Anxiety sensitivity and fear of pain in patients with recurring headaches

Asmundson, Gordon J.G.; Norton, Peter J.; Veloso, Felix

doi:10.1016/s0005-7967(98)00172-7

Cited by 98 publications

(88 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Importantly, this includes spinal cord activity because the spinally mediated nociceptive flexion reflex is influenced by central pain modulation processes. 50 While the exact mechanisms responsible for emotional modulation of pain are not fully understood, heightened anxiety appears to increase sensitivity to pain (hyperalgesia), [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] while moderate fear inhibits pain (hypoalgesia). 51,[69][70][71][72][73][74][75][76][77] This suggests that anticipation of an unpredictable, threatening intervention could result in enhanced pain, while hypoalgesia results from exposure to a predictable, threatening event (fear).…”

Section: Discussionmentioning

confidence: 99%

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Watson

Drummond

2014

Headache

View full text Add to dashboard Cite

Objective.-To investigate cervical, interictal reproduction of usual head pain and its effect on the nociceptive blink reflex in migraineurs.Background.-Anatomical and neurophysiological studies in animals and humans have confirmed functional convergence of trigeminal and cervical afferent pathways. Migraineurs often present with occipital and neck symptoms, and cervical pain is referred to the head in most cases, suggesting that cervical afferent information may contribute to headache. Furthermore, the effectiveness of greater occipital nerve blockade in migraine and demonstrable modulation of trigeminal transmission following greater occipital nerve blockade suggest an important role for cervical afferents in migraine. However, to what extent cervical afferents contribute actively to migraine is still unknown.Methods.-The passive accessory intervertebral movements of the atlanto-occipital and C2-3 spinal segments of 15 participants (14 females, 1 male; age 24-44 years, mean age 33.3 years) with migraine were examined interictally. During 1 session, either the atlanto-occipital or C2-3 segment was examined, resulting in referred usual head pain, while in another session, pressure was applied over the common extensor origin (lateral epicondyle of the humerus) of the ipsilateral arm. Each intervention was repeated 4 times. The nociceptive blink reflex to a supraorbital electrical stimulus was elicited ipsilaterally during both sessions before and during each intervention. The main outcome variables were the number of recorded blinks, area under the curve and latencies of the R2 components of the nociceptive blink reflex. Participants also rated the intensity of referred head pain and the supraorbital stimulus on a scale of 0-10, where 0 = "no pain" and 10 = "intolerable pain," and rated the intensity of applied pressure where 0 = "pressure but no pain" and 10 = "intolerable pain."Results.-Participants reported a significant reduction in local tenderness ratings across the 4 trials for the cervical intervention but not for the arm (P = .005). The cervical intervention evoked head pain in all participants. As the cervical intervention was sustained, head pain decreased significantly from the beginning to the end of each trial (P = .000) and from the beginning of the first trial to the end of the last (P = .000). Pain evoked by the supraorbital stimulus was consistent from baseline to across the 4 trials (P = .635) and was similar for the cervical and arm interventions (P = .072). The number of blinks decreased significantly across the experiment (P = .000) and was comparable in the cervical and arm interventions (P = .624). While the R2 area under the curve decreased irrespective of intervention (P = .000), this reduction was significantly greater for the cervical intervention than when pressure was applied to the arm (P = .037). Analysis of the R2 latencies revealed a notable increase across the experiment (P = .037). However, this increase was significantly greater following the cervical than arm intervention (P ...

show abstract

Section: Discussionmentioning

confidence: 99%

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Watson

Drummond

2014

Headache

View full text Add to dashboard Cite

show abstract

“…Some studies reported that migraine patients are overcontrolled in their behaviour and present personality traits that lead others to regard them as nice and agreeable people [16]. Other studies [24][25][26] suggested that migraine patients do not have a great deal of anger and/or suppressed anger, and if it is present, it is probably an unconscious defence mechanism; tension-type headache patients are more openly hostile and consciously troubled. Anger is a feeling that may be prone to denial because of social and moral norms, and in some cases, pain sufferers could have the tendency to deny angry feelings and aggressiveness [1].…”

