1
|
Fox J, Gaul C, Slijepcevic M, Ohse J, Peperkorn N, Shiban Y. The impact of fear of attacks on pain-related disability in cluster headache: Insights from the fear avoidance model. Headache 2024. [PMID: 39224926 DOI: 10.1111/head.14823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/13/2024] [Accepted: 06/21/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study utilized the theoretical framework of the "fear avoidance model" (FAM) and investigated the role of fear of attack in pain-related disability. To this end, a measurement specific to cluster headache (CH) was used to investigate whether fear of attacks, alongside attack frequency, is a significant predictor of pain-related disability in CH. BACKGROUND Cluster headache substantially impacts daily functioning, yet empirical research exploring specific contributing factors is limited. METHODS A cross-sectional online survey was undertaken in patients with CH, gathering sociodemographic, clinical data, and responses on the Cluster Headache Scale and the Depression, Anxiety and Stress Scale. RESULTS Analysis of data from 640 patients (chronic CH: 287/640 [44.8%]; female: 264/640 [41.3%]; male: 373/640 [58.3%]; gender diverse: three of 640 [0.5%]; age range: 18-86 years; mean [standard deviation] Cluster Headache Scales subscale disability score: 36.9 [9.8]; out of 869 respondents) revealed that both attack frequency and fear of attacks significantly predicted pain-related disability (p < 0.001, percentage of variance explained: R2 = 0.24). More variance was explained by fear of attacks (R2 = 0.22) than by attack frequency (R2 = 0.02). This relationship remained significant even when controlling for depression and anxiety, which were also identified as independent predictors of pain-related disability (p < 0.001, R2 = 0.44). CONCLUSION This study emphasizes the relevance of psychological factors in CH-related disability. Fear of attacks was found to be an independent predictor, while attack frequency was of minor relevance. Empirical investigation of the FAM in CH could improve the understanding of the mechanisms underlying disability and contribute to the development of CH-specific interventions.
Collapse
Affiliation(s)
- Janosch Fox
- Department of Psychology, PFH Göttingen, Göttingen, Germany
- University Medical Centre Göttingen, Göttingen, Germany
| | - Charly Gaul
- Medical Faculty, University of Duisburg-Essen, Duisburg, Germany
- Headache Center Frankfurt, Frankfurt am Main, Germany
| | | | - Julia Ohse
- Department of Psychology, PFH Göttingen, Göttingen, Germany
| | | | - Youssef Shiban
- Department of Psychology, PFH Göttingen, Göttingen, Germany
| |
Collapse
|
2
|
Sturgeon JA, Pierce J, Trost Z. Initial validation of the 12-item Tampa Scale of Kinesiophobia in a retrospective sample of adults with chronic headache. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:187-193. [PMID: 37930882 PMCID: PMC11032727 DOI: 10.1093/pm/pnad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/22/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION An area of emerging interest in chronic pain populations concerns fear of pain and associated fear of movement (kinesiophobia)-a cognitive appraisal pattern that is well-validated in non-headache chronic pain. However, there is limited research on whether this construct can be measured in a similar manner in headache populations. METHODS The current project details a confirmatory factor analysis of the 12-Item Tampa Scale of Kinesiophobia (TSK-12) using a clinical data set from 210 adults with diverse headache diagnoses presenting for care at a multidisciplinary pain clinic. One item (concerning an "accident" that initiated the pain condition) was excluded from analysis. RESULTS Results of the confirmatory factor analysis for the remaining 12 items indicated adequate model fit for the previously established 2-factor structure (activity avoidance and bodily harm/somatic focus subscales). In line with previous literature, total TSK-12 scores showed moderate correlations with pain severity, pain-related interference, positive and negative affect, depressive and anxious symptoms, and pain catastrophizing. DISCUSSION The current study is the first to examine the factor structure of the TSK-12 in an adult headache population. The results support the relevance of pain-related fear to the functional and psychosocial status of adults with chronic headache, although model fit of the TSK-12 could be characterized as adequate rather than optimal. Limitations of the study include heterogeneity in headache diagnosis and rates of comorbid non-headache chronic pain in the sample. Future studies should replicate these findings in more homogenous headache groups (eg, chronic migraine) and examine associations with behavioral indices and treatment response.
Collapse
Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48105, United States
| | - Jennifer Pierce
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48105, United States
| | - Zina Trost
- Department of Psychology, Texas A&M University, College Station, TX 77840, United States
| |
Collapse
|
3
|
McCracken HT, Lee AA, Smitherman TA. Headache and psychological variables as predictors of disability in individuals with primary headache disorders. Headache 2023; 63:1259-1270. [PMID: 37795575 DOI: 10.1111/head.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To examine the relative contribution of headache symptoms and psychological factors to headache-related disability. BACKGROUND Both headache symptoms and comorbid psychological factors (psychiatric symptoms and transdiagnostic constructs) negatively impact functioning among individuals with migraine and tension-type headache, but few studies have explored their relative contribution to headache-related disability. We hypothesized that psychiatric symptoms and transdiagnostic variables would afford incremental contribution to disability beyond headache symptoms, and we investigated the moderating role of headache diagnosis on these relationships. METHODS This cross-sectional study examined data from a southern U.S. university online sample of 1818 young adults (mean [SD] age 19.0 [5.1] years; 74.6% female) who met the International Classification of Headache Disorders, third edition criteria for primary headache disorders (46.6% episodic migraine, 11.6% chronic migraine, 38.3% episodic tension-type headache, 3.5% chronic tension-type headache) and completed measures assessing psychological factors and headache-related disability. Headache, psychiatric symptoms, and transdiagnostic factors were examined in relation to headache-related disability, after controlling for sex. Moderation analyses examined the conditional effect of diagnosis on disability. RESULTS As predicted, both psychiatric and transdiagnostic symptoms accounted for unique variance in headache-related disability beyond headache symptoms (R2 changes of 2.7% and 2.3%, respectively). Significant three-way interactions revealed the relationship between psychiatric symptoms and disability (b = -3.16, p = 0.002), and between transdiagnostic variables and disability (b = -2.37, p = 0.034). Tests of simple slopes showed greater psychiatric symptoms and transdiagnostic variables were associated with higher levels of disability. However, the associations of these variables with disability were strongest among individuals with chronic tension-type headache (B = 3.93 for psychiatric symptoms and B = 4.62 for transdiagnostic symptoms, both p < 0.001). CONCLUSION Psychiatric and transdiagnostic factors contribute uniquely to headache-related functional impairment, which may be important for expanding targeted assessment and behavioral interventions.
Collapse
Affiliation(s)
- Halle T McCracken
- Department of Psychology, University of Mississippi, University, Mississippi, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, University, Mississippi, USA
| | - Todd A Smitherman
- Department of Psychology, University of Mississippi, University, Mississippi, USA
| |
Collapse
|
4
|
Sturgeon JA, Ehde DM, Darnall BD, Barad MJ, Clauw DJ, Jensen MP. Psychological Approaches for Migraine Management. Anesthesiol Clin 2023; 41:341-355. [PMID: 37245946 PMCID: PMC10513739 DOI: 10.1016/j.anclin.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Migraine headaches are among the most prevalent and disabling pain conditions worldwide. Best-practice migraine management is multidisciplinary and includes the psychological approaches to address cognitive, behavioral, and affective factors that worsen pain, distress, and disability. The psychological interventions with the strongest research support are relaxation strategies, cognitive-behavioral therapy, and biofeedback, though the quality of clinical trials for all psychological interventions needs continued improvement. The efficacy of psychological interventions may be improved by validating technology-based delivery systems, developing interventions for trauma and life stress, and precision medicine approaches matching treatments to patients based on specific clinical characteristics.
Collapse
Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA.
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, 325 Ninth Avenue, Box 359612, Seattle, WA 98104, USA
| | - Beth D Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 430 Broadway Street, Pavilion C, 3rd Floor MC6343, Redwood City, CA 94063, USA
| | - Meredith J Barad
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero, Suite 200, MC 5596, Palo Alto, CA 94304, USA
| | - Daniel J Clauw
- Department of Anesthesiology, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, 325 Ninth Avenue, Box 359612, Seattle, WA 98104, USA
| |
Collapse
|
5
|
Şentürk İA, Aşkın Turan S, Eyigürbüz T, Şentürk E, Kale İçen N. Pain-Related Cognitive Processes, Pain Interference, and Alexithymia in Patients With Primary Headaches. Cureus 2023; 15:e39688. [PMID: 37398774 PMCID: PMC10309013 DOI: 10.7759/cureus.39688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives This study aims to investigate the effects of pain-related cognitive processes (PRCPs) and emotional state on pain-related disability (PRD) and pain interference (difficulty in performing daily routines, difficulty in engaging in social activities [the enjoyment of life], and the impact on work and/or school performance) in patients with primary headaches (PHs). Methodology PRCPs were evaluated with the Pain Anxiety Symptom Scale-20 (PASS-20), Pain Catastrophizing Scale (PCS), and Pain Belief Questionnaire (PBQ). Anxiety, depression, and alexithymia were investigated to assess the emotional state. PRD was assessed by Headache Impact Test-6 (HIT-6). Health-related quality of life (HRQoL) was evaluated under three headings: daily activities (with Short Form-36 [SF-36] Question [Q] 22), social activities (with Graded Chronic Pain Scale-Revised [GCPS-R] Q 4), as well as the working ability (with GCPS-R Q 5). Two separate models were constructed to identify the factors influencing PRD and HRQoL in PHP: M1 to reveal the factors affecting PRD and M2 to determine the independent factors affecting pain interference. In both models, correlation analysis was applied first and the significant data were then evaluated with regression analysis. Results A total of 364 participants (74 healthy controls [HCs] and 290 PHPs) completed the study. In M1, the following domains were significantly associated with PRD: cognitive anxiety (β = 0.098; 95% confidence interval [CI] = 0.001-0.405; P = 0.049); helplessness (β = 0.107; 95% CI = 0.018-0.356; P = 0.031); alexithymia (β = 0.077; 95% CI = 0.005-0.116; P = 0.033); depression (β = 0.083; 95% CI = 0.014-0.011; P = 0.025). In M2, factors associated with impairment in daily activities for PHP were as follows: duration of pain, pain intensity, alexithymia, escape-avoidance response, psychological anxiety, anxiety, and poor sleep quality (R = 0.770; R2 = 0.588). The independent factors affecting social activities for PHP were pain intensity and pain-related anxiety (R = 0.90; R2 = 0.81). Independent risk factors that affected the ability to work for PHP were pain intensity, cognitive anxiety, escape-avoidance response, and pain anxiety (R = 0.90; R2 = 0.81). Conclusions This study highlights the importance of cognitive and emotional processes that help increase our understanding of the patient with PHs. This understanding may help to reduce disability and improve the quality of life in this population by helping to guide multidisciplinary treatment goals.
Collapse
Affiliation(s)
| | - Suna Aşkın Turan
- Pain Management, Mersin City Education and Research Hospital, Mersin, TUR
| | - Tuğba Eyigürbüz
- Neurology, Bağcılar Education and Research Hospital, İstanbul, TUR
| | - Erman Şentürk
- Psychiatry, NP Feneryolu Medical Center, Üsküdar University, İstanbul, TUR
| | | |
Collapse
|
6
|
Rosignoli C, Ornello R, Onofri A, Caponnetto V, Grazzi L, Raggi A, Leonardi M, Sacco S. Applying a biopsychosocial model to migraine: rationale and clinical implications. J Headache Pain 2022; 23:100. [PMID: 35953769 PMCID: PMC9367111 DOI: 10.1186/s10194-022-01471-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/02/2022] [Indexed: 12/23/2022] Open
Abstract
Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.
Collapse
Affiliation(s)
- Chiara Rosignoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Agnese Onofri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Caponnetto
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| |
Collapse
|
7
|
The Role of Pain Inflexibility and Acceptance among Headache and Temporomandibular Disorders Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137974. [PMID: 35805650 PMCID: PMC9265370 DOI: 10.3390/ijerph19137974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023]
Abstract
Temporomandibular disorders (TMD) and headache are complex. This study aims to assess the association between TMD, headache, and psychological dimensions such as psychological inflexibility and pain acceptance. The sample consisted of 120 participants following a non-probabilistic convenience sampling strategy through a direct invitation to the patients attending our facilities and their relatives (n = 61 diagnosed with headache, n = 34 diagnosed with TMD-headache, n = 25 control group). Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), International Classification of Headache Disorders (ICHD-3 beta version), Chronic Pain Acceptance Questionnaire (CPAQ-8), and Psychological Inflexibility in Pain Scale (PIPS) were used as assessment tools. One-way ANOVA, multiple regression analysis (MRA), and the Johnson-Neyman approach were run by IBM SPSS, version 27 (IBM® Company, Chicago, IL, USA). The significance level was 0.05. One third of our sample presented with headache with TMD. Females were predominant. Males with headache, no systemic disease, less pain severity but higher frequency, living longer with the disease and having sensitive changes, showed higher pain acceptance. When headache occurs with TMD, women with higher education, no headache family history, less pain, and no motor changes showed higher pain acceptance. Patients with both conditions are more liable to have chronic pain and pain inflexibility. Pain intensity and willingness explain 50% of the psychological inflexibility in the headache group. In our sample, individuals suffering from both conditions show greater pain inflexibility, implicating more vivid suffering experiences, leading to altered daily decisions and actions. However, further studies are needed to highlight this possible association.
Collapse
|
8
|
Klan T, Bräscher A, Klein S, Diezemann‐Prößdorf A, Guth A, Gaul C, Witthöft M. Assessing attack‐related fear in headache disorders—Structure and psychometric properties of the Fear of Attacks in Migraine Inventory. Headache 2022; 62:294-305. [DOI: 10.1111/head.14272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Timo Klan
- Department of Psychology Johannes Gutenberg‐University of Mainz Mainz Germany
| | | | - Silja Klein
- Department of Psychology Johannes Gutenberg‐University of Mainz Mainz Germany
| | | | | | | | - Michael Witthöft
- Department of Psychology Johannes Gutenberg‐University of Mainz Mainz Germany
| |
Collapse
|
9
|
Pohl H, Gantenbein AR, Sandor PS, Schoenen J, Andrée C. The impact of the disease burden on the quality of life of cluster headache patients. CEPHALALGIA REPORTS 2021. [DOI: 10.1177/25158163211029909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Cluster headache cannot be cured, and not all attacks can be aborted or prevented. Nevertheless, therapeutic guidelines focus solely on the attacks and ignore reverberations of the disorder on patients’ lives. However, it is likely that not only pain reduces patients’ quality of life (QoL). Objective: To investigate whether the interictal burden independently influence the QoL of subjects suffering from cluster headache. Methods: In this cross-sectional study, we asked patients with a self-reported cluster headache diagnosis to answer a modified EUROLIGHT questionnaire that included the EURO-HIS QoL scale. We built a generalised linear model and included the QoL as the dependent variable. Independent variables comprised both the ictal and the interictal burden. Results: The data of 625 participants entered the analysis. Several aspects of the interictal burden independently reduced the QoL. Among them were fear of pain, self-concealment, and private life difficulties due to the disorder. Conclusion: Both the ictal and the interictal burden of cluster headache independently reduce patients’ QoL. We advocate adopting a more holistic approach to cluster headache management extending the focus towards the afflicted person and their QoL, which would generate novel therapeutic goals and strategies, complementary to treating and preventing cluster headache attacks.
Collapse
Affiliation(s)
- Heiko Pohl
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Andreas R Gantenbein
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
- Department of Neurology & Neurorehabilitation, ZURZACH Care, Bad Zurzach, Switzerland
| | - Peter S Sandor
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
- Department of Neurology & Neurorehabilitation, ZURZACH Care, Bad Zurzach, Switzerland
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology, Citadelle Hospital, University of Liège, Liège, Belgium
| | - Colette Andrée
- Migraine Action, Bottmingen, Switzerland
- Department of Pharmaceutical Sciences, University Basel, Basel, Switzerland
| |
Collapse
|
10
|
Lemme J, Holmes S, Sibai D, Mari J, Simons LE, Burstein R, Zurakowski D, Lebel A, O'Brien M, Upadhyay J, Borsook D. Altered Brain Network Connectivity Underlies Persistent Post-Traumatic Headache following Mild Traumatic Brain Injury in Youth. J Neurotrauma 2021; 38:1632-1641. [PMID: 33183144 DOI: 10.1089/neu.2020.7189] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Post-traumatic headaches (PTHs) are associated with mild traumatic brain injuries (mTBI) and may predict the persistence of concussion symptoms. Altered brain networks implicated in brain injury and the affective components of headache-related pain may underlie the resolution of PTH. This is a hypothesis-generating investigation to evaluate the extent to which pain symptom reporting and functional brain changes are different in a cohort of young mTBI patients with resolved (PTH-R) and persistent (PTH-P) post-traumatic headache symptoms relative to healthy controls. This was a cross-sectional investigation involving 59 participants between the ages of 12-24 (PTH-P, n = 21; PTH-R, n = 18; healthy control, n = 20). Participants had no significant history of pre-existing headaches, chronic pain, or psychiatric neurological conditions. The primary outcome was resting-state functional connectivity (RS-Fc) alterations between cohorts. Secondary outcomes were self-reported pain-related symptoms. Elevated scores were reported for fear of pain in both PTH cohorts. Using a false discovery rate of p = 0.05, the PTH-P cohort showed altered connectivity relative to healthy controls in brain regions such as the frontal, temporal, and cerebellar regions, as well as sub-cortical regions including the amygdala and accumbens. The PTH-R cohort showed altered RS-Fc between cerebellar and temporal lobe sub-regions. Our results indicate that a core network of brain regions implicated in the affective pain response are functionally altered in PTH cohorts. Results should be interpreted given limitations on sample size and multiple comparisons. Despite the resolution of symptoms, persons who experience PTH may experience ongoing functional brain abnormalities, which may underlie symptom chronification.
Collapse
Affiliation(s)
- Jordan Lemme
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Scott Holmes
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Diana Sibai
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Joud Mari
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Laura E Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rami Burstein
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Alyssa Lebel
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Michael O'Brien
- Department of Orthopedic Surgery, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - Jaymin Upadhyay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| | - David Borsook
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
11
|
Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
Collapse
|
12
|
Migliore S, Paolucci M, Quintiliani L, Altamura C, Maffi S, D'Aurizio G, Curcio G, Vernieri F. Psychopathological Comorbidities and Clinical Variables in Patients With Medication Overuse Headache. Front Hum Neurosci 2020; 14:571035. [PMID: 33328928 PMCID: PMC7728851 DOI: 10.3389/fnhum.2020.571035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/06/2020] [Indexed: 01/03/2023] Open
Abstract
The psychopathological profile of patients with medication overuse headache (MOH) appears to be particularly complex. To better define it, we evaluated their performance on a targeted psychological profile assessment. We designed a case-control study comparing MOH patients and matched healthy controls (HC). Headache frequency, drug consumption, HIT-6, and MIDAS scores were recorded. All participants filled in the following questionnaires: Beck Depression Inventory-II Edition (BDI-2), trait subtest of State-Trait Anxiety Inventory (STAI-Y), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), Toronto Alexithymia Scale (TAS-20). The primary endpoint was to establish if MOH patients have an altered psychopathological profile. The secondary endpoint was to establish whether the worst profile correlates with the worsening of headache and disability measures. We enrolled 48 consecutive MOH patients and 48 HC. MOH patients showed greater difficulty in recognition/regulation of emotions (DERS, TAS-20), depression (BDI-2), anxiety (STAI-Y), and impulsiveness (BIS-11). We found a positive correlation among DERS, BDI-2, STAI-Y, and BIS scores and MIDAS and HIT-6 scores and among DERS and headache frequency and drug consumption. MOH patients showed a high rate of emotion regulation difficulties, depression, and anxiety, which may negatively affect their headaches. The ability to regulate/recognize emotions may play a central role in sustaining medication overuse.
Collapse
Affiliation(s)
- Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Matteo Paolucci
- UOS Cefalee e Neurosonologia, Neurology, University Campus Bio-Medico, Rome, Italy
| | | | - Claudia Altamura
- UOS Cefalee e Neurosonologia, Neurology, University Campus Bio-Medico, Rome, Italy
| | - Sabrina Maffi
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Fabrizio Vernieri
- UOS Cefalee e Neurosonologia, Neurology, University Campus Bio-Medico, Rome, Italy
| |
Collapse
|
13
|
Polk AN, Protti TA, Smitherman TA. Allodynia and Disability in Migraine: The Mediating Role of Stress. Headache 2020; 60:2281-2290. [DOI: 10.1111/head.14012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Ashley N. Polk
- Department of Psychology University of Mississippi Oxford MS USA
| | - Tracy A. Protti
- Department of Psychology University of Mississippi Oxford MS USA
| | | |
Collapse
|
14
|
Locking down the CGRP pathway during the COVID-19 pandemic lockdown: the PandeMig study. Neurol Sci 2020; 41:3385-3389. [PMID: 33001407 PMCID: PMC7527669 DOI: 10.1007/s10072-020-04767-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The COVID-19 pandemic and the consequent lockdown came as a storm disrupting people's everyday life. This study aimed at observing whether the COVID-19 related lockdown influenced migraine frequency and disability in migraine patients on therapy with monoclonal antibodies inhibiting the CGRP pathway. METHODS In this longitudinal observational cohort study, 147 consecutive patients receiving monthly administration of erenumab or galcanezumab were enrolled in four Italian headache centers. All patients filled a questionnaire concerning working and household settings, recent flu symptoms or COVID-19 diagnosis, and family loss due to COVID-19 infection. Monthly migraine days (MMDs), monthly painkiller intake (MPI), and HIT-6 disability relative to the first month of lockdown imposition (T-lock) and the month before (T-free) were also collected. RESULTS From T-free to T-lock, the cohort displayed a reduction in MMDs (from 10.5 ± 7.6 to 9.8 ± 7.6, p = .024) and HIT-6 scores (from 59.3 ± 8.3 men reduced MPI more frequently than women (p = .005). CONCLUSIONS Our study observed that the lockdown impact to 57.8 ± 8.8, p = .009), while MPI resulted unchanged (from 11.6 ± 11.5 to 11.1 ± 11.7; p = .114). MMDs, MPI, and HIT-6 variations from T-free to T-lock did not differ according to work settings or household. Patients beyond the first 3 months of therapy presented less often a reduction in MMDs (p = .006) and on everyday life did not affect the migraine load in patients receiving monoclonal antibodies inhibiting the CGRP pathway. Patients in the first months of therapy experienced a greater improvement according to drug pharmacokinetics, while women more frequently needed rescue medications, possibly indicating presenteeism or cephalalgophobia.
