Skip to main content

Advertisement

Log in

Defense Mechanisms, Dissociation, Alexithymia and Childhood Traumas in Chronic Migraine Patients

  • Published:
Journal of Rational-Emotive & Cognitive-Behavior Therapy Aims and scope Submit manuscript

Abstract

Objective

The aim of the present study was to investigate the childhood traumas, dissociation and alexithymia levels and defense mechanisms used by migraine patients.

Materials and Methods

This study included 100 patients diagnosed with migraine-type headaches according to the International Pain Association criteria. Of these 100 patients, 66 (66%) had chronic migraine, 24 (24%) episodic migraine without aura and 10 (10%) episodic migraine with aura. In addition, a control group of 90 age- and gender-matched healthy subjects was also included in the study. All participants completed a Standardized Sociodemographic Data Collection Form, and were administered multiple scales including Beck Depression Inventory, Toronto Alexithymia Scale, Childhood Traumas Questionnaire, the Defensive Style Questionnaire and the Dissociative Experiences Scale.

Findings

The patients had significantly higher dissociation scores and were found to more likely employ immature defense mechanisms compared to healthy controls (p < 0.001 for both). Similarly, the alexithymia scores for the emotional abuse and neglect subdimensions and the total alexithymia scores were higher in the patient group compared to the control group (p < 0.001 for all).

Conclusion

These results indicated that migraine patients had a higher prevalence of childhood traumas, tended to have higher alexithymia, depression and dissociation scores, and were likely to employ immature defense mechanisms compared to healthy individuals. Based on these findings, we suggest that extensive evaluation of migraine patients by healthcare practitioners could be highly beneficial to better understand their clinical features, discover and treat their hidden psychiatric comorbidities, provide better assistance for these patients and improve their functionality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Andrews, G., Singh, M., & Bond, M. (1993). The defense style questionnaire. The Journal of Nervous and Mental Disease, 181, 246–256.

    PubMed  Google Scholar 

  • Antonaci, F., Nappi, G., Galli, F., Manzoni, G. C., Calabresi, P., & Costa, A. (2011). Migraine and psychiatric comorbidity: A review of clinical findings. The Journal of Headache and Pain, 12, 115–125.

    PubMed  PubMed Central  Google Scholar 

  • Ashina, S., Bendtsen, L., Lyngberg, A. C., Lipton, R. B., Hajiyeva, N., & Jensen, R. (2015). Prevalence of neck pain in migraine and tension-type headache: A population study. Cephalalgia, 35(3), 211–219.

    PubMed  Google Scholar 

  • Ashina, S., Serrano, D., Lipton, R. B., et al. (2012). Depression and risk of transformation of episodic to chronic migraine. The Journal of Headache and Pain, 13, 615–624.

    PubMed  PubMed Central  Google Scholar 

  • Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty item Toronto Alexithymia Scale–I: Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(23–32), 18.

    Google Scholar 

  • Baskin, S. M., Lipchik, G. L., & Smitherman, T. A. (2006). Mood and anxiety disorders in chronic headache. Headache, 46(3), 76–87.

    Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    PubMed  Google Scholar 

  • Bernstein, D. P., Fink, L., Handelsman, L., et al. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151, 1132–1136.

    Google Scholar 

  • Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174, 727–735.

    PubMed  Google Scholar 

  • Bottiroli, S., Galli, F., Viana, M., Sances, G., & Tassorelli, C. (2018). Traumatic experiences, stressful events, and alexithymia in chronic migraine with medication overuse. Frontiers in Psychology, 9, 704.

    PubMed  PubMed Central  Google Scholar 

  • Cevoli, S., Giannini, G., Favoni, V., Pierangeli, G., & Cortelli, P. (2012). Migraine and sleep disorders. Neurological Sciences, 33(1), 43–46.

    Google Scholar 

  • Colovic, O., Tosevski, D. L., Mladenovic, I. P., Milosavljevic, M., & Munjiza, A. (2016). Defense mechanisms in “pure” anxiety and “pure” depressive disorders. The Journal of Nervous and Mental Disease, 204, 746–751.

    PubMed  Google Scholar 

  • Demiryürek, E. Ö., Demiryürek, B. E., Tekin, A., Güzey, Y. A., Güngen, B. D., & Erdoğan, S. (2017). The association between childhood traumatic events and headache-related parameters in patients with migraine: A cross-sectional study in turkish population. Archives of Neuropsychiatry, 54, 291–294.

    PubMed  PubMed Central  Google Scholar 

  • Dikmen, P. Y., Aysevener, E. O., Kosak, S., Aydınlar, E. I., & Kocaman, A. S. (2017). Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients. Acta Neurologica Belgica, 16, 1–8.

    Google Scholar 

  • Dodick, D. W. (2009). Review of comorbidities and risk factors for the development of migraine complications (infarct and chronic migraine). Cephalalgia, 29(3), 7–14.

    PubMed  Google Scholar 

  • Fornaro, M., & Stubbs, B. (2015). A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder. Journal of Affective Disorders, 178, 88–97.

