The Role Of Fear Of Pain In Headache

Recurrent headache sufferers are often fearful of pain, which disrupts cognitive thought processes, interferes with daily activities, and may maintain headache-related disability through avoidance and associated negative reinforcement. The aim of this cross-sectional study was to 1) examine differences in fear of pain between headache sufferers and non-headache controls; 2) examine differences in fear of pain across primary headache diagnostic groups; 3) assess the extent to which fear of pain predicts headache variables (e.g., severity, frequency, disability); and 4) determine whether fear of pain mediates the relationship between pain severity and headache-related disability. The sample consisted of 908 young adults ages 18-49 (M = 19.52 years; 64.9% female). Of those, 237 (26.1%) met the diagnostic criteria for episodic tension-type headache, 232 (25.6%) for episodic migraine (167 [18.4%] without aura and 65 [7.2%] with aura), 38 (4.2%) for chronic migraine, and 19 (2.1%) for chronic tension-type headache; 382 (42.1%) served as non-headache controls. Fear of pain differed among groups, with headache sufferers reporting greater fear of pain than those without headache; migraineurs typically endorsed greater fear of pain than those with tension-type headache. Among those with headache, fear of pain significantly predicted headache severity (R2 = 6.1%) and frequency (R2 = 4.5%), and accounted for more variance in disability (R2 = 17.5%) than gender, anxiety, and depression combined (13.8%). Pain severity and disability were strongly associated ( r = .61, p < .001), and fear of pain partially mediated this association (indirect effect point estimate = 0.38; 95% confidence interval [CI]: 0.23 to 0.57). Fear of pain differentiates migraineurs from those without headache and plays a significant role in primary headache, particularly in headache-related disability. Findings build upon and extend those from previous chronic pain studies and highlight the need for longitudinal and experimental studies to further explore this construct in headache.

Name thesis:degree_name

M.A. in Psychology

Level thesis:degree_level

Thesis

Discipline thesis:degree_discipline

Psychology

Year dc:date.available

2015

Author dc:creator

• Black, Anna Katherine

Contributors dc:contributor

• Todd A. Smitherman
• Alan M. Gross
• Michael Allen

• Disability
• Fear Of Pain
• Headache
• Mediator
• Migraine
• Tension-Type Headache
• Clinical Psychology

Repository record dc:identifier

https://egrove.olemiss.edu/etd/812

OAI identifier oai:identifier

oai:egrove.olemiss.edu:etd-1811