Collapse
|
15
|
Rogers DG, Bond DS, Bentley JP, Smitherman TA. Objectively Measured Physical Activity in Migraine as a Function of Headache Activity. Headache 2020; 60:1930-1938. [DOI: 10.1111/head.13921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/08/2020] [Accepted: 07/09/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Daniel G. Rogers
- Department of Psychology University of Mississippi Oxford MS USA
| | - Dale S. Bond
- Department of Psychiatry and Human Behavior Alpert Medical School of Brown UniversityThe Miriam Hospital/Weight Control and Diabetes Research Center Providence RI USA
| | - John P. Bentley
- Department of Pharmacy Administration University of Mississippi Oxford MS USA
| | | |
Collapse
|
16
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the role of avoidance behavior in headache-related disability and overview relevant clinical implications. RECENT FINDINGS Avoidance occupies a central role in contemporary psychological perspectives on headache disorders and other chronic pain conditions. Several cognitive constructs of relevance to headache are influenced and maintained by avoidance behavior. A growing body of literature attests to the notion that avoidance of headache triggers, of stimuli that exacerbate headache, and of broader life domains can negatively affect headache progression, disability/quality of life, and comorbid psychiatric symptoms. Interventions targeting avoidance behavior, such as therapeutic exposure to headache triggers, mindfulness, and acceptance and commitment therapy (ACT), hold promise for headache disorders but need to be tested in larger trials. Researchers and clinicians are encouraged to attend to functional impairment as a critically important treatment outcome. Comprehensive understanding of headache disorders necessitates attention not merely to diagnostic symptoms and their reduction, but to patterns of avoidance behavior that inadvertently exacerbate headache and contribute to functional impairment.
Collapse
|
17
|
Seng EK. Using Cognitive Behavioral Therapy Techniques to Treat Migraine. ACTA ACUST UNITED AC 2020; 44:68-73. [PMID: 33907734 DOI: 10.1007/bf03544665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Migraine is a common and disabling neurologic disorder that often occurs alongside anxiety and mood disorders. Information is provided on the biological basis of the disorder, the interactive effects of co-morbidity, and common psychological distortions manifested by individuals with migraine. Psychological treatments based on cognitive behavioral techniques have demonstrated efficacy to treat migraine. Migraine treatment can be incorporated in private practice and integrated care settings.
Collapse
|
18
|
Clementi MA, Chang YH, Gambhir R, Lebel A, Logan DE. The Impact of Sleep on Disability and School Functioning: Results From a Tertiary Pediatric Headache Center. J Child Neurol 2020; 35:221-227. [PMID: 31726920 DOI: 10.1177/0883073819887597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pediatric headache patients often experience significant sleep disturbance, which may be a risk factor for poor physical, academic, and emotional functioning, including increased anxiety/fear. The current retrospective cohort study of a clinical sample of youth with persistent headache aimed to examine the impact of sleep on functional outcomes and to explore pain-related fear as a mediator of the association between sleep problems and functioning. A total of 109 youth (aged 7-17 years) with persistent headache presenting to a tertiary pediatric headache center (and their parents) completed measures of sleep problems, fear of pain, functional disability, and school functioning at the time of an initial evaluation and 6 months later. After controlling for age and headache frequency and severity, linear regression analyses indicated that increased sleep problems at baseline were associated with increased functional disability and poorer school functioning at baseline (β = 0.28, P = .01; β = -0.42, P < .001, respectively). Poor sleep at baseline was associated with poorer school functioning (but not functional disability) at follow-up (β = -0.25, P = .02). Mediation models demonstrated an indirect mediating effect of pain-related fear on the association between baseline sleep problems and follow-up functional disability (β = 0.06, 95% confidence interval 0.01, 0.15) and between baseline sleep problems and follow-up school functioning (β = -0.06, 95% confidence interval -0.13, -0.004). Sleep disturbance in youth with headache may be a risk factor for poor functional outcomes, both concurrently and over time, and may be explained partially through pain-related fear. Given the frequency with which pediatric headache patients experience co-occurring sleep problems, sleep should be thoroughly assessed and considered as a potential early treatment target.
Collapse
Affiliation(s)
- Michelle A Clementi
- Department of Anesthesiology, Division of Pain Medicine, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yu-Hsing Chang
- Department of Anesthesiology, Division of Pain Medicine, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Rupa Gambhir
- Department of Anesthesiology, Division of Pain Medicine, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alyssa Lebel
- Department of Anesthesiology, Division of Pain Medicine, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Deirdre E Logan
- Department of Anesthesiology, Division of Pain Medicine, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
19
|
Development of a measure to assess acceptance of headache: The Headache Acceptance Questionnaire (HAQ). Cephalalgia 2020; 40:797-807. [DOI: 10.1177/0333102420907596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Disability resulting from headache disorders is attributable in part to avoidant coping. Acceptance of pain connotes a willingness to experience pain in the service of life values, such that meaningful activities and goals are pursued despite pain. Acceptance facilitates positive health outcomes but has rarely been investigated in headache. Because headache disorders manifest differently than other forms of chronic pain, the present study sought to develop and validate a measure of acceptance of headache. Methods Forty-five candidate items were developed and, with input from an expert panel, reduced to 24 items. Five items were eliminated following administration to a development sample and exploratory factory analysis. Nineteen items were administered to a validation sample for confirmatory factory analysis and assessment of psychometric properties. Results Factor analysis produced a unidimensional six-item measure, the Headache Acceptance Questionnaire (HAQ). The HAQ evidenced good internal consistency, convergent validity with headache disability and related psychological constructs, and divergent validity with social desirability. The measure also distinguished between headache diagnostic groups. Conclusions Pending further validation in clinical settings, the HAQ may have utility in assessing psychological responses to headache symptoms, identifying targets of treatment for interventions that focus on reducing avoidance, and studying mechanisms of change.
Collapse
|
20
|
Wang X, Baeken C, Fang M, Qiu J, Chen H, Wu GR. Predicting trait-like individual differences in fear of pain in the healthy state using gray matter volume. Brain Imaging Behav 2020; 13:1468-1473. [PMID: 30206819 DOI: 10.1007/s11682-018-9960-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Fear of pain (FOP) can be considered as a product of evolution from overstated negative interpretations of pain and sometimes may cause more damage than the actual pain itself. While trait-like measures of FOP have emerged as predictors for the inception and development of chronic pain, its neural underpinnings are not well understood. To investigate the relationship between gray matter volumes (GMV) and trait-like individual differences in FOP, we analyzed structural magnetic resonance imaging data in a sample of healthy young adults. Regression analysis results showed that individuals with higher FOP scores displayed higher GMV in brain regions important for the regulation of pain and fear. These brain areas include the pregenual anterior cingulate cortex (ACC), the anterior part of the dorsal ACC, the dorsomedial prefrontal cortex, and the adjacent pre-supplementary motor area. Furthermore, cross-validation analysis confirmed that the identified regional GMV offered a reliable neural signature of trait-like FOP. Our findings shed more light on the neuroanatomical architecture of FOP in currently pain-free people, which may be helpful to guide early interventions to prevent FOP from becoming chronic.
