Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

M.A. in Psychology



First Advisor

Todd Smitherman

Second Advisor

Laura Dixon

Third Advisor

Aaron Lee

Relational Format



Headache disorders are among the most prevalent disorders of the nervous system, affecting more than half of the global population during the lifetime. Tension-type headache and migraine are disabling conditions, and their resulting symptoms negatively impact quality of life and reduce daily functioning. These conditions are often comorbid with psychiatric disorders such as depression and anxiety disorders, and headache-related disability is often compounded by these psychiatric symptoms as well as transdiagnostic factors, such as stress, fear of pain, and anxiety sensitivity. The present study aimed to explore the relative contributions of headache symptoms and psychological factors to headache-related disability and investigate the moderating role of headache diagnosis on these relationships. We hypothesized that psychiatric symptoms and transdiagnostic psychological factors would account for significant unique variance beyond headache variables in “predicting” headache-related disability. Additionally, we hypothesized that the aforementioned relationships would be stronger among those with migraine than tension-type headache. As predicted, both psychiatric and transdiagnostic symptoms accounted for unique variance in headache-related disability beyond headache symptoms (R-squared changes of 2.7% and 2.3%, respectively). Significant three-way interactions revealed the relationship between psychiatric symptoms and disability, and between transdiagnostic variables and disability, was strongest for individuals with a diagnosis of chronic tension-type headache. Results of the present study suggest psychiatric and transdiagnostic factors contribute uniquely to headache-related disability, which may be important for expanding assessment and targeting behavioral interventions.


Clinical Psychology



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