ABSTRACT
Chronic headache in adolescents is frequent and often associated with anxiety and depression. The present study investigated, whether psychological and physical stress symptoms have an infl uence on the occurrence of anxiety and depression and what is the role of stress coping. The sample consisted of 77 15 years old girls with chronic headache and 72 girls, who served as controls. Stress symptoms and stress coping were measured with the Stressverarbeitungsfragebogen für Kinder und Jugendliche (Coping with Stress Questionnaire for Children and Adolescents), depression was assessed by the Depression Inventory for Children and Adolescents, anxiety by the State-Trait Anxiety Inventory for Children. Linear regression was used to analyze the relationship between stress factors and anxiety resp. depression. Physical stress symptoms were related to anxiety, but not to depression. Coping strategies of the depressed as well as the anxious children were characterized by stress reinforcing behaviors. The results point to focusing on physical symptoms in the anxious headache patients and to avoidance coping in the depressed children.
Subject(s)
Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Headache Disorders/epidemiology , Headache Disorders/psychology , Stress, Psychological/complications , Stress, Psychological/epidemiology , Adaptation, Psychological , Adolescent , Cross-Sectional Studies , Female , Humans , Internal-External Control , Risk Factors , Sex Factors , Statistics as Topic , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
Starting from a discussion of the validity of neuropsychological methods for the diagnosis of ADHD the results of an own study are presented. What is the diagnostic value of the German version of the CPT (Continuous Performance Task) and the DAT (Dortmunder Aufmerksamkeitstest) in discriminating ADHD subtypes (according to DSM-IV) and in which areas do the children of each subtype differ from a control group of normal children? The computer versions of the CPT and DAT were administered to 14 boys with the "combined subtype" of ADHD, 14 boys with the "predominantly inattentive type" of ADHD and 18 boys without clinical signs; all groups were matched in age and intelligence. Subsequently the mean differences between the various test parameters were assessed as to their significance. Contrary to other studies there were no significant differences either between both ADHS types or relative to the control group with regard to the CPT omission errors and the reaction time. There were differences in the reaction variability both between the ADHD subtypes and relative to the control group. Only the "combined subtype", not the "pre-dominantly inattentive type" differed from the control group as to the CPT commission errors. Regarding the DAT, there were significant differences between all three groups regarding both the solution quality and the response delay.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Diagnosis, Computer-Assisted , Neuropsychological Tests/statistics & numerical data , Attention , Attention Deficit Disorder with Hyperactivity/classification , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit and Disruptive Behavior Disorders/classification , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Child Behavior Disorders/classification , Child Behavior Disorders/diagnosis , Child Behavior Disorders/psychology , Diagnostic and Statistical Manual of Mental Disorders , Humans , Language Development Disorders/classification , Language Development Disorders/diagnosis , Language Development Disorders/psychology , Learning Disabilities/classification , Learning Disabilities/diagnosis , Learning Disabilities/psychology , Male , Psychometrics/statistics & numerical data , Psychomotor Disorders/classification , Psychomotor Disorders/diagnosis , Psychomotor Disorders/psychology , Reaction Time , Reference Values , Reproducibility of Results , SoftwareABSTRACT
In the present study, Brandtstädter's (1992) distinction between assimilation and accommodation as two fundamental means of coping is applied to the field of chronic pain. Assimilative coping involves active attempts (e.g. instrumental activities, self-corrective actions, compensatory measures) to alter unsatisfactory life circumstances and situational constraints in accordance with personal preferences. Conversely, accommodative coping (e.g. downgrading of aspirations, positive reappraisal, self-enhancing comparisons) is directed towards a revision of self-evaluative and personal goal standards in accordance with perceived deficits and losses. Our research is based on the assumption that chronic pain can be described as a major source of threat or impediment to personal goals. When goals are no longer perceived to be attainable through active-assimilative coping efforts, accommodative coping should become increasingly important in dealing with chronic pain. In a study of 120 chronic pain patients, dispositional differences in assimilative (tenacious goal pursuit) and accommodative coping tendencies (flexible goal adjustment), as well as measures of pain-related coping and adjustment (depression, pain-related disability, pain intensity) were assessed. The results suggest that accommodative coping functions as a protective resource by preventing global losses in the psychological functioning of chronic pain patients and maintaining a positive life perspective. Most important, the ability to flexibly adjust personal goals attenuated the negative impact of the pain experience (pain intensity, pain-related disability) on psychological well-being (depression). Furthermore, pain-related coping strategies led to a reduction of disability only when accompanied by a high degree of flexible goal adjustment. The theoretical and clinical implications of these findings for coping research and the treatment of chronic pain patients are discussed.