Collapse
Affiliation(s)
- Xiaowan Wang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZBrussel), Laarbeeklaan 101, 1090, Brussels, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Mengxia Fang
- Department of Art Education, Chongqing Vocational College of Applied Technology, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China.
| |
Collapse
|
21
|
Effectiveness of a primary care-based group educational intervention in the management of patients with migraine: a randomized controlled trial. Prim Health Care Res Dev 2019; 20:e155. [PMID: 31833464 PMCID: PMC7003525 DOI: 10.1017/s1463423619000720] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Aim: The aim of this study was to assess the effectiveness of a primary care-based group educational intervention about concepts of pain neuroscience for the management of migraine compared to the routine medical care delivered to patients with this condition. Background: The way pain is understood has been radically changed in recent decades, thanks to developments in the field of neuroscience. Thus, migraine may develop as a result of an exaggerated perception of threat that activates the pain neuromatrix, which might be modifiable, from a learning perspective, by adjusting the beliefs and behaviours that favour the onset of an attack. Methods: A randomised controlled trial was carried out in five primary care health centres of Vitoria-Gasteiz (Basque Country, Spain). The follow-up period was 12 months. The main outcome measure was the reduction in days lost due to migraine-related disability according to the Migraine Disability Assessment Test (MIDAS) score. Secondary outcome measures included the intensity and frequency of the pain and the number of analgesic drugs taken in the previous three months. A positive response to treatment was considered when the MIDAS score decreased by at least 50% from baseline. Findings: Days lost due to migraine-related disability decreased by at least 50% in 68.9% (n = 37) of patients in the intervention group and 34.6% of patients in the control group (n = 18) (P < 0.001). The intensity of the headache [odds ratio (OR) 9.116; P = 0.005] and the medication intake (OR 13.267; P < 0.001) were also significantly reduced with the intervention. Conclusions: The provision of suitable information through a group educational intervention delivered in primary care appears to be effective in preventing migraine attacks. Moreover, the intervention could offer a new cost-effective management alternative that seems to reduce the need for pharmacological treatment in patients with migraine.
Collapse
|
22
|
Pohl H, Gantenbein AR, Sandor PS, Schoenen J, Andrée C. The impact of depressive symptoms on the burden of cluster headache: Results of the EUROLIGHT Cluster Headache Project, an Internet-based, cross-sectional study of people with cluster headache. CEPHALALGIA REPORTS 2019. [DOI: 10.1177/2515816319888211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Many patients affected by cluster headache (CH) have a co-morbid depression. The aim of this study is to evaluate how the burden of disease is influenced by depressive symptoms measured by a depression score. The study was cross-sectional and Internet-based. We included individuals with a self-reported diagnosis of CH and asked them to fill out the EUROLIGHT questionnaire, which includes a depression score. The number of headache days was higher among patients with higher depression scores. In these participants, worrying about future attacks, avoiding triggers, believing to have earned less and avoiding to talk about the disease were more common as well. Individuals with higher depression scores reported a significantly higher burden of disease. It is possible that fear of pain, self-concealment and fear of impoverishment are consequences of the depression attributed to the headache disorder.
Collapse
Affiliation(s)
- Heiko Pohl
- Department of Neurology, University Hospital Zurich, Zürich, Switzerland
| | - Andreas R Gantenbein
- Department of Neurology, University Hospital Zurich, Zürich, Switzerland
- RehaClinic Group, Bad Zurzach, Switzerland
| | - Peter S Sandor
- Department of Neurology, University Hospital Zurich, Zürich, Switzerland
- RehaClinic Group, Bad Zurzach, Switzerland
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology–Citadelle Hospital, University of Liège, Liège, Belgium
| | - Colette Andrée
- Migraine Action Switzerland, Bottmingen, Switzerland
- Department of Pharmaceutical Sciences, University Basel, Basel, Switzerland
| |
Collapse
|
23
|
Sorgenfrei V, Kropp P, Straube A, Ruscheweyh R. High Achievement Motivation is Not Related to Increased Use of Acute Headache Medication in Migraine: A Cross-sectional Observational Cohort Study. Headache 2018; 58:1629-1638. [PMID: 30367817 DOI: 10.1111/head.13431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine if migraine patients with high achievement motivation have an increased use of acute headache medication. BACKGROUND It has been hypothesized that high achievement-motivated migraine patients have an increased use of acute headache medication to be able to perform at work and during daily life, putting them at risk for medication overuse headache (MOH). METHODS The Achievement Motivation Inventory and use of acute headache medication were assessed in 117 migraine patients (60 episodic, 57 chronic) at their first appointment at our tertiary headache center. RESULTS Patients with low vs high achievement motivation were not significantly different in acute headache medication days per month (10.8 ± 6.9 vs 10.9 ± 7.8, P = .98), in acute headache medication use in the absence of headache (to prevent occurrence of headache later that day: 51.8% vs 48.2%, P = .38), in having a diagnosis of MOH (37.9 vs 23.7%, P = .12), or in reduction of acute headache medication days at 3 and 6 months follow-up (both P > .20). CONCLUSIONS High achievement motivation in migraine patients was not associated with increased acute headache medication use or more frequent diagnosis of MOH.
Collapse
Affiliation(s)
- Verena Sorgenfrei
- Department of Neurology, Ludwig Maximilians University, Munich, Germany.,MVZ für Psychotherapie, Munich, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Rostock, Germany
| | - Andreas Straube
- Department of Neurology, Ludwig Maximilians University, Munich, Germany
| | - Ruth Ruscheweyh
- Department of Neurology, Ludwig Maximilians University, Munich, Germany
| |
Collapse
|
24
|
Sirri L, Pierangeli G, Cevoli S, Cortelli P, Grandi S, Tossani E. Illness perception in patients with migraine: An exploratory study in a tertiary care headache centre. J Psychosom Res 2018; 111:52-57. [PMID: 29935755 DOI: 10.1016/j.jpsychores.2018.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Illness perception is significantly related to several outcome measures in different medical conditions. However, little is known about headache-related causal attributions and cognitive and emotional representations in patients with migraine. OBJECTIVE To examine perceived causes of headache and demographic, clinical, and psychological correlates and predictors of illness perception in patients with migraine attending a tertiary care headache centre. METHODS A sample of 143 patients with migraine (85.3% women, mean age 44.0 ± 12.1 years) completed the Brief Illness Perception Questionnaire (Brief IPQ), the Symptom Questionnaire (SQ), and the Migraine Disability Assessment (MIDAS) Questionnaire. A set of demographic and clinical characteristics was also collected. RESULTS Stress, heredity, and nervousness were the most frequent perceived causes of headache. Female gender was significantly related to higher Brief IPQ "consequences" and "emotional response" scores. Increased psychological distress and a poorer clinical course were significantly associated with more negative illness representations. In multiple regression analysis, a longer illness duration, increased depressive symptoms, and higher levels of headache-related disability and painfulness of headache attacks independently predicted a worse illness perception. CONCLUSIONS In patients with migraine, depressive symptoms and a worse disease status, characterized by a longer history of suffering, higher disability and more painful headache attacks, may negatively affect illness perception. It could also be that dysfunctional illness representations lead to depressive symptoms and decrease patients' motivation to adhere to treatments, resulting in a worse outcome. Future studies should examine whether the improvement of illness perception through specific psychological interventions may promote a better adaptation to migraine.
Collapse
Affiliation(s)
- Laura Sirri
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
| | - Giulia Pierangeli
- Department of Biomedical and NeuroMotor Sciences - DiBiNeM, University of Bologna, Bologna, Italy; IRCCS Institute of Neurological Sciences of Bologna - AUSL Bologna, Bologna, Italy.
| | - Sabina Cevoli
- Department of Biomedical and NeuroMotor Sciences - DiBiNeM, University of Bologna, Bologna, Italy; IRCCS Institute of Neurological Sciences of Bologna - AUSL Bologna, Bologna, Italy.
| | - Pietro Cortelli
- Department of Biomedical and NeuroMotor Sciences - DiBiNeM, University of Bologna, Bologna, Italy; IRCCS Institute of Neurological Sciences of Bologna - AUSL Bologna, Bologna, Italy.
