Perceived Stress and Coping Strategies in Headache (Migraine & Tension-Type Headache) Patients
Perceived Stress and Coping Strategies in Headache (Migraine & Tension-Type Headache) Patients
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头痛（偏头痛）的压力感知和应对策略
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
S. Aslam
中科院分区：
文献类型：
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作者：
N. Najam;S. Aslam
头痛是普通人群中最常见的现代医疗投诉之一。头痛通常分为偏头痛和紧张型头痛，或两者兼而有之。在5%到10%的人口中，慢性问题是偏头痛，而大约30%到40%的人患有慢性紧张性头痛（Carlson，& Peckham，2001;山楂，&雷德蒙，1998; Baum，Gatchel，& Krantz，1997 a，1997 b）。偏头痛、紧张型和丛集性头痛被分类为原发性头痛，无器质性，偏头痛通常被定义为神经系统疾病，其症状是严重的和致残的发作性头痛（Cooke，Rose，& Becker，2000）。它现在被很好地记录为血管疾病，由于主要颅外血管的张力丧失，导致痛苦的扩张和极度疼痛。化学物质如缓激肽或神经激肽在扩张的血管一侧释放（Baum，Krantz，& Gatchel，1997 a）。偏头痛有其触发因素，并以三种形式表达，典型偏头痛，普通偏头痛或复杂性偏头痛（Nowak，& Handford，2004）。偏头痛触发因素来自广泛的变量，行为，环境，感染，饮食，化学和/或激素触发因素可以促使偏头痛发作。据报道，压力、耀眼的光线、酒精、食物、睡眠过多或过少以及天气是引发偏头痛发作的最常见因素。由于天气变化的敏感性，天气也被报道为常见的降水因素之一（Prince，Rapoport，Sheftell，Tepper，& Bigal，2004;山楂，&雷德蒙，1998）。加拿大阿尔伯塔的奇努克风就是偏头痛的一个诱因（Cook，Rose，& Becker，2000）。女性荷尔蒙水平可能与偏头痛的发生有关，因为据报道，偏头痛的发生频率增加，特别是在月经期间。Mazal（1978）报道偏头痛发作主要发生在妊娠期间，口服避孕药可加重偏头痛。偏头痛似乎也有遗传基础，因为80%的偏头痛患者报告有偏头痛家族史。低收入或教育程度较低的患者报告偏头痛的发生率较高，年龄在35至45岁之间的患者也是如此紧张型头痛这种疼痛以带状形式放射，从前额到枕叶区域，报告有紧张感，压迫感和隐痛。与偏头痛相比，紧张型头痛具有不同的病理学，因为后者似乎局限于头部和颈部肌肉，并且可以持续数天或数周（Baum，Gatchel，& Krantz，1997 a，Hatch，1993; Baum，Gatchel，& Krantz，1997 b，Millea，& Brodie，2002）。紧张性头痛可能是由于对压力型疼痛的敏感性增强（Baum，Gatchel和Krantz，1997 b）。此外，肌肉硬度和疼痛也与紧张型头痛有关（Millea，& Brodie，2002）。患者的头部两侧会出现非搏动性压力、饱胀感或僵硬。紧张型头痛是逐渐发生的（Nowak，& Handford，2004），女性（88%）比男性（69%）更多地报告紧张型头痛（Marcus，2005）。在我们早期的研究中已经报道，在户外诊所报告的头痛患者中女性占68%（Tanwir，& Naj am，1992），并且在慢性患者中女性占73%（Tanwir，& Naj am，1994）。似乎感知到的压力会引发紧张型头痛。研究表明，头痛患者感知到更高水平的主观压力，并且所有被报告为更高水平压力的参与者都使用解脱应对方式（Myers，Wittrock，& Foreman，2004）。…
Headaches are among the most common modern medical complaints in the general population. Headaches are usually categorized as migraine and tension-type headaches, or a combination of both. In 5 to 10 percent of the population chronic problem is occur with migraine headaches, while around 30 to 40 percent experience chronic problems of tension headaches (Carlson, & Peckham, 2001; Hawthorn, & Redmond, 1998; Baum, Gatchel, & Krantz, 1997a, 1997b).The migraine, tension-type and cluster headaches are classified as primary headaches with no organicity, and headaches with underlying organic pathology are secondary headaches (Millea, & Brodie, 2002).Migraine is generally defined as neurological condition where the symptom is a severe and disabling episodic headache, (Cooke, Rose, & Becker, 2000). It is now well documented as vascular disorder, due to loss of tone in the major extra-cranial blood vessels, leading to painful dilation and excruciating pain. Chemicals such as bradykinin or neurokinin are released at the side of the dilated vessels (Baum, Krantz, & Gatchel, 1997a). Migraine has its triggers and is expressed in wither of the three forms, classic migraine, common migraine or complicated migraine (Nowak, & Handford, 2004).Migraine triggers emerge from a wide range of variables and behavioral, environmental, infectious, dietary, chemical and/or hormonal triggers can precipitate migrainic episodes. Stress, dazzling light, alcohol, food, too much or too little sleep and weather are reported as most frequent factors that trigger migraine attack. Weather has also been reported as one of the frequent precipitators due to sensitivity to weather changes (Prince, Rapoport, Sheftell, Tepper, & Bigal, 2004; Hawthorn, & Redmond, 1998). The Chinook winds of Alberta, Canada are a case of one such migraine trigger (Cook, Rose, & Becker, 2000).More women as compared to men suffer from migraines. Female hormonal levels may be related to the occurrence of migraine as it has been reported occurrence frequency increases especially around the time of menstruation. Mazal (1978) reports that migraine onset is mostly during pregnancy and can be exacerbated by oral contraceptives. Migraine also appears to have hereditary basis as 80% of migraine sufferers report a family history of migraine.Low-income or less well-educated have a higher reported occurrence, as well those within age range of 35 and 45 years (Baum, Gatchel, & Krantz, 1997b).Tension-type HeadachesThis pain radiates in a band-like form, from forehead to the occipital lobe area with reported tightness, pressure and dull ache. Tension-type headache have a different symptomology as compared to migraine as the latter appears to be localized in the head and neck muscles and can last for days or weeks (Baum, Gatchel, & Krantz, 1997a, Hatch, 1993; Baum, Gatchel, & Krantz, 1997b, Millea, & Brodie, 2002). Tension headaches may be due to heightened sensitivity to pressure-type pain, (Baum, Gatchel, & Krantz, 1997b). Further, Muscle hardness and pain is also associated with tension-type headache (Millea, & Brodie, 2002). Patients experience a non throbbing pressure, fullness, or stiffness on both sides of the head. The tension-type headache occurs gradually (Nowak, & Handford, 2004).More women (88%) than men (69%) report tension-type headaches, (Marcus, 2005). It has been reported in our earlier studies women were 68%) of headache patients reporting in outdoor clinics (Tanwir, & Naj am, 1992) and were 73% of the chronic patients (Tanwir, & Naj am, 1994).Perceived StressPerceived stress has been given due importance in the understanding and management of pain. It appears that perceived stress can trigger tension-type headaches. Research has shown that the headaches sufferers perceived higher level of subjective stress, and all the participants who are reported higher level of stress are using disengagement coping style (Myers, Wittrock, & Foreman, 2004). …