Paediatric headache trajectories - a reappraisal after nine years.

Background The long-term consequences of paediatric headache can involve functional disabilities and mental health problems in adulthood. Objective To analyse the predictive power of paediatric headache trajectory classes for headache and related outcomes in adulthood. Methods In a previous study, a population-based sample (N = 3227, 9-14 years of age at first assessment) was followed across four annual assessment points, and sex-specific headache trajectory classes were identified (girls: "no pain", "moderate pain", "increasing pain", "high pain"; boys: "no pain", "moderate pain"). These trajectory classes were used to predict headache frequency, functional disability, depression, quality of life and self-efficacy nine years later (N = 994). Negative binomial regression analyses and pairwise comparisons were computed. Results Women showing an elevated trajectory ("increasing pain" or "high pain") had a higher adult headache frequency and a poorer outcome on associated variables (functional disability, depression, quality of life, and self-efficacy) than women having a lower-level trajectory. Men of the "no pain" and "moderate pain" trajectory classes differed significantly from one another in their headache frequency and related variables. Conclusion Belonging to an elevated paediatric headache trajectory class involves a considerable risk for headache and headache-related problems in adulthood.

Developmental trajectories of paediatric headache - sex-specific analyses and predictors.

BACKGROUND: Headache is the most common pain disorder in children and adolescents and is associated with diverse dysfunctions and psychological symptoms. Several studies evidenced sex-specific differences in headache frequency. Until now no study exists that examined sex-specific patterns of change in paediatric headache across time and included pain-related somatic and (socio-)psychological predictors. METHOD: Latent Class Growth Analysis (LCGA) was used in order to identify different trajectory classes of headache across four annual time points in a population-based sample (n = 3 227; mean age 11.34 years; 51.2 % girls). In multinomial logistic regression analyses the influence of several predictors on the class membership was examined. RESULTS: For girls, a four-class model was identified as the best fitting model. While the majority of girls reported no (30.5 %) or moderate headache frequencies (32.5 %) across time, one class with a high level of headache days (20.8 %) and a class with an increasing headache frequency across time (16.2 %) were identified. For boys a two class model with a 'no headache class' (48.6 %) and 'moderate headache class' (51.4 %) showed the best model fit. Regarding logistic regression analyses, migraine and parental headache proved to be stable predictors across sexes. Depression/anxiety was a significant predictor for all pain classes in girls. Life events, dysfunctional stress coping and school burden were also able to differentiate at least between some classes in both sexes. CONCLUSIONS: The identified trajectories reflect sex-specific differences in paediatric headache, as seen in the number and type of classes extracted. The documented risk factors can deliver ideas for preventive actions and considerations for treatment programmes.

Two dimensions of social anxiety disorder: a pilot study of the Questionnaire for Social Anxiety and Social Competence Deficits for Adolescents.

BACKGROUND: The Questionnaire for Social Anxiety and Social Competence Deficits for Adolescents (SASKO-J) was developed as an instrument for clinical diagnostics of social anxiety disorder in youths by measuring social anxiety and social deficits in two separate dimensions. The study provides an initial assessment of the scale's psychometric properties in a clinical sample. METHOD: The reliability and validity of the SASKO-J were assessed in a mixed clinical sample of 12- to 19-year-old German adolescents (N = 85; mean age 15.71 years; SD = 1.92; 62.4 % girls). In a second step, the diagnostic validity was evaluated in a clinical sample of 31 adolescent patients with social anxiety disorder (mean age 16.10 years; SD = 1.54; 74.2 % girls) and a sample of 115 German high school students (mean age 15.84 years; SD = 1.65; 60.9 % girls) via Receiver Operating Characteristic (ROC) analysis. RESULTS: The internal consistencies of the total scale and the subscales were good to excellent (0.80 ≤ α ≤ 0.96), and the results indicated a good convergent and divergent validity. The ROC analysis revealed a satisfying area under curve (AUC = 0.866), and a cutoff of 41.5 for the SASKO-J total score represented the best balance of sensitivity (0.806) and specificity (0.826). CONCLUSIONS: The results of this pilot study provide initial support for the clinical use of the SASKO-J in the diagnostic process. Future research should address the question of psychometric properties in a social anxiety disorder sample as well as the questionnaire's sensitivity for detecting change in symptoms during therapy.

Developmental trajectories and predictors of externalizing behavior: a comparison of girls and boys.

Recent studies have shown that the development of externalizing behavior in childhood and adolescence can be described through different developmental pathways. However, knowledge about differences between the sexes regarding the trajectories is limited. This study focused on potential differences by examining the trajectories of self-reported externalizing symptoms for girls and boys separately. In addition, the relationships of several familiar and child-specific variables with those developmental courses were assessed. The study was conducted on a large community sample of German youths (N = 3,893; mean age 11.38 years; 50 % girls) over 4 years. Using growth mixture modeling, three different classes of trajectories were found for both sexes. The classes differed with regard to the level and the course of symptoms ("low", "moderate", "high-decreasing"). Girls were overrepresented in the "low" class, whereas boys were predominant in the "moderate" and "high-decreasing" classes. The multiple group analysis revealed that the girls and boys differed significantly in their level and linear course of symptoms with regard to the "high-decreasing" class. In contrast, no sex differences were found in the growth factors of the "low" and "moderate" classes. The regression analyses showed that the children's depressive symptoms, dysfunctional parenting style, and negative family climate were associated significantly with the level and course of symptoms as well as the class membership of girls and boys. Life events predicted class membership only for boys, whereas maternal depressive symptoms and family conflict did not demonstrate any significant relationship. The sizes of the predictive associations with the growth factors were similar for both sexes. The results are discussed with regard to existing developmental models and their possible implications for prevention and future research.

Different trajectories of depressive symptoms in children and adolescents: predictors and differences in girls and boys.

The development of depressive symptoms in childhood and adolescence can follow different pathways. This study examined heterogeneity in the development of self-reported depressive symptoms and the predictive influence of mothers' depressive symptoms, the number of life events, and loss events via growth mixture modeling over a four-year period in a large community sample of German children and adolescents (N = 3,902; mean age 11.39 years; 49.6% female). This procedure was conducted for the total sample as well as for separate samples of girls and boys. Four different classes of trajectories for the total and the girls' model were identified, but only three classes for the boys. Girls showed higher intercepts and stronger increases in symptoms over time, whereas boys displayed stronger decreases. In the total model, mothers' depressive symptoms and the number of life events significantly increased the level of depressive symptoms. In the gender models, only mothers' depressive symptoms showed significant influence on the level of symptoms in girls and boys, whereas for life events this was only true for boys. In every model, the significant predictors discriminated at least between some classes. Loss events showed no significant influence in any model. In sum, there are meaningful differences in the development of depressive symptoms in girls and boys. These results have several implications for prevention and future research.