Abstract
This study investigated the content validity, factor structure, and psychometric properties of the Children's Headache Assessment Scale (CHAS), a parent rating scale for identifying environmental variables associated with pediatric headache. In Study 1, input from physicians and psychologists was obtained to develop a revised set of 44 items receiving high endorsement. In Study 2, the questionnaire was administered to parents of 92 child headache sufferers, ages 6–16, and readministered 2 weeks later. An exploratory factor analysis revealed five factors (Disruptive Impact, Social Consequences, Stress Antecedents, Physical Antecedents and Quiet Coping, and Prescription Medication Use) that reflect distinct environmental concomitants of childhood headache. Scale reliabilities (alpha, .64–.82) indicate acceptable internal consistency, and test-retest reliabilities indicate relatively stable factors and items. High scores on the Disruptive Impact factor were associated with more severe, lengthy, and infrequent headache occurrence, lending initial support for the validity of this factor. Overall, the findings support the clinical and research utility of the CHAS in behavioral treatment of childhood headache.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Andrasik, F., Blake, D. D., and McCarran, M. S. (1986). A biobehavioral analysis of pediatric headache. In Krasnegor, N. A., Arasteh, J. D., and Cataldo, M. F. (eds.),Child Health Behavior: A Behavioral Pediatrics Perspective, Wiley, New York, pp. 394–434.
Appelbaum, K. A., Radnitz, C. L., Blanchard, E. B., and Prins, A. (1988). The Pain Behavior Questionnaire (PBQ): A global report of pain behavior in chronic headache.Headache 28: 53–58.
Bakal, D. A. (1982).The Psychobiology of Chronic Headache, Springer, New York.
Barrios, B. A. (1988). On the changing nature of behavioral assessment. In Bellack, A. S., and Hersen, M. (eds.),Behavioral Assessment: A Practical Handbook, 3rd ed., Pergamon, New York, pp. 3–41.
Bernstein, I. H. (1988).Applied Multivariate Analysis, Springer-Verlag, New York.
Bijou, S. W., Peterson, R. F., and Ault, M. H. (1968). A method to integrate descriptive and experimental field studies at the level of data and empirical concepts.J. Appl. Behav. Anal. 1: 175–191.
Bille, B. (1962). Migraine in school children.Acta Paediat. Scand. 51 (Suppl. 136): 1–151.
Bille, B. (1981). Migraine in childhood and its prognosis.Cephalalgia 1: 71–75.
Budd, K. S., and Kedesdy, J. H. (1989). Investigation of environmental factors in pediatric headache.Headache 29: 569–573.
Diamond, S., and Dalessio, D. J. (1982).The Practicing Physician's Approach to Headache, 3rd ed., Williams & Wilkins, Baltimore.
Dolgin, M. J., and Jay, S. M. (1989). Pain management in children. In Mash, E. J., and Barkley, R. A. (eds.),Treatment of Childhood Disorders, Guilford, New York, pp. 383–401.
Duckro, P. N., and Cantwell-Simmons, E. (1989). A review of studies evaluating biofeedback and relaxation training in the management of pediatric headache.Headache 29: 428–433.
Durand, V. M., and Crimmins, D. B. (1988a). The Motivation Assessment Scale. Unpublished manuscript, Department of Psychology, State University of New York at Albany, Albany.
Durand, V. M., and Crimmins, D. B. (1988b). Identifying the variables maintaining self-injurious behavior.J. Autism Dev. Disord. 18: 99–117.
Egermark-Eriksson, I. (1982). Prevalence of headache in Swedish school-children.Acta Paediat. Scand. 71: 135–140.
Forsythe, W. I., Gillies, D., and Sills, M. (1984). Propranolol (“inderal”) in the treatment of childhood migraine.Dev. Med. Child Neurol. 26: 737–741.
Gascon, G. G. (1984). Chronic and recurrent headaches in children and adolescents.Pediat. Clin. No. Am. 31: 1027–1051.
Harbeck, C., and Peterson, L. (1992). Elephants dancing in my head: A developmental approach to children's concepts of specific pains.Child Dev. 63: 138–149.
Hayes, S. C., Nelson, R. O., and Jarrett, R. B. (1987). The treatment utility of assessment: A functional approach to evaluating assessment quality.Am. Psychol. 42: 963–974.
