressive and anxiety symptoms), functional coping (i.e. involvement in school, work, and other age appropriate activities)) and, 3) describe the relationship among study variables. This is the first study in a program of research designed to improve the health outcomes of adolescents with CDH. PUBLIC HEALTH RELEVANCE: Treatment of chronic daily headaches in adolescents is one of the biggest challenges for healthcare providers and is a burden for teens as they cause significant morbidity if not treated effectively and in a timely manner. Because of burden of chronic daily headaches, adolescents, oftentimes exhaust their emotional and functional coping abilities and may experience depressive symptoms, anxiety, and withdrawal from school and other social activities. Timely and effective management of chronic daily headaches in adolescents, especially those with depressive symptoms, is essential in order to decrease the risk of multiple adverse outcomes to include depression, anxiety, suicide and other behavioral manifestations.