Tension, or muscle contraction, headache is by definition associated with life stress. However, there has been relatively little empirical research on the role of naturally occurring stressors in causing tension headache. The current investigation sought to examine some psychological variables hypothesized to be related to chronic tension headache, particularly psychosocial factors. The temporal relationship of headache activity and stress was a major focus. A second purpose of the study was to investigate the family as a particularly salient environmental source of stress for the headache sufferer. Experimental subjects were 18 family pairs, with one member diagnosed as having chronic tension headache. Control subjects were 15 family pairs in which one member had recently sustained an orthopedic injury, resulting in pain. All subjects kept a 14-day diary, monitoring mood swings, the occurrence of stressful events, headache and other somatic complaints. Subjects participated in a semi-structured interview and completed questionnaires concerning depression, anxiety, physical complaints, life hassles, previous illness experiences, and family life. Analyses revealed moderate correlation between targets' average headache activity and average diary ratings of their own hassles and their families' hassle. Additionally, correlations between targets' average headache activity and their own average mood ratings and physical symptom ratings approached significance. Concerning temporal relationships, analyses revealed mild-to-moderate isomorphic correlations between target headache activity and diary ratings of target hassles. Cross-lagged correlations indicated daily headache fluctuations were also mildly-to-moderately related to target hassles from the previous day and the following day. Temporal results are discussed in terms of potential cause and consequence. Implications are discussed in terms of support for a multi-component model of chronic tension headache. / Ph. D.

To aid in understanding headache etiology and symptomatology, psychological and physiological variables were examined in patients with migraine and combination headaches (combined migraine and muscle-contraction headaches). One hundred patients being evaluated for treatment of their headaches at The New England Center for Headache participated in this study. They were assigned to the migraine or combination group, based on diagnoses made by three headache specialists—a psychologist, a psychiatrist, and a nuerologist. Personality data from the MMPI and frontalis electromyographic readings reflecting muscle tensions across three stimulus conditions were compared between the two groups. Subjects were also asked to rate the perceived level of stress elicited by the three conditions.

Review of previous research on cultural differences in pain experience and/or pain behavior revealed that cultural affiliation affects pain perception and response. Unfortunately, the many inconsistent findings in the literature on cultural differences in pain experience and behavior have made interpretations and comparisons of results problematic. These inconsistent findings could be attributed to variations in acculturation level among cultural groups. The purpose of this study was to investigate cultural differences in pain experience (assessed by McGill Pain Questionnaire, the Box Scale, the Headache Pain Drawing, and the Headache Questionnaire) and pain behavior (measured by determining medication use and interference of daily functioning due to headaches) among Mexican (n = 43), Mexican American (n = 36), and Anglo American (n = 50) female chronic headache pain sufferers. The contribution of acculturation to differences in pain experience and behavior among cultural groups was measured by the Acculturation Rating Scale for Mexican Americans. The three cultural groups of women significantly differed on pain experience and pain behavior. Specifically, Mexican women experienced their headache pain more intensely, severely, and emotionally than Mexican American and Anglo American women. Furthermore, Mexican women were more willing to verbally express their pain than the other two groups. As for pain behavior, Mexican women took more medication and reported more severe inhibition of daily activities due to headaches than Mexican American and Anglo American women. Ethnic identity, ethnic pride, and language preference were factors in the acculturation process which contributed the most to women's chronic pain experience and behavior. The greatest variability occurred within the Mexican American group of women who perceived themselves as being more Mexican in attitudes and/or behaviors, but more similar to Anglo American in their pain experience and pain behavior. Results are explained using biocultural multidimensional pain theory, social learning theory, and acculturation theory.

Chronic headache may be the most frequently reported somatic symptom, yet it puzzles health experts and poses a considerable treatment challenge. It was suggested that this is because conventional views of headache, adhering to a Newtonian-Cartesian epistemology, focus almost exclusively on intrapsychic factors ignoring the wider social context in which the problem is embedded. An overview of the existing body of knowledge on the most widely researched headache conditions was presented, and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This study was conducted within an holistic, ecosystemic epistemology. A qualitative approach employing a case study method was adopted to provide rich descriptions of the contexts in which two chronic headache sufferers' symptoms were embedded. The case study presentations also illustrated the attempts that were made to intervene into the headache contexts from a second-order cybernetics stance. / Psychology / M.A. (Clinical Psychology)

Chronic headache may be the most frequently reported somatic symptom, yet it puzzles health experts and poses a considerable treatment challenge. It was suggested that this is because conventional views of headache, adhering to a Newtonian-Cartesian epistemology, focus almost exclusively on intrapsychic factors ignoring the wider social context in which the problem is embedded. An overview of the existing body of knowledge on the most widely researched headache conditions was presented, and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This study was conducted within an holistic, ecosystemic epistemology. A qualitative approach employing a case study method was adopted to provide rich descriptions of the contexts in which two chronic headache sufferers' symptoms were embedded. The case study presentations also illustrated the attempts that were made to intervene into the headache contexts from a second-order cybernetics stance. / Psychology / M.A. (Clinical Psychology)