Introduction to Special Section: Innovations in Pediatric Headache Research

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DOI: 10.1093/jpepsy/jsac023


Headache in children and adolescents remains one of the most common of all health conditions. Over 700 million youth ages 5–19 across the world have migraine or tension-type headache, with these two conditions alone accounting for 7% of all-cause years lived with disability (Leonardi et al., 2020). By mid-adolescence, migraine ranks first among all other diseases for disability-adjusted life-years (Stovner et al., 2018). Worldwide data indicates that prevalence of pediatric headache disorders is increasing, and the associated significant disease burden is at best unchanged despite advances in medical treatments (Nieswand et al., 2020). Each headache episode during childhood can result in an increased risk for progressive worsening of headache frequency, severity, and impact into adulthood (Isensee et al., 2016; Torres-Ferrús et al., 2020). Thus, research to inform the identification and effective treatment of headache disorders in childhood remains urgently needed.

We have long known that headache frequency, intensity, and interference in child/family life are modulated by socio-environmental, behavioral, cognitive, and emotional factors (Andrasik et al., 2005; Nicholson et al., 2007). Recent advances in the understanding of the pathophysiology of headache disorders continue to support this biopsychosocial conceptualization, with multidisciplinary care considered the aspirational standard to address the complexity of factors involved in these conditions (Oskoui et al., 2019). For most youth with headache, however, pharmacological therapies remain the first-line intervention (Ernst et al., 2015; Knestrick et al., 2022). Referral to multidisciplinary care often occurs only after numerous medical treatments have been unsuccessful (Zernikow, 2021). A large body of research supports the efficacy and safety of psychological pain management interventions (e.g., cognitive-behavioral therapy, biofeedback, relaxation training) as part of multidisciplinary care (Fisher et al., 2018), but patient response is variable and effect sizes for changes in headache frequency and disability are in the small to medium range (Fisher et al., 2018). To advance the field of pediatric headache medicine, strategies to reduce barriers to multidisciplinary care and optimize available psychological pain management interventions are needed.

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Journal of Pediatric Psychology





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