title: Pain sensitivity mediates the relationship between stress and headache intensity in chronic tension-type headache.
abstract: BACKGROUND
  A central model for chronic tension-type headache (CTH) posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. The prediction from this model that pain sensitivity mediates the relationship between stress and headache activity has not yet been examined.
  
  
  OBJECTIVE
  To determine whether pain sensitivity mediates the relationship between stress and prospective headache activity in CTH sufferers.
  
  
  METHODS
  Self-reported stress, pain sensitivity and prospective headache activity were measured in 53 CTH sufferers recruited from the general population. Pain sensitivity was modelled as a mediator between stress and headache activity, and tested using a nonparametric bootstrap analysis.
  
  
  RESULTS
  Pain sensitivity significantly mediated the relationship between stress and headache intensity.
  
  
  CONCLUSIONS
  The results of the present study support the central model for CTH, which posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. Implications for the mechanisms and treatment of CTH are discussed.
authors.affiliation: University of Canberra, Canberra, Australia. stuart.cathcart@canberra.edu.au
authors.forename: Stuart
authors.initials: S
authors.lastname: Cathcart
authors.forename: Navjot
authors.initials: N
authors.lastname: Bhullar
authors.forename: Maarten
authors.initials: M
authors.lastname: Immink
authors.forename: Chris
authors.initials: C
authors.lastname: Della Vedova
authors.forename: John
authors.initials: J
authors.lastname: Hayball
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017288:Pain Threshold / Q000502:physiology*; D011446:Prospective Studies; D057566:Self Report; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000150:complications*; D018781:Tension-Type Headache / Q000209:etiology* / Q000523:psychology; D055815:Young Adult