The purpose of the study is to test the cross-cultural adaptation and psychometric properties of a Danish version of the Headache-Specific Locus of Control Scale (HSLC) and the Headache Management Self-Efficacy Scale (HMSE) in a tertiary headache centre. HSLC and HMSE are headache-specific measures of locus of control (LOC) and SE. The Danish versions of the HSLC and the HMSE were created according to the guidelines for cross-cultural adaptation of self-report measures. The HSLC and HMSE were administered to 135 consecutively referred headache patients in a tertiary headache centre together with other self-report measures concerning general distress, anxiety, depression, and health-related quality of life. Internal stability of the HSLC subscales and the HMSE were analysed using Chronbach’s α coefficient. The psychometric properties of the Danish version of the HSLC and the HMSE were analysed using Spearman’s rank correlation test. Cronbach’s α ranged from 0.71 to 0.88 and the corrected item-total correlations were acceptable. The mean corrected item-total correlations for the three subscales of HSLC (health-care LOC, internal LOC, and chance LOC) were 0.40, 0.59, and 0.40 respectively. The mean corrected item-total correlation for HMSE was 0.42. High HMSE scores were found to be associated with high scores on internal LOC and low scores on chance LOC. High scores on chance LOC were positively associated with low scores on social functioning independently of headache frequency. The results are consistent with the earlier findings of the original American versions of HMSE and HSLC. These scales seem to be valid and valuable tools for testing of psychological aspects related to level of functioning and quality of life for headache patients across different cultures of Western society. The HMSE and the HSLC proved valuable in clinical headache research. Since scores on HSLC and HMSE were associated with measures of physical and social functioning the HSLC and HMSE may be of particular interest for intervention studies aimed at enhancing level of functioning for headache patients.
The objective was to discover possible psychological factors influencing treatment outcome for headache patients referred to psychological treatment in a tertiary headache centre by initial assessment using the Millon Clinical Multiaxial Inventory III (MCMI-III). The MCMI-III was administered to 136 referred patients. Patients with valid protocols who had completed their treatment by October 2003 were included. Multidisciplinary treatment was offered including psychological treatment, mainly pain and stress management, pharmacological treatment and physiotherapy. Medians of MCMI-III scales for patients with and without reduction in headache frequency were compared. All of the eligible 58 patients were included in the study. Patients with reduction in headache frequency after treatment had lower scores on the MCMI-III Somatoform, Major depression and Avoidant personality pattern scales and higher scores on the Alcohol Dependence, Self-Defeating personality pattern, Depressive personality pattern, Drug Dependence, Aggressive personality pattern and Bipolar: Manic scales before treatment compared to patients without effect. Patients with a positive treatment effect reported less symptoms of depression and seemed less inclined to somatisation than non-responders. Responders also appeared more likely to experience increased social or occupational distress and report difficulties with handling emotions and an enduring tendency to focus on negative aspects of the self-image. The results can give valuable information regarding treatment planning and development.
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