    PubMed  Google Scholar 

  • Freud, A. (2004). Ben ve savunma mekanizmaları. (Y. Erim, Trans.). İstanbul: Metis Publications.

  • Frewen, P. A., Lanius, R. A., Dozois, D. J., et al. (2008). Clinical and neural correlates of alexityhymia in posttraumatic stress disorder. Journal of Abnormal Psychology, 117, 171–181.

    PubMed  Google Scholar 

  • Fuller-Thomson, E., Baker, T. M., & Brennenstuhl, S. (2010). Investigating the association be-tween childhood physical abuse and migraine. Headache, 50, 749–760.

    PubMed  Google Scholar 

  • Galli, F., Caputi, M., Sances, G., Vegni, E., Bottiroli, S., Nappi, G., et al. (2017). Alexithymia in chronic and episodic migraine: A comparative study. Journal of Mental Health, 26, 192–196.

    PubMed  Google Scholar 

  • Gordon-Smith, K., Forty, L., Chan, C., et al. (2015). Rapid cycling as a feature of bipolar disorder and comorbid migraine. Journal of Affective Disorders, 175, 320–324.

    PubMed  PubMed Central  Google Scholar 

  • Güleç, H., Köse, S., Yazıcı Güleç, M., et al. (2009). Psychometric properties of the Turkish version 20 item Toronto alexithymia scala: According to cut-off score. Klinik Psikiyatri, 19, 213–219.

    Google Scholar 

  • Hisli-Sahin, N. (1988). Beck Depresyon Envanterinin geçerliği üzerine bir çalışma. Psikoloji Dergisi, 6, 118–126.

    Google Scholar 

  • Honkalampi, K., Koivumaa-Honkanen, H., Hintikka, J., et al. (2004). Do stressful life-events or sociodemographic variables associate with depression and alexithymia among a general population? A 3-year follow-up study. Comprehensive Psychiatry, 45, 254–260.

    PubMed  Google Scholar 

  • Karşıkaya, S., Kavakcı, Ö., Kuğu, N., & Güler, A. S. (2013). Post-traumatic stress disorder in migraine patients: Migraine, trauma and alexithymia. Nöro Psikiyatr Arşivi, 50, 263.

    Google Scholar 

  • Kucukgoncu, S., Ornek, F. Y., Cabalar, M., Bestepe, E., & Yayla, V. (2004). Childhood trauma and dissociation in tertiary care patients with migraine and tension type headache: a controlled study. Journal of Psychosomatic Research, 77, 40–44.

    Google Scholar 

  • Louter, M. A., Piipers, J. A., Wardenaar, K. J., et al. (2015). Symptom dimensions of affective disorders in migraine patients. Journal of Psychosomatic Research, 79, 458–463.

    PubMed  Google Scholar 

  • Nickel, R., & Egle, U. T. (2006). Psychological defense styles, childhood adversities and psychopathology in adulthood. Child Abuse and Neglect, 30, 157–170.

    PubMed  Google Scholar 

  • Peck, K. R., Smitherman, T. A., & Baskin, S. M. (2015). Traditional and alternative treatments for depression: Implications for migraine management. Headache, 55, 351–355.

    PubMed  Google Scholar 

  • Peres, M. F. P., Mercante, J. P., Tobo, P. R., Kamei, H., & Bigal, M. E. (2017). Anxiety and depression symptoms and migraine: A symptom-based approach research. The Journal of Headache and Pain, 18, 37.

    PubMed  PubMed Central  Google Scholar 

  • Peterlin, B. L., Ward, T. N., Lidicker, J. R., & Levin, M. (2007). A retrospective, comparative study on the frequency of abuse in migraine and chronic daily headache. Headache, 47, 397–401.

    PubMed  Google Scholar 

  • Price, D. D., McGrath, P. A., Rafii, A., & Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17, 45–56.

    PubMed  Google Scholar 

  • Şar, V., Öztürk, E., & İkikardeş, E. (2012). Çocukluk Çağı Ruhsal Travma Ölçeğinin Türkçe Uyarlamasının Geçerlilik ve Güvenilirliği. Türkiye Klinikleri Journal of Medical Sciences, 32, 1054–1063.

    Google Scholar 

  • Savilahti, E. M., Haravuori, H., Rytilä-Manninen, M., Lindberg, N., Kettunen, K., & Marttunen, M. (2018). High beck depression inventory 21 scores in adolescents without depression are associated with negative self-image and immature defense style. Psychiatry Research, 263, 61–68.

    PubMed  Google Scholar 

  • Silberstein, S. D., Olesen, J., & Bousser, M. G. (2005). Headache classification subcommittee of the international headache society. ‘The international classification of headache disorders’. Cephalalgia, 25, 1–151.

    Google Scholar 

  • Taycan, O., Özdemir, A., & Erdoğan, S. (2017). Alexithymia and somatization in depressed patients: The role of the type of somatic symptom attribution. Archives of Neuropsychiatry, 54, 99–104.

    PubMed  PubMed Central  Google Scholar 

  • Tietjen, G. E., Brandes, J. L., Digre, K. B., et al. (2007). History of child-hood maltreatment is associated with comorbid depression in women with migraine. Neurology, 69, