• Tonya M Palermo, Janel Putnam, Geniel Armstrong, and Sarah Daily.
• Department of Anesthesiology and Peri-Operative Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. palermot@ohsu.edu
• Clin J Pain. 2007 Jun 1;23(5):458-65.

ObjectivesThe aims of this study were to examine the relationships between a range of family factors, including autonomy and general family functioning, on headache outcomes (ie, pain and functional impairment) in adolescents with recurrent headaches.MethodsForty nine adolescents, ages 11 to 16 years, (mean age=13.5 y, 63% female) receiving treatment through pediatric neurology for recurrent headaches were enrolled. Adolescents and their parents completed measures of pubertal status, pain, functional impairment, parental solicitousness, behavioral autonomy, depressive symptoms, and family functioning.ResultsLower levels of adolescent autonomy (r=0.53, P<0.01) and less healthy family functioning (r=0.32, P<0.01) were significantly related to higher levels of functional impairment. In multivariate regression analyses controlling for pain intensity, pubertal status, and depressive symptoms, parent and family variables added significant variance in the prediction of functional impairment (r change=0.21, P<0.05). Both adolescent autonomy (beta=0.38, P<0.05) and general family functioning (beta=0.34, P<0.05) were significant individual predictors of adolescent functional impairment.DiscussionThis study extends research on family factors and adolescent headache-related pain and disability. Future research is needed to discover whether family based interventions helping adolescents to acquire appropriate and supportive levels of autonomy may be useful in reducing headache-related disability.

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