title: Effects of Flexibility in Coping with Chronic Headaches on Depressive Symptoms.
abstract: BACKGROUND
  Coping flexibility refers to one's ability or skill to effectively modify one's coping strategy according to the nature of each stressful situation one encounters; the coping flexibility hypothesis (CFH) predicts that more flexible coping will produce more adaptive outcomes.
  
  
  OBJECTIVE
  Qur purpose was to test the validity of the CFH in chronic headaches.
  
  
  METHODS
  The validity of the CFH in chronic pain was tested in female college students who suffered from chronic daily headaches in Japan. Over a period of approximately 3 months, primary participants with chronic headaches (n = 73) and participants with low frequency headaches (n = 123) completed questionnaires related to flexibility in coping and coping with headaches, as well as depressive symptoms later.
  
  
  RESULTS
  A hierarchical multiple regression analysis revealed that flexibility in coping with chronic headaches was significantly associated with reduced depressive symptoms later, even after controlling for the effects of coping strategies with chronic headaches; the CFH for chronic pain was supported by data from chronic headache sufferers. Similar results were also obtained for participants with low frequency headaches. Catastrophizing, a strategy for coping with chronic headaches, was negatively and significantly associated with depressive symptoms later.
  
  
  CONCLUSIONS
  The CFH was supported in cases of chronic headache. Our findings indicate the importance of the effects of flexibility in coping with primary headaches on distress.
authors.affiliation: Department of Social Psychology, Toyo University, Hakusan, 5-20-26, Bunkyo-ku, Tokyo, Japan, mtsukasa@hotmail.com.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kato
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D058443:Catastrophization / Q000523:psychology; D003863:Depression / Q000523:psychology*; D005260:Female; D020773:Headache Disorders / Q000523:psychology*; D006801:Humans; D007564:Japan; D015999:Multivariate Analysis; D012044:Regression Analysis; D013315:Stress, Psychological / Q000523:psychology*; D013334:Students; D011795:Surveys and Questionnaires; D055815:Young Adult