Cognitive processing styles of children and adolescents with headache and back pain: a longitudinal epidemiological study

Figures & data

Figure 1 Flowchart showing numbers of participating children from W1 to W3.

Notes: Children characterized as “new” participants for W2 and W3 were children who reached the age of 9 years in the interim and thus became eligible for filling in the questionnaire for the first time in that wave.
Abbreviations: W1, wave 1 (2003); W2, wave 2 (2004); W3, wave 3 (2005).

Figure 2 Flowchart for the headache incidence sample.

Figure 3 Flowchart for the back pain incidence sample.

Table 1 Dependent variable (criterion 1): headache frequency in the last 6 months (wave 3)

Headache	Absolute frequency (%)
≥1×/week	115 (6.7)
≥1×/month	253 (14.7)
<1×/montha	439 (25.4)
No headachea	858 (49.7)
Missing	60 (3.5)
Total	1,725 (100)

Note:

a Reference categories of items in regression analyses.

Table 2 Control variables for headache: age and sex (wave 2)

Variable	Absolute frequency (%)
Age (years)
10	229 (13.8)
11	281 (16.8)
12	256 (15.4)
13	209 (12.6)
14	236 (14.2)
15	231 (13.8)
16	179 (10.8)
17	44 (2.6)
Sex
Boysa	898 (53.9)
Girls	767 (46.1)

Note:

a Reference categories of items in regression analyses.

Table 3 Predictor variables for headache (wave 2)

Variable	Absolute frequency, n (%)
	Nevera	Seldom/very little	Sometimes	Often	Always/very much	Missing
Dysfunctional stress coping strategies	416 (25.0)	836 (50.2)	327 (19.6)	55 (3.3)	1 (0.1)	30 (1.8)
Pain catastrophizingb	126 (7.6)	259 (15.6)	51 (3.1)	2 (0.1)	–	1,227 (73.6)
Anxiety sensitivity	1,197 (71.8)	426 (25.6)	30 (1.8)	3 (0.2)	1 (0.1)	8 (0.5)
Somatosensory amplification	602 (36.2)	894 (53.6)	152 (9.1)	6 (0.4)	3 (0.2)	8 (0.5)

Notes:

a Reference categories of items in regression analyses;

b the pain catastrophizing items were only answered by children aged 11 years or older.

Table 4 Dependent variable (criterion 2): back pain in the last 6 months (wave 3)

Back pain	Absolute frequency (%)
Always	4 (0.2)
Often	74 (3.6)
Sometimes	274 (13.4)
Seldom	424 (20.8)
Nevera	1,264 (62)
Missing	–
Total	2,040 (100)

Note:

a Reference categories of items in regression analyses.

Table 5 Control variables for back pain: age and sex (wave 2)

Variable	Absolute frequency (%)
Age (years)
10	302 (14.7)
11	359 (17.6)
12	336 (16.5)
13	299 (14.7)
14	265 (13)
15	231 (11.3)
16	198 (9.7)
17	50 (2.5)
Sex
Boysa	1,098 (53.8)
Girls	942 (46.2)

Note:

a Reference categories of items in regression analyses.

Table 6 Predictor variables for back pain (wave 2)

Variable	Absolute frequency, n (%)
	Nevera	Seldom/very little	Sometimes	Often	Always/very much	Missing
Dysfunctional stress coping strategies	506 (24.8)	1,015 (49.8)	419 (20.5)	63 (3.1)	2 (0.1)	35 (1.7)
Pain catastrophizingb	181 (8.9)	458 (22.5)	90 (4.4)	12 (0.6)	–	1,299 (63.6)
Anxiety sensitivity	1,421 (69.6)	559 (27.4)	48 (2.4)	4 (0.2)	2 (0.1)	6 (0.3)
Somatosensory amplification	675 (33.1)	1138 (55.8)	209 (10.2)	10 (0.5)	2 (0.1)	6 (0.3)

Notes:

a Reference categories of items in regression analyses;

b the pain catastrophizing items were only answered by children aged 11 years or older.

Table 7 Summary of univariable and multivariable logistic regression analyses predicting the incidence of headache in boys and girls

Variable	Univariable analyses				Multivariable analyses
	P	Odds ratio	95% confidence interval	Nagelkerke’s pseudo-R^2	P	Odds ratio	95% confidence interval
Boys
Dysfunctional coping	0.473	1.15	0.79–1.68	0.019	–	–	–
Pain catastrophizing	0.486	0.79	0.40–1.54	0.037	–	–	–
Anxiety sensitivity	0.505	1.14	0.77–1.68	0.020	–	–	–
Somatosensory amplification	0.980	1.01	0.71–1.42	0.019	–	–	–
Girls
Dysfunctional coping	0.002	2.11	1.32–3.36	0.021	0.386	1.54	0.58–4.09
Pain catastrophizing	0.172	0.66	0.36–1.20	0.019	0.089	0.57	0.29–1.09
Anxiety sensitivity	0.674	0.93	0.65–1.32	0.001	–	–	–
Somatosensory amplification	0.026	1.52	1.05–2.19	0.010	0.297	1.43	0.73–2.81

Note: Nagelkerke’s pseudo-R² for the multivariable analyses in girls: R²=0.034.

Table 8 Summary of univariable and multivariable logistic regression analyses predicting the incidence of back pain in boys and girls

Variable	Univariable analyses				Multivariable analyses
	P	Odds ratio	95% confidence interval	Nagelkerke’s pseudo-R^2	P	Odds ratio	95% confidence interval
Boys
Dysfunctional coping	0.002	1.61	1.19–2.18	0.036	0.022	1.44	1.06–1.97
Pain catastrophizing	0.785	1.07	0.66–1.72	0.024	–	–	–
Anxiety sensitivity	0.001	1.61	1.21–2.15	0.036	0.012	1.47	1.09–1.99
Somatosensory amplification	0.030	1.35	1.03–1.77	0.029	0.187	1.22	0.91–1.62
Girls
Dysfunctional coping	0.131	1.30	0.92–1.83	0.026	0.392	1.36	0.68–2.72
Pain catastrophizing	0.068	0.63	0.39–1.03	0.015	0.015	0.51	0.30–0.88
Anxiety sensitivity	0.291	0.86	0.65–1.14	0.022	–	–	–
Somatosensory amplification	0.044	1.36	1.01–1.83	0.026	0.035	1.78	1.04–3.05

Notes: Nagelkerke’s pseudo-R² for the multivariable analyses in boys: R²=0.049; for girls R²: =0.036.

Table S1 Instruments with which the predictor variables (wave 2) were measured

Predictor variable	Example item	Number of items	Item source	Internal consistency (Cronbach’s α)
Dysfunctional stress coping strategies	If other children put me under pressure or I am under pressure in school … Examples: … I would like to pretend to be ill. … I complain about everything.	5	SVF-KJ^Citation1	0.73
Pain catastrophizing	When I am in pain, I worry all the time about whether the pain will end.	13	PCS-C^Citation5,Citation6	0.88
Anxiety sensitivity	It scares me when my heart beats rapidly.	4	ASI^Citation3,Citation4	0.72
Somatosensory amplification	I can sometimes hear my pulse or my heartbeat throbbing in my ear.	4	SSAS^Citation2	0.71

Abbreviations: SVF-KJ, German Coping Questionnaire for Children and Adolescents; SSAS, Somatosensory Amplification Scale; ASI, Anxiety Sensitivity Index; PCS-C, Pain Catastrophizing Scale for Children.

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