| | - Silvana Grandi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
| | - Eliana Tossani
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
| |
Collapse
|
25
|
Seng EK, Kuka AJ, Mayson SJ, Smitherman TA, Buse DC. Acceptance, Psychiatric Symptoms, and Migraine Disability: An Observational Study in a Headache Center. Headache 2018; 58:859-872. [PMID: 29924411 PMCID: PMC6020159 DOI: 10.1111/head.13325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate relationships between psychiatric symptoms, acceptance, and migraine-related disability in a sample of people with migraine presenting at a tertiary care headache center. BACKGROUND Migraine is a chronic disease that can be severely disabling. Despite a strong theoretical basis and evidence in other pain conditions, little is known about relationships between acceptance, psychiatric symptoms, and migraine-related disability. METHODS Ninety patients with physician-diagnosed migraine completed surveys assessing demographics, headache symptoms, severe migraine-related disability (Migraine Disability Assessment Scale total score dichotomized at ≥ 21), depression (Patient Health Questionnaire-9) and anxiety symptoms (Generalized Anxiety Disorder-7), and acceptance (Chronic Pain Acceptance Questionnaire; subscales: Pain Willingness and Activity Engagement). RESULTS Participants (77.8% white, non-Hispanic; 85.6% women; and 50.0% with a graduate level education) reported an average headache pain intensity of 6.7/10 (SD = 2.0). One-third (36.0%) reported chronic migraine, and half (51.5%) reported severe migraine-related disability. Lower acceptance was associated with severe migraine-related disability, t(54) = 4.13, P < .001. Higher activity engagement was associated with lower average headache pain intensity (r = -.30, P = .011). Higher acceptance was associated with lower levels of depression (r = -.48, P < .001) and anxiety symptoms (r = -.37, P = .003). Pain willingness and activity engagement serially mediated relationships between depression symptoms and severe migraine-related disability (indirect effect = 0.05, 95% CI = 0.01, 0.15), and between anxiety symptoms and severe migraine-related disability (indirect effect = 0.12, 95% CI = 0.02, 0.31). CONCLUSION Results provided preliminary support for a theoretical pathway by which psychiatric symptoms may influence migraine-related disability, in part, through their relationships with pain willingness and activity engagement.
Collapse
Affiliation(s)
- Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alexander J Kuka
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| | | | - Todd A Smitherman
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| | - Dawn C Buse
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
26
|
Krøll LS, Sjödahl Hammarlund C, Gard G, Jensen RH, Bendtsen L. Has aerobic exercise effect on pain perception in persons with migraine and coexisting tension-type headache and neck pain? A randomized, controlled, clinical trial. Eur J Pain 2018; 22:1399-1408. [PMID: 29635806 DOI: 10.1002/ejp.1228] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND A large subset of persons with migraine suffers from coexisting tension-type headache and neck pain which may adversely affect the prognosis of migraine. Aerobic exercise has been shown to decrease migraine burden in these persons. Therefore, the aim of this study was to investigate whether the effect of aerobic exercise in persons with migraine and coexisting tension-type headache and neck pain can be explained by changes in pain perception. METHOD Seventy consecutively recruited persons with migraine and coexisting tension-type headache and neck pain were randomized into exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 min, three times/week for 3 months. Controls continued their usual daily activities. Pericranial tenderness, pain thresholds, supra-thresholds and temporal summation were assessed at baseline, after treatment and at follow-up (6 months from baseline). RESULTS Fifty-two persons with migraine and coexisting tension-type headache and neck pain completed the study. Aerobic exercise did not induce consistent changes in nociceptive pathways measured by pericranial tenderness, pressure pain thresholds and sensitivity to electrical stimulation. CONCLUSION The effect of aerobic exercise cannot be explained by measurable effects on the pain modulation system. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour. Aerobic exercise can be recommended as a safe and inexpensive migraine treatment strategy. SIGNIFICANCE This study adds further knowledge about the positive effect of aerobic exercise for persons with migraine and coexisting tension-type headache and neck pain. This effect cannot be measured by changes in pain modulation, but may rather be explained by positive alteration of avoidance behaviour.
Collapse
Affiliation(s)
- L S Krøll
- Department of Health Sciences, Lund University, Sweden
- Department of Neurology, Danish Headache Centre, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | | | - G Gard
- Department of Health Sciences, Lund University, Sweden
| | - R H Jensen
- Department of Neurology, Danish Headache Centre, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | - L Bendtsen
- Department of Neurology, Danish Headache Centre, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| |
Collapse
|
27
|
Peck KR, Roland MM, Smitherman TA. Factors Associated With Medication-Overuse Headache in Patients Seeking Treatment for Primary Headache. Headache 2018. [PMID: 29520765 DOI: 10.1111/head.13294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Although risk factors for medication-overuse headache have been identified within the general population, most studies have neglected clinical samples. The present study examined the relative and combined associations of these factors with medication-overuse headache in a sample of US adults seeking treatment for primary headache disorders. METHODS Treatment-seeking headache patients provided data on demographics, headache variables, psychiatric variables, use of headache medications, and use of other prescription medications and substances. A classification tree selection strategy was utilized within this cross-sectional study to differentiate between those with and without medication-overuse headache, and a final multivariable model assessed their combined utility. RESULTS Forty-three of 164 participants (26.2%) met diagnostic criteria for medication-overuse headache. Relative to non-medication-overuse headache participants, participants with medication-overuse headache reported greater headache-related disability (odds ratio = 1.09, 95% confidence interval = 1.01-1.18), escape and avoidance responses indicative of fear of pain (odds ratio = 1.07, 95% confidence interval = 1.00-1.15), and use of combination medications for headache (odds ratio = 3.10, 95% confidence interval = 1.51-6.36). The final multivariable model differentiated well between the 2 groups (area under the receiver operating characteristic curve = .78; 95% confidence interval = .71-.86). CONCLUSIONS Items that assess headache-related disability, use of combination medications, and fear of pain help identify patients who are currently overusing acute headache medications and may serve as indicators of treatment progress. Future studies should apply similar analytic approaches longitudinally to identify headache sufferers at risk for medication-overuse headache prior to headache progression.
Collapse
Affiliation(s)
- Kelly R Peck
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA
| | | | - Todd A Smitherman
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| |
Collapse
|
28
|
Solstrand Dahlberg L, Linnman CN, Lee D, Burstein R, Becerra L, Borsook D. Responsivity of Periaqueductal Gray Connectivity Is Related to Headache Frequency in Episodic Migraine. Front Neurol 2018; 9:61. [PMID: 29487563 PMCID: PMC5816750 DOI: 10.3389/fneur.2018.00061] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/24/2018] [Indexed: 01/17/2023] Open
Abstract
Migraineurs show hypersensitivity to sensory stimuli at various stages throughout the migraine cycle. A number of putative processes have been implicated including a dysfunction in the descending pain modulatory system in which the periaqueductal gray (PAG) is considered to play a crucial role. Recurring migraine attacks could progressively perturb this system, lowering the threshold for future attacks, and contribute to disease chronification. Here, we investigated PAG connectivity with other brain regions during a noxious thermal stimulus to determine changes in migraineurs, and associations with migraine frequency. 21 episodic migraine patients and 22 matched controls were included in the study. During functional MRI, a thermode was placed on the subjects' temple delivering noxious and non-noxious heat stimuli. A psychophysiological interaction (PPI) analysis was carried out to examine pain-induced connectivity of the PAG with other brain regions. The PPI analysis showed increased PAG connectivity with the S1 face representation area and the supplementary motor area, an area involved with pain expectancy, in patients with higher frequency of migraine attacks. PAG connectivity with regions involved with the descending pain modulatory system (i.e., prefrontal cortex) was decreased in the migraineurs versus healthy individuals. Our results suggest that high frequency migraineurs may have diminished resistance to cephalic pain and a less efficient inhibitory pain modulatory response to external stressor (i.e., noxious heat). The findings support the notion that in migraine there is less effective pain modulation (viz., decreased pain inhibition or increased pain facilitation), potentially contributing to increased occurrence of attacks/chronification of migraine.
