Balottin Laura, Mannarini Stefania, Candeloro Daniela, Mita Alda, Chiappedi Matteo, Balottin Umberto
Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy.
Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Front Neurol. 2018 Mar 20;9:160. doi: 10.3389/fneur.2018.00160. eCollection 2018.
The literature examining primary headache, including migraine, in adolescents, has pointed out the key role played by a wide range of psychiatric disorders in reducing the patients' quality of life. Moreover, pioneering studies showed that preexisting personality characteristics, specific emotion regulation styles and psychological-psychiatric difficulties are likely to increase the risk of the onset, maintenance, and outcome of headache. Still personality issues in migraine have been poorly studied, in particular in children and adolescents. This study aims, therefore, to investigate the specific characteristics of personality, and in particular emotion regulation and coping strategies, in adolescent with migraine, comparing them with age-matched patients with idiopathic epilepsy and healthy adolescents. 52 adolescents (age: 11-17) were assessed using a multi-method test battery, which included a self-report questionnaire (the youth self-report), a proxy-report (child behavior checklist) along with a projective personality test, the Rorschach Test, administered and scored according to the Exner comprehensive system. The results showed specific personality characteristics in adolescents with migraine, revealing a marked difficulty in modulating and regulating affections through thoughts and reflections, resorting instead to impulsive acts and maladaptive coping strategies, thus revealing a vague and immature perception of reality. Differently from adolescents belonging to the general population, but similarly to patients with epilepsy, adolescents with migraine perceive a high situational stress, probably related to the condition of suffering from chronic disease. They have, therefore, a lower self-consideration and self-esteem along with a poorer insight regarding themselves as well as the relations with others. In line with previous findings, these preliminary results suggest the need for further research on ample samples, using also standardized projective test in order to better understand the pathogenesis of psychological difficulties in patients with migraine. As a clinical implication, the results seem to indicate that providing a psychological integrated approach can play a pivotal role in the assessment and treatment of adolescent with migraine, in order to improve the outcome and the quality of life of the young patients.
关于青少年原发性头痛（包括偏头痛）的文献指出，多种精神疾病在降低患者生活质量方面发挥着关键作用。此外，开创性研究表明，先前存在的人格特征、特定的情绪调节方式以及心理 - 精神方面的困难可能会增加头痛发作、持续和预后的风险。然而，偏头痛中的人格问题研究较少，尤其是在儿童和青少年中。因此，本研究旨在调查偏头痛青少年的人格特质，特别是情绪调节和应对策略，并将他们与年龄匹配的特发性癫痫患者和健康青少年进行比较。52名青少年（年龄：11 - 17岁）使用多方法测试组合进行评估，该测试组合包括一份自我报告问卷（青少年自我报告）、一份代理报告（儿童行为清单）以及一项投射性人格测试——罗夏测验，并根据埃克斯纳综合系统进行施测和评分。结果显示偏头痛青少年具有特定的人格特征，表明他们在通过思考和反思来调节和管理情感方面存在明显困难，而是诉诸冲动行为和适应不良的应对策略，从而揭示出对现实的模糊和不成熟认知。与普通人群中的青少年不同，但与癫痫患者相似，偏头痛青少年感受到较高的情境压力，这可能与患有慢性病的状况有关。因此，他们的自我认知和自尊较低，对自己以及与他人关系的洞察力也较差。与先前的研究结果一致，这些初步结果表明需要对大量样本进行进一步研究，同时使用标准化的投射性测试，以便更好地理解偏头痛患者心理困难的发病机制。作为临床启示，结果似乎表明提供一种心理综合方法在偏头痛青少年的评估和治疗中可以发挥关键作用，以改善年轻患者的预后和生活质量。
