Metacognition and headache: which Is the role in childhood and adolescence?

Headache, in particular migraine, is one of the most frequent neurological symptoms in children and adolescents and it affects about 60% of children and adolescents all over the world. Headache can affect several areas of child’s functioning, such as school, physical activities, peer, and family relationship. The global and severe burden of this disease requires a multidisciplinary strategy and an effective treatment addressed all of the patient’s needs and based on cutting-edge scientific research. In recent years, research has focused on cognitive factors specifically in functions called metacognitive processes. Metacognition can be defined as the knowledge, beliefs, and cognitive processes involved in monitoring, control, and assessment of cognition. Metacognition seems to be closely related to the ability of theory of mind, the ability to infer, and reason about the mental states of other people in order to predict and explain own behavior. Recent studies found a relationship between metacognitive skills and anxiety, depression, motivation, academic performance, human social interactions, and stress symptoms. This relationship is very interesting for headache treatment, because these factors are the most commonly reported triggers in this disorder and there is a high comorbidity with anxiety and depression in children and adolescents with headache. So, headache and these comorbidities, in particular anxiety and depression, may have in common persistent and maladaptive patterns of thinking which are related to maladaptive metacognitive beliefs. Further research should assess metacognitive processes of children and adolescents with headache in order to increase their ability to control their own cognitive processes and consequently monitor factors which may trigger the attacks

Behavioral management of headache in children and adolescents

Headache is the most frequent neurological symptom and the most prevalent pain in children and adolescents, and constitutes a serious health problem that may lead to impairment in several areas. Psychosocial factors, social environment, life events, school and family stressors are all closely related to headaches. A multidisciplinary strategy is fundamental in addressing headache in children and adolescents. Applying such a strategy can lead to reductions in frequency and severity of the pain, improving significantly the quality of life of these children.It has been demonstrated that behavioral intervention is highly effective, especially in the treatment of paediatric headache, and can enhance or replace pharmacotherapy, with the advantage of eliminating dangerous side effects and or reducing costs. Behavioral interventions appear to maximize long-term therapeutic benefits and improve compliance with pharmacological treatment, which has proven a significant problem with child and adolescent with headache.The goal of this review is to examine the existing literature on behavioral therapies used to treat headache in children and adolescents, and so provide an up-to-date picture of what behavioral therapy is and what its effectiveness is

Headache and alexithymia in children and adolescents: what Is the connection?

Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were "alexithymia" combined with the "primary headache," "migraine," "tension type headache," "children," and "adolescents." Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness

Alexithymia and psychopathological symptoms in adolescent outpatients and mothers suffering from migraines. A case control study

Background: Headache is a common disorder affecting a growing number of children and adolescents. In recent years, there has been an increase in scientific interest in exploring the relationship between migraine and emotional regulation, and in particular, the impact of emotional dysregulation on mental and physical health. The present study aims to explore the relationship between migraine and alexithymia among adolescents and their mothers as well as the impact of this association on mental health. An additional aim is to verify whether alexithymia may be a predictor of psychopathological symptoms in adolescents and mothers with migraines. Methods: A total of 212 subjects were involved in this study. The sample was divided into (a) Experimental Group (EG) consisting of 106 subjects (53 adolescents and 53 mothers) with a diagnosis of migraine according to International Classification of Headache Disorders (ICHD-3) and (b) Control Group (CG) including 106 subjects (53 adolescents and 53 mothers) without a diagnosis of migraine. All participants completed the Toronto Alexithymia Scale to assess alexithymia and the Symptom Checklist-90-R to assess psychopathological symptoms. Results: Higher rates of alexithymia were found in the adolescents and mothers of the EG in comparison to the adolescents and mothers of the CG. Furthermore, adolescents and mothers experiencing both migraine and alexithymia, demonstrated a higher risk of psychopathology. Conclusions: Findings from this study provide evidence that the co-occurrence of migraine and alexithymia increases the risk of psychopathology for both adolescents and their mother

Don't judge a book by its cover. factitious disorder imposed on children-report on 2 cases

Factitious Disorder Imposed on Another (FDIA), also known as Munchausen Syndrome by Proxy (MSbP) is a very serious form of child abuse. The perpetrator, usually the mother, invents symptoms or causes real ones in order to make her child appear sick. Usually this is due to a maladaptive disorder or to an excessive of attention-seeking on her part. We report here two new cases of FDIA. The first one is a 9-year-old boy with a history of convulsive episodes, reduced verbal production, mild psychomotor disorder and urological problems who underwent several invasive procedures and hospitalizations before a diagnosis of FDIA was made. The second is a 12 year-old girl with headache, abdominal pain, lipothymic episodes, seizures and a gait impairment, who was hospitalized in several hospitals before an FDIA was diagnosed

