Department of Psychology, Clark University, USA.
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA.
J Pediatr Psychol. 2022 Apr 8;47(4):391-402. doi: 10.1093/jpepsy/jsab115.
Given how frequently youth with chronic headache and migraine experience setbacks in treatment, identifying factors that promote coping and resilience is critical. Mindsets have gained attention as predictors of behavior and targets of intervention across contexts, including health. Health mindsets may help to explain how children with chronic pain interpret and respond to treatment. This study evaluated whether growth health mindsets might relate to adaptive outcomes in patients with chronic pediatric headache.
Participants were 88 children and adolescents (ages 10-17 years) with headache or migraine contacted following an appointment at a pediatric headache clinic, and their parent. Patients rated their beliefs about health as more fixed versus growth-oriented. They were presented with vignettes depicting hypothetical treatment setbacks and instructed to reflect upon real-life setbacks. Patients completed questionnaires about their cognitive appraisals of setbacks, coping, quality of life, life satisfaction, and functional impairment.
The higher children rated their growth health mindsets, the less likely they were to appraise setbacks as threatening and endorse quality-of-life problems. Children with higher growth mindsets reported higher life satisfaction and lower functional disability. There was also an indirect relation between children's mindsets and coping through cognitive appraisals of setbacks as a threat, but not challenge.
This research extends the health mindsets literature by contributing preliminary evidence of health mindsets as tied to adaptive outcomes in youth with chronic headache. These findings may be of interest to clinicians and parents, as health mindsets may offer an avenue by which resilience is promoted and maladaptive appraisals are minimized.
鉴于患有慢性头痛和偏头痛的年轻人在治疗中经常遇到挫折，确定促进应对和适应能力的因素至关重要。心态作为行为预测因素和跨情境干预目标（包括健康）受到了关注。健康心态可能有助于解释患有慢性疼痛的儿童如何解释和应对治疗。本研究评估了慢性儿科头痛患者的成长型健康心态是否与适应性结果相关。
参与者为 88 名儿童和青少年（10-17 岁），他们在儿科头痛诊所就诊后联系了他们的父母。患者对健康的信念评估为更固定型还是成长型。向他们呈现描述假设治疗挫折的情景，并指示他们反思现实生活中的挫折。患者完成了关于挫折认知评估、应对、生活质量、生活满意度和功能障碍的问卷。
儿童对成长型健康心态的评价越高，他们将挫折评估为威胁和引发生活质量问题的可能性就越小。具有较高成长心态的儿童报告生活满意度较高，功能障碍较低。在挫折被视为威胁而不是挑战的情况下，儿童的心态与应对之间也存在间接关系。
本研究通过提供关于慢性头痛青少年健康心态与适应性结果相关的初步证据，扩展了健康心态文献。这些发现可能对临床医生和家长感兴趣，因为健康心态可能提供了促进适应能力和最小化适应不良评估的途径。