Collapse
Affiliation(s)
- Linda Solstrand Dahlberg
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Clas N Linnman
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Danielle Lee
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
| | - Rami Burstein
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Lino Becerra
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - David Borsook
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
29
|
Greene NR, Smith CV, Jewell DE, Smitherman TA. A Diary Study of Basic Psychological Needs and Daily Headache Experience. Headache 2018; 58:581-588. [DOI: 10.1111/head.13273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/14/2017] [Accepted: 01/01/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Nathaniel R. Greene
- Department of Psychological Sciences; University of Missouri Columbia; MO USA
| | | | - Devin E. Jewell
- Department of Psychology; University of Mississippi, Oxford; MS USA
| | | |
Collapse
|
30
|
Krøll LS, Hammarlund CS, Linde M, Gard G, Jensen RH. The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial. Cephalalgia 2018; 38:1805-1816. [PMID: 29333870 DOI: 10.1177/0333102417752119] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 minutes, three times/week. Controls continued usual daily activities. Pain frequency, intensity, and duration; physical fitness, level of physical activity, well-being and ability to engage in daily activities were assessed at baseline, after treatment and at follow-up. Results Fifty-two persons completed the study. Significant between-group improvements for the exercise group were found for physical fitness, level of physical activity, migraine burden and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Within the exercise group, significant reduction was found for migraine frequency, pain intensity and duration, neck pain intensity, and burden of migraine; an increase in physical fitness and well-being. Conclusions Exercise significantly reduced the burden of migraine and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Exercise also reduced migraine frequency, pain intensity and duration, although this was not significant compared to controls. These results emphasize the importance of regular aerobic exercise for reduction of migraine burden.
Collapse
Affiliation(s)
- Lotte Skytte Krøll
- 1 Department of Health Sciences, Lund University, Lund, Sweden.,2 Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | | | - Mattias Linde
- 3 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunvor Gard
- 1 Department of Health Sciences, Lund University, Lund, Sweden
| | - Rigmor Højland Jensen
- 2 Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| |
Collapse
|
31
|
Successful Treatment of Multifactorial Chronic Daily Headaches at an Interdisciplinary Chronic Pain Program: A Case Study. PM R 2017; 10:446-451. [PMID: 29111462 DOI: 10.1016/j.pmrj.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 08/29/2017] [Accepted: 10/23/2017] [Indexed: 11/23/2022]
Abstract
Chronic daily headaches (CDHs) are common, disabling, and difficult to treat. We report a case of a patient with a complex medical history experiencing multifactorial CDH referred for and eventually enrolled in an interdisciplinary chronic pain program. Focusing on enhancing the patient's function while minimizing the use of medications and invasive procedures, this comprehensive rehabilitation intervention consists of diverse treatment approaches, including cognitive-behavioral therapy, physical and occupational therapy, and medical interventions. Despite the patient's challenges with implementation of strategies learned in the program, positive results were seen, including decreased symptomatology, decreased opioid use, and attainment of employment. Although time-intensive, interdisciplinary chronic pain programs may result in a greater likelihood for sustained functional improvements and prevention of disability for patients with CDH, even in the most complex. LEVEL OF EVIDENCE IV.
Collapse
|
32
|
Abstract
Background Oliver Sacks (1933–2015) published a large number of books on a variety of neurological topics. Of these, numerous copies have been sold and they probably serve as the only or main source of information on neurological diseases for many persons without a medical background. His first book was on migraine and in his subsequent books many descriptions of migraine can be found, mainly those of auras. Methods We explored the descriptions of migraine in Sacks’ work in order to evaluate the image of migraine offered to the readers. Conclusion Oliver Sacks gave wonderful descriptions of migraine auras, but hardly any of migraine headache. Furthermore, he described rare auras such as ‘amusia’ and olfactory auras. Overall, this makes his descriptions of migraine not very useful to serve as medical information for laypersons. Oliver Sacks, however, wrote great literature.
Collapse
Affiliation(s)
- Joost Haan
- Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ad A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bastiaan C ter Meulen
- Department of Neurology, St Lucas Andreas Hospital, Amsterdam and Zaans Medisch Centrum, Zaandam, The Netherlands
| |
Collapse
|
33
|
Lillis J, Graham Thomas J, Seng EK, Lipton RB, Pavlović JM, Rathier L, Roth J, O'Leary KC, Bond DS. Importance of Pain Acceptance in Relation to Headache Disability and Pain Interference in Women With Migraine and Overweight/Obesity. Headache 2017; 57:709-718. [PMID: 28295273 DOI: 10.1111/head.13058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Pain acceptance involves willingness to experience pain and engaging in valued activities while pain is present. Though pain acceptance could limit both headache-related disability and pain interference in individuals with migraine, few studies have addressed this issue. This study evaluated whether higher levels of total pain acceptance and its two subcomponents, pain willingness and activity engagement, were associated with lower levels of headache-related impairment in women who had both migraine and overweight/obesity. METHODS In this cross-sectional study, participants seeking weight loss and headache relief in the Women's Health and Migraine trial completed baseline measures of pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]), headache-related disability (Headache Impact Test-6), and pain interference (Brief Pain Inventory). Migraine headache frequency and pain intensity were assessed daily via smartphone diary. Using CPAQ total and subcomponent (pain willingness and activity engagement) scores, headache frequency, pain intensity, and body mass index (BMI) as predictors in linear regression, headache-related disability, and pain interference were modeled as outcomes. RESULTS On average, participants (n = 126; age = 38.5 ± 8.2 years; BMI = 35.3 ± 6.6 kg/m2 ) reported 8.4 ± 4.7 migraine days/month and pain intensity of 6.0 ± 1.5 on a 0-10 scale on headache days. After correcting for multiple comparisons (adjusted α = .008), pain willingness was independently associated with both lower headache-related disability (P < .001; β = -0.233) and pain interference (P < .001; β = -0.261). Activity engagement was not associated with headache-related disability (P = .128; β = -0.138) and pain interference (P = .042; β = -0.154). CPAQ total score was not associated with headache-related disability (P = .439; β = 0.066) and pain interference (P = .305; β = 0.074). Pain intensity was significantly associated with outcomes in all analyses (Ps < .001; βs 0.343-0.615). CONCLUSIONS Higher pain willingness, independent of degree of both migraine severity and overweight, is associated with lower headache-related disability and general pain interference in treatment-seeking women with migraine and overweight/obesity. Future studies are needed to clarify direction of causality and test whether strategies designed to help women increase pain willingness, or relinquish ineffective efforts to control pain, can improve functional outcomes in women who have migraine and overweight/obesity.
