Primary headache in Italian early adolescents: The role of perceived teacher unfairness

Background: The impact of perceived teacher unfairness on headache incidence has previously been insufficiently investigated. Objective: The aims of the study are to analyze the prevalence of headache among Italian early adolescents as well as to examine the role of perceived teacher unfairness and classmate social support in predicting this health outcome. Methods: Data were taken from the "Health Behaviour in School Aged Children," a cross-sectional survey investigating health behaviors among early adolescents in selected European countries. Headache, perceived teacher unfairness, and classmate social support were measured through a self-administered questionnaire filled out by a representative sample of 4386 (48.4% males) Italian students (11, 13, and 15 years old). Covariates included demographic characteristics (age, gender) and socioeconomic status (parental educational attainment), and other confounding psychological factors (eg, family empowerment, bullying). Results: Prevalence of frequent headaches (at least once a week) was about 40%. Girls were more likely to report frequent headaches compared with boys. Prevalence of frequent headaches increased with age. After adjusting for age and gender, teacher unfairness showed a significant association with frequent headache (P <.001). This relationship remained significant even after additional adjustment for several psychosocial factors. Classmate social support seems to act as a protective factor, but not as a buffering mechanism against the negative effects of teacher unfairness. Conclusions: Italian early adolescents show a quite high prevalence of frequent headache. Results show that characteristics of the school setting, such as teacher unfairness and classmate social support, can be significant predictors of frequent headache among early adolescents. Longitudinal research is needed to delineate causal relationships between school factors and recurrent headache.