Hays, W. L. (1981).Statistics, 3rd ed., Holt, Rinehart & Winston, New York.
Hoelscher, T. J., and Lichstein, K. L. (1984). Behavioral assessment and treatment of child migraine: Implications for clinical research and practice.Headache 24: 93–103.
Holroyd, K. A., and Andrasik, F. (1982). Cognitive-behavioral approach to recurrent tension and migraine headache. In Kendall, P. C. (ed.),Advances in Cognitive-Behavioral Research and Therapy, Vol. 1, Academic, New York, pp. 275–320.
Joffe, R., Bakal, D. A., and Kaganov, J. (1983). A self-observation study of headache symptoms in children.Headache 23: 20–25.
Johnson, R. S., Lichstein, K. L., and Hoelscher, T. J. (1990). Child migraine: Behavioral assessment and treatment. In Morgan, S. B., and Okwumabua, T. M. (eds.),Child and Adolescent Disorders: Developmental and Health Psychology Perspectives, Erlbaum. Hillsdale, NJ, pp. 241–266.
Keefe, F. J. (1982). Behavioral assessment and treatment of chronic pain: Current status and future directions.J. Consult. Clin. Psychol. 50: 896–911.
Kerns, R. D., Haythornthwaite, J., Rosenberg, R., Southwick, S., Giller, E. L., and Jacob, M. C. (1991). The Pain Behavior Check List (PBCL): Factor structure and psychometric properties.J. Behav. Med. 14: 155–167.
Labbe, E. E. (1988). Childhood muscle contraction headache: Current issues in assessment and treatment.Headache 28: 430–434.
Labbe, E. E., Williamson, D. A., and Southard, D. R. (1985). Reliability and validity of children's reports of migraine headache symptoms.J. Psychopathol. Behav. Assess. 7: 375–383.
Lake, A. E. (1981). Behavioral assessment considerations in the management of headache.Headache 21: 170–178.
Leviton, A., Slack, W. V., Masek, B., Bana, D., and Graham, J. R. (1984). A computerized behavioral assessment for children with headaches.Headache 24: 182–185.
Masek, B. J., Russo, D. C., and Varni, J. W. (1984). Behavioral approaches to the management of chronic pain in children.Pediat. Clin. No. Am. 31: 1113–1131.
Mash, E. J., and Terdal, L. G. (eds.) (1988).Behavioral Assessment of Childhood Disorders. 2nd ed., Guilford, New York.
McGrath, P. A. (1987). The multidimensional assessment and management of recurrent pain syndromes in children.Behav. Res. Ther. 25: 251–262.
Mindell, J. A., Andrasik, F., Quinn, S. J., Blake, D. D., Kabela, E., and McCarran, M. S. (1986). Antecedents and consequences of pediatric headache: Validation of clinical interviews. Paper presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Chicago, Nov.
Olness, K., MacDonald, J. T., and Uden, D. L. (1987). Comparison of self-hypnosis and propranolol in the treatment of juvenile classic migraine.Pediatrics 79: 593–597.
Prensky, A. L. (1976). Migraine and migrainous variants in pediatric patients.Pediat. Clin. No. Am. 23: 461–471.
Quick, D. M., and Budd, K. S. (1992). Children's Headache Assessment Scale: A criterion validity study, Unpublished manuscript, Department of Psychology, Illinois Institute of Technology, Chicago.
Shinnar, S., and D'Souza, B. J. (1981). The diagnosis and management of headaches in childhood.Pediat. Clin. No. Am. 29: 79–94.
Sillanpaa, M. (1983). Changes in prevalence of migraine and other headaches during the first seven school years.Headache 23: 15–19.
Sills, M., Congdon, P., and Forsythe, I. (1982). Clonidine and childhood migraine: A pilot and double-blind study.Dev. Med. Child Neurol. 24: 837–841.
Tatsouka, M. M. (1989).Multivariate Analysis 2nd ed., Wiley, New York.
Walker, L. S., and Zeman, J. L. (1992). Parental response to child illness behavior.J. Pediat. Psychol. 17: 49–71.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Budd, K.S., Workman, D.E., Lemsky, C.M. et al. The Children's Headache Assessment Scale (CHAS): Factor structure and psychometric properties. J Behav Med 17, 159–179 (1994). https://doi.org/10.1007/BF01858103
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01858103