Section: Discussionmentioning

confidence: 99%

Anger and emotional distress in patients with migraine and tension–type headache

Perozzo¹,

Savi

Castelli

et al. 2005

J Headache Pain

View full text Add to dashboard Cite

The objective was to evaluate the prevalence and the characteristics of anger and emotional distress in migraine and tension– type headache patients. Two hundred and one headache patients attending the Headache Center of the University of Turin were selected for the study and divided into 5 groups: (1) migraine, (2) episodic tension–type headache, (3) chronic tension–type headache, (4) migraine associated with episodic tension–type headache and (5) migraine associated with chronic tension–type headache. A group of 45 healthy subjects served as controls. All the subjects completed the State–Trait Anger Expression Inventory, the Beck's Depression Inventory and the Cognitive Behavioral Assessment. Anger control was significantly lower in all headache patients ( p <0.05) except in migraineurs. Patients with migraine and tension–type headache showed a significantly higher level of angry temperament and angry reaction ( p <0.05). In addition, chronic tension–type headache and migraine associated with tension–type headache patients reported a higher level of anxiety ( p <0.05), depression ( p <0.001), phobias ( p <0.001) and obsessive–compulsive symptoms ( p <0.01), emotional liability ( p <0.001) and psychophysiological disorders ( p <0.001). Our study shows that chronic tension–type headache and migraine associated with tension–type headache patients present a significant impairment of anger control and suggests a connection between anger and the duration of headache experience.

show abstract

“…The PDI demonstrates good construct validity as evidenced by its significant relationship with other measures of painrelated disability and distress. 47 .4 8 Test-retest reliability of the PDI is good (r = 0.91) 49 and the internal consistency is high (ex= 0.86).…”

Section: Pdimentioning

confidence: 98%

“…and recurrent headaches. 8 Anxiety sensitivity has also been shown to predict fear of pain better than depression and pain severity in a heterogenous chronic pain population. 9 Furthermore, in a sample of children and adolescents with chronic pain, anxiety sensitivity accounted for 38.6% of the variance in fear of pain and fear of pain accounted for 39.9% of the variance in pain-related disability.…”

mentioning

confidence: 99%

Posttraumatic Stress Symptoms and the Diathesis-Stress Model of Chronic Pain and Disability in Patients Undergoing Major Surgery

Martínez-Cutillas

Halket

Asmundson

et al. 2010

The Clinical Journal of Pain

Self Cite

View full text Add to dashboard Cite

Objectives: To (1) use structural equation modeling (SEM) to examine relationships proposed in Turk's diathesis-stress model of chronic pain and disability as well as (2) investigate what role, if any, posttraumatic stress symptoms (PTSS) play in predicting pain disability, relative to some of the other factors in the model. Methods:The study sample consisted of 208 patients scheduled for general surgery, 21 to 60 years of age (mean age= 47.18 y, SD = 9.72 y), who reported experiencing persistent pain for an average of 5.56 years (SD = 7.90 y). At their preadmission hospital visit, patients completed the Anxiety Sensitivity Index, Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale-20, Pain Disability Index, posttraumatic stress disorder Checklist, and rated the average intensity of their pain (0 to 10 numeric rating scale). SEM was used to test a model of chronic pain disability and to explore potential relationships between PTSS and factors in the diathesis-stress model.Results: SEM results provided support for a model in which anxiety sensitivity predicted fear of pain and catastrophizing, fear of pain predicted escape/avoidance, and escape/avoidance predicted pain disability. Results also provided support for a feedback loop between disability and fear of pain. SEM analyses provided preliminary support for the inclusion of PTSS in the diathesisstress model, with PTSS accounting for a significant proportion of the variance in pain disability. Discussion: Results provide empirical support for aspects of Turk's diathesis-stress model in a sample of patients with persistent pain. Findings also offer preliminary support for the role of PTSS in fear-avoidance models of chronic pain.

show abstract

Anxiety sensitivity and fear of pain in patients with recurring headaches

Cited by 98 publications

References 28 publications

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Anger and emotional distress in patients with migraine and tension–type headache

Posttraumatic Stress Symptoms and the Diathesis-Stress Model of Chronic Pain and Disability in Patients Undergoing Major Surgery

Contact Info

Product

Resources

About