Collapse
Affiliation(s)
- Jason Lillis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Elizabeth K Seng
- Department of Neurology, Albert Einstein College of Medicine, Ferkauf Graduate School of Psychology, Yeshiva University, New York City, NY, USA
| | - Richard B Lipton
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Jelena M Pavlović
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Lucille Rathier
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Julie Roth
- Department of Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA
| | - Kevin C O'Leary
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Dale S Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| |
Collapse
|
34
|
Seng EK, Klepper JE. Development of the Cogniphobia Scale for Headache Disorders (CS-HD): A pilot study. Psychol Assess 2017; 29:1296-1301. [PMID: 28125248 DOI: 10.1037/pas0000432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cogniphobia refers to the specific fear and avoidance of cognitive exertion, which is believed to precipitate or exacerbate headache. This parallels a well-documented phenomenon, kinesiophobia (fear of movement), in chronic pain. The existing measure of cogniphobia (C-Scale) was developed in persons with posttraumatic headache, and item content may not generalize to the broader headache population. This study aimed to develop and begin the initial examination of the psychometrics of a novel measure of cogniphobia for headache disorders: The Cogniphobia Scale for Headache Disorders (CS-HD). Candidate CS-HD items were developed through content analysis, patient evaluation, and peer debriefing. Eighty adults with migraine recruited from a headache center completed 23 candidate items for the CS-HD and surveys of demographics, anxiety, and headache locus of control. A series of dimensionality analyses identified a single component, composed of 15 items, which accounted for 54.05% of the variance in the CS-HD items. The CS-HD demonstrated high internal consistency in this sample (α = 0.94). Preliminary convergent validity analyses found CS-HD total scores were positively associated with anxiety (ρ = .37, p = .001) and locus of control (internal, r = .45, p < .001; chance, r = .30, p = .009). This study provides initial evidence supporting the use of the CS-HD to evaluate cogniphobia in people with headache. (PsycINFO Database Record
Collapse
|
35
|
Kokonyei G, Szabo E, Kocsel N, Edes A, Eszlari N, Pap D, Magyar M, Kovacs D, Zsombok T, Elliott R, Anderson IM, William Deakin JF, Bagdy G, Juhasz G. Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress. Psychol Health 2016; 31:1481-1497. [PMID: 27616579 PMCID: PMC5062042 DOI: 10.1080/08870446.2016.1235166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 09/05/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The relationship between migraine and psychological distress has been consistently reported in cross-sectional and longitudinal studies. We hypothesised that a stable tendency to perseverative thoughts such as rumination would mediate the relationship between migraine and psychological distress. Design and Main Outcomes Measures: Self-report questionnaires measuring depressive rumination, current psychological distress and migraine symptoms in two independent European population cohorts, recruited from Budapest (N = 1139) and Manchester (N = 2004), were used. Structural regression analysis within structural equation modelling was applied to test the mediational role of brooding and reflection, the components of rumination, between migraine and psychological distress. Sex, age and lifetime depression were controlled for in the analysis. RESULTS Migraine predicted higher brooding and reflection scores, and brooding proved to be a mediator between migraine and psychological distress in both samples, while reflection mediated the relationship significantly only in the Budapest sample. CONCLUSIONS Elevated psychological distress in migraine is partially attributed to ruminative response style. Further studies are needed to expand our findings to clinical samples and to examine how rumination links to the adjustment to migraine.
Collapse
Affiliation(s)
- Gyongyi Kokonyei
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Edina Szabo
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Natalia Kocsel
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Andrea Edes
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Nora Eszlari
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Dorottya Pap
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Mate Magyar
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine, Department of Neurology, Semmelweis University, Budapest, Hungary
| | - David Kovacs
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Terezia Zsombok
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine, Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Ian Muir Anderson
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - John Francis William Deakin
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Gyorgy Bagdy
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Gabriella Juhasz
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| |
Collapse
|
36
|
Cardoso S, Esculpi D, Carvalho AR, Pereira DR, Torres S, Mercado F, Barbosa F. The European Portuguese adaptation of the Fear of Pain Questionnaire. REVISTA BRASILEIRA DE REUMATOLOGIA 2016; 56:377-383. [PMID: 27692386 DOI: 10.1016/j.rbre.2016.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 10/13/2015] [Indexed: 01/13/2023] Open
Abstract
In Portugal, it is estimated that chronic pain affects 36.7% of the population, constituting a multifactorial phenomenon with great impact at individual, family, community, and social levels. In the fear-avoidance model of pain, one of the most consistent consensual in the literature, the fear arises as one of the variables that can contribute to the development and maintenance of this condition. Thus, instruments for evaluating the fear of pain, as Fear of Pain Questionnaire (FPQ-III), may be useful in the conceptualization of the subjective experience of pain. Accordingly, this paper aims to describe the adaptation of FPQ-III for the European Portuguese. A total of 1094 participants (795 women; mean age=25.16, SD=7.72) completed the web based questionnaire. The results pointed to a different factor solution found in the first study of the original scale (five factors: minor pain, severe pain, medical pain, injection pain, and afflicted pain), good internal consistency (.75-.85) and good correlations (between .30 and .59) between subscales and (between .68 and .85) for the total score and subscales. Given the need to meet the various dimensions of subjective experience of pain, the Fear of Pain Questionnaire is assumed as a useful tool, in combination with other, may contribute to the evaluation and intervention procedures progressively more comprehensive and adjusted to the challenges raised with the issue of chronic pain.
Collapse
Affiliation(s)
- Susana Cardoso
- Laboratório de Neuropsicofisiologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal; Centro de Psicologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Rey Juan Carlos, Madrid, Spain.
| | - Daniel Esculpi
- Centro de Psicologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Ana Rita Carvalho
- Laboratório de Neuropsicofisiologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Diana R Pereira
- Laboratório de Neuropsicofisiologia - CIPsi, Escola de Psicologia, Universidade do Minho, Braga, Portugal
| | - Sandra Torres
- Centro de Psicologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Francisco Mercado
- Faculdade de Ciências da Saúde, Universidade Rey Juan Carlos, Madrid, Spain
| | - Fernando Barbosa
- Laboratório de Neuropsicofisiologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| |
Collapse
|
37
|
Cardoso S, Esculpi D, Carvalho AR, R Pereira D, Torres S, Mercado F, Barbosa F. The European Portuguese adaptation of the Fear of Pain Questionnaire. REVISTA BRASILEIRA DE REUMATOLOGIA 2016; 56:S0482-5004(16)00025-5. [PMID: 26947178 DOI: 10.1016/j.rbr.2015.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/11/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022] Open
Abstract
In Portugal, it is estimated that chronic pain affects 36.7% of the population, constituting a multifactorial phenomenon with great impact on individual, family, community, and social levels. In the fear-avoidance model of pain, one of the most consistent consensus in the literature, the fear arises as one of the variables that can contribute to the development and maintenance of this condition. Thus, instruments for evaluating the fear of pain, as Fear of Pain Questionnaire (FPQ-III), may be useful in the conceptualization of the subjective experience of pain. Accordingly, this paper aims to describe the adaptation of FPQ-III to the European Portuguese idiom. A total of 1,094 participants (795 female; mean age=25.16, SD=7.72 years old) completed the web based questionnaire. The results point to a different factor model found in the first study of the original scale (five factors: minor pain, severe pain, medical pain, injection pain, and afflicted pain), good internal consistency (0.75 to 0.85) and good correlations (between 0.30 and 0.59) between subscales and (between 0.68 e 0.85) for the total score and subscales. Given the need to meet the various dimensions of the subjective experience of pain, the Fear of Pain Questionnaire is assumed as a useful tool that, in combination with other tools, may contribute to the evaluation and intervention procedures progressively more comprehensive and adjusted to the challenges raised with the issue of chronic pain.
Collapse
Affiliation(s)
- Susana Cardoso
- Laboratório de Neuropsicofisiologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal; Centro de Psicologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Rey Juan Carlos, Madrid, Espanha.
| | - Daniel Esculpi
- Centro de Psicologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Ana Rita Carvalho
- Laboratório de Neuropsicofisiologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Diana R Pereira
- Laboratório de Neuropsicofisiologia - CIPsi, Escola de Psicologia, Universidade do Minho, Braga, Portugal
| | - Sandra Torres
- Centro de Psicologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Francisco Mercado
- Faculdade de Ciências da Saúde, Universidade Rey Juan Carlos, Madrid, Espanha
| | - Fernando Barbosa
- Laboratório de Neuropsicofisiologia, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
| |
Collapse
|
38
|
|
39
|
Walters AB, Smitherman TA. Development and Validation of a Four-Item Migraine Screening Algorithm Among a Nonclinical Sample: The Migraine-4. Headache 2015; 56:86-94. [DOI: 10.1111/head.12716] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 01/03/2023]
Affiliation(s)
- A. Brooke Walters
- Department of Psychology; University of Mississippi; Oxford MS 38677 USA
| | - Todd A. Smitherman
- Department of Psychology; University of Mississippi; Oxford MS 38677 USA
| |
Collapse
|