Influences on Stress Load in Young Girls with Chronic Headache

Research Article

Austin Child Adolesc Psychiatry. 2022; 6(1): 1022.

Influences on Stress Load in Young Girls with Chronic Headache

Simone Bung, Helmut Saile and Reinhold Laessle*

University of Trier, Frauenstr 7, 54290 Trier, Germany

*Corresponding author: Reinhold Laessle, University of Trier, Frauenstr 7, 54290 Trier, Germany

Received: March 02, 2022; Accepted: March 22, 2022; Published: March 29, 2022


The present study investigated influences of stress coping strategies and activity of HPA axis on stress load in young girls with chronic headache (migraine or tension-type). Anxiety and depression were also measured. These psychopathological characteristics significantly contributed to stress load, whereas the activity of HPA axis had no contribution. A lack of seeking social support and destructive stress coping were identified as possible influencing factors.

Keywords: Headache; Adolescents; Stress load; Stress coping; Anxiety; Depression


Chronic headache in children and adolescents is frequent. A metaanalysis of [1] was based on data of 50 studies, which were published worldwide and included 80,000 patients. Lifetime prevalence of chronic headache was 58.4%. For migraine in particular 7, 7% are reported, whereby the prevalence for girls is greater than for boys.

Stress load in daily life of adolescents with chronic headache is heightened, which has been shown in a study of [2] in 113 school girls.

The interrelationship between stress and headache in the longterm has been confirmed also by [3].

A very high stress load in university students with chronic headache was observed in a case-control study of [4]. When a high stress load was present in young college students, headache was significantly more present than other somatic complaints [5].

School absenteeism as an indicator of stress load has been found in adolescents with chronic headache by [6].

On the other hand stress coping of youth with chronic headache is characterized by widely inadequate strategies. This has been demonstrated in a study of [7] by using projective test methods.

A long-term study of [8] found a high comorbidity of headache and anxiety as well as depression.

This was supported by [9].

A third study by [10] presented the same results.

The empirical evidence suggests that girls with headache are suffering from more stress load and on the other hand are not able to cope adequately with stress. The present investigation is an attempt to confirm previous results. As an extension to previous data influences on stress load were investigated.


All participants with headache were recruited in schools and had to fulfill ICHD-3 criteria for migraine or tension-type headache. The control group was recruited on the University campus in Trier. Before participation, acute diseases were excluded by a medical doctor.

20% of the girls fulfilled the criteria for migraine, 70% criteria for tension-type headache, the rest could not be classified definitely.

Depression and anxiety of the children were measured by [12,13].

Stress load was assessed by the questionnaire for stress and stress coping for children and adolescents (SSKJ) [14].

The subscales comprise: 1) Vulnerability to stress; 2) Physical symptoms of stress such as headache, stomach ache or exhaustion. 3) Psychological symptoms of stress such as depressed mood and anxiety.


Comparison of mean values with MANOVA revealed F (3,145) = 9.4 p<0.001. Girls with headache had physically as well as psychologically more stress load and were also more vulnerable against stress situations (Table 1 and 2).