Emozioni e paure. Come la politica utilizza l'Altro

Il tema della paura e' centrale in questo saggio che considera il ruolo delle emozioni nell'uso strumentale delle questioni pertinenti al tema dell'immigrazione e delle relazioni interetniche e multiculturali. Vengono analizzate soprattutto le strategie impiegate quando i politici fanno leva sulle insicurezze della popolazione per attrarre l'attenzione dell'elettorato e creare maggiore consenso

Root and crown tot of olive caused dy Phytophthora spp.

Phytophthora root and crown rot has been traditionally considered a minor disease of olive. However, in recent years it has been recognized as an emerging problem in several olive-growing countries such as Australia, Italy and Spain probably as a consequence of the expansion of plantings in new areas with heavy soils and the more intensive use of irrigation in both olive nurseries and commercial groves. The disease has been reported from most olive-growing countries and is caused by several soil -borne species of Phytophthora, including P. cinnamomi, P. citricola, P. cryptogea, P. drechsleri, P. gonapodyides, P. inundata, P. megasperma,P. nicotianae and P.palmivora. Diagnosis is currently based on the isolation and identification of isolates by both traditional and molecular methods. New molecular techniques are currently available that could be applied for both the identification of isolates and Phytophthora infections directly in host-tissues as well as insoil and water samples. A number of dedicated databases could improve the efficiency of these techniques. Moreover, DNA analysis has greatly contributed to phylogenetic studies of Phytophthora. Control of Phytophthora root and crown rot of olive is mainly based on preventive measures

Abitare la differenza: indagine sugli spazi relazionali della città multiculturale

In this investigation we explore the concept of difference as city’s interpretational paradigm, in order to understand the changes of multicultural contexts. Difference is read as a moment of transition and change among points of view, in their mutual relation. We study ongoing dynamics in the relationship between public and private space, and especially in intermediate spaces generated by the simultaneous presence of differences. The presence of migrant communities that cohabit in the same place enhance the continuous regeneration of different space interpretations. The on-field investigation, brought on through the comparison among three different multicultural realities (Sassari, Dakar, Aubervilliers, in Paris outskirts), made the presence of mutable spaces emerge, being defined by unpredictable relationships. This way it is possible to identify dense places, special spaces of change, by following the traces of urban space appropriation forms. The on-field investigation has moreover emphasized the conflicting role, which expresses itself through the relationships built up among the present dualities. This study intends to reconsider the conflict as a necessary tool towards urban regeneration and production of new differences

bipolar disorder preceding the onset of multiple sclerosis

Multiple sclerosis (MS) is the most common inflammatory demyelinating brain disease. The occurrence of psychiatric disorders, especially for major depression, in the course of MS is high. Reports concerning bipolar disorder (BD) remain rather scarce although early descriptions were found in the old neurological literature. The purpose of this article is to provide a critical review of the epidemiology, comorbidity, and treatment findings regarding BD preceding the onset of MS

The role of Attachment Insecurity in the emergency of anxiety symptoms in children and adolescent with migraine: an empirical study

Background: It is widely recognised that there are associations between headache, psychiatric comorbidity and attachment insecurity in both adults and children. The aims of this study were: 1) to compare perceived attachment security and anxiety in children and adolescents with migraine without aura and a healthy control group; 2) to test whether the child’s perceived security of attachment to the mother and the father mediated the association between migraine and anxiety. Methods: One hundred children and adolescents with Migraine without Aura were compared with a control group of 100 children without headache. The Security Scale (measures perceived security of attachments) and the Self-Administered Psychiatric Scales for Children and Adolescents, a measure of anxiety symptoms, were administered to all participants. Results: The clinical group had lower attachment security than the control group and higher scores on all anxiety scales. Anxiety was negatively correlated with attachment. Children’s attachment to their mother mediated the increase in global anxiety in the clinical group. Insecure paternal attachment was associated with greater insecurity in maternal attachment, suggesting that there is a complex pathway from migraine to anxiety symptoms mediated by perceived insecurity of paternal attachment and hence also by perceived insecurity of maternal attachment. Conclusion: These results suggest that insecure parental attachment may exacerbate anxiety in children and adolescents with migraine and point to the importance of multimodal interventions, perhaps taking account of family relationships, for children and adolescents with migraine