title: Initial responses of different health care professionals to various patients with headache: which are perceived as difficult?
abstract: BACKGROUND
  Somatizing patients are considered a challenge to health care professionals.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the responses of different health care professionals' to patients with headache with different presentations.
  
  
  METHODS
  Medical professionals (n = 77), clinical psychologists (n = 40), and psychology students (n = 115) were shown with four different manifestations of headache (neutral, somatic trauma, anxious-depressed, and severe somatizing). Health professionals rated their initial cognitive and emotional responses using a standardized questionnaire.
  
  
  RESULTS
  The severe somatizing and anxious-depressed patients with headache evoked significantly more negative cognitive and emotional responses in all three samples. Even brief exposure to a patient's story yields specific initial responses from various health care professionals irrespective of their disciplines.
  
  
  CONCLUSIONS
  Patients with headache and with a distressed presentation evoke significantly more negative cognitive and emotional responses in different health care professionals. Health care professionals should be more aware of their own response to difficult patients; in this way they will be more capable of managing this patient group.
authors.affiliation: Transcare, Transdisciplinary Pain Management Centre, Barkmolenstraat 196, 9723 DM, Groningen, The Netherlands, c.p.vanwilgen@online.nl.
authors.forename: C Paul
authors.initials: CP
authors.lastname: van Wilgen
authors.forename: Maaike
authors.initials: M
authors.lastname: Koning
authors.forename: Theo K
authors.initials: TK
authors.lastname: Bouman
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D006261:Headache / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D010820:Physicians / Q000523:psychology*; D011369:Professional-Patient Relations; D011584:Psychology; D013001:Somatoform Disorders / Q000523:psychology*; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult