The Role of Fear of Pain in Headache
The Role of Fear of Pain in Headache
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DOI：
10.1111/head.12561
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发表时间：
2015-05-01
期刊：
影响因子：
5
通讯作者：
Smitherman, Todd A.
中科院分区：
文献类型：
--
作者：
Black, Anna Katherine;Fulwiler, Joshua C.;Smitherman, Todd A.
研究背景复发性头痛患者常因疼痛而产生恐惧感，疼痛会扰乱思维过程，干扰日常活动，并可能通过回避和相关的负强化来维持头痛相关的残疾。（2）检查原发性头痛诊断组之间FOP的差异;（3）评估FOP预测头痛变量的程度（例如，严重程度，频率，残疾）;和（4）确定FOP是否介导疼痛严重程度和头痛相关disability.MethodsThe样本由908名年轻人（M年龄=19.5岁，64.9%女性）之间的关系。其中，237（26.1%）符合发作性紧张型头痛（TTH）的诊断标准，232（25.6%）发作性偏头痛（167例[18.4%]无先兆，65例[7.2%]有先兆），38例（4.2%）慢性偏头痛，（2.1%）慢性TTH; 382（42.1%）作为非头痛controls.ResultsFOP组之间的差异，头痛患者报告更大的FOP比那些没有头痛;偏头痛患者的FOP通常比TTH患者大。在头痛患者中，FOP显著预测头痛严重程度（R-2=6.1%）和频率（R-2=4.5%），并解释更多的残疾差异（R-2=17.5%）比性别，焦虑和抑郁的组合（13.8%）。疼痛严重程度与残疾密切相关（r=0.61，P
BackgroundRecurrent headache sufferers are often fearful of pain, which disrupts thought processes, interferes with daily activities, and may maintain headache-related disability through avoidance and associated negative reinforcement.ObjectiveThe aim of this cross-sectional study was to (1) examine differences in fear of pain (FOP) between headache sufferers and non-headache controls; (2) examine differences in FOP across primary headache diagnostic groups; (3) assess the extent to which FOP predicts headache variables (eg., severity, frequency, disability); and (4) determine whether FOP mediates the relationship between pain severity and headache-related disability.MethodsThe sample consisted of 908 young adults (M age=19.5 years; 64.9% female). Of those, 237 (26.1%) met the diagnostic criteria for episodic tension-type headache (TTH), 232 (25.6%) for episodic migraine (167 [18.4%] without aura and 65 [7.2%] with aura), 38 (4.2%) for chronic migraine, and 19 (2.1%) for chronic TTH; 382 (42.1%) served as non-headache controls.ResultsFOP differed among groups, with headache sufferers reporting greater FOP than those without headache; migraineurs typically endorsed greater FOP than those with TTH. Among those with headache, FOP significantly predicted headache severity (R-2=6.1%) and frequency (R-2=4.5%), and accounted for more variance in disability (R-2=17.5%) than gender, anxiety, and depression combined (13.8%). Pain severity and disability were strongly associated (r=0.61, P