title: The contribution of pain-related anxiety to disability from headache.
abstract: 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.
authors.affiliation: Centers for Behavioral and Preventive Medicine, Brown Medical School/The Miriam Hospital, Providence, Rhode Island, USA. Justin_Nash@brown.edu
authors.forename: Justin M
authors.initials: JM
authors.lastname: Nash
authors.forename: David M
authors.initials: DM
authors.lastname: Williams
authors.forename: Robert
authors.initials: R
authors.lastname: Nicholson
authors.forename: Peter C
authors.initials: PC
authors.lastname: Trask
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology*; D010146:Pain / Q000523:psychology*; D010147:Pain Measurement; D012044:Regression Analysis; D020377:Self Efficacy; D012803:Sick Role; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology; D018781:Tension-Type Headache / Q000523:psychology*