Date of Award
2015
Document Type
Thesis
Degree Name
M.A. in Psychology
Department
Psychology
First Advisor
Todd A. Smitherman
Second Advisor
Alan M. Gross
Third Advisor
Michael Allen
Relational Format
dissertation/thesis
Abstract
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.
Recommended Citation
Black, Anna Katherine, "The Role Of Fear Of Pain In Headache" (2015). Electronic Theses and Dissertations. 812.
https://egrove.olemiss.edu/etd/812
Concentration/Emphasis
Emphasis: Clinical Psychology