The contribution of pain-related anxiety to disability from headache

• Published in: Journal of behavioral medicine Vol. 29; no. 1; pp. 61 - 67
• Main Authors: NASH, Justin M, WILLIAMS, David M, NICHOLSON, Robert, TRASK, Peter C
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.02.2006; Springer Nature B.V
• Subjects: Absenteeism; Activities of Daily Living - psychology; Adolescent; Adult; Aged; Anxiety; Anxiety - complications; Anxiety - psychology; Biological and medical sciences; Disability Evaluation; Female; Fundamental and applied biological sciences. Psychology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Illness and personality; Illness, stress and coping; Internal-External Control; Male; Medical sciences; Middle Aged; Migraine Disorders - psychology; Nervous system (semeiology, syndromes); Neurology; Pain - psychology; Pain Measurement; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Regression Analysis; Self Efficacy; Sick Role; Stress, Psychological - complications; Stress, Psychological - psychology; Tension-Type Headache - psychology; United States; North America; America; Social environment; Human; Affect affectivity; Headache; Nervous system diseases; Locus of control; Mental health; pain anxiety; Personality; Cognition; Disability; Pain; Psychological distress; self-efficacy; Self efficacy; Anxiety; Neurological disorder; Predictive factor; Public health
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-005-9033-4

Disability associated with headache cannot be fully accounted for by pain intensity and headache frequency. As such, a variety of cognitive and affective factors have been identified to help explain headache-related disability beyond that accounted for by pain levels. Pain-related anxiety, a multidimensional construct, also has been found to contribute to disability in headache sufferers. What is not known is whether pain-related anxiety is unique in contributing to disability beyond the role of headache-specific cognitive factors and emotional distress. The present study examines the influence of pain-related anxiety on disability, after controlling for pain, cognitive (self-efficacy and locus of control), and affective factors (emotional distress) in a sample of 96 primary headache sufferers. Pain, headache-related control beliefs, and emotional distress accounted for 32%, with locus of control related to health care professionals contributing unique variance. In the full model, with the addition of pain-related anxiety, only pain-related anxiety was a unique predictor of disability. These findings suggest that pain-related anxiety may have a unique and important role in contributing to disability in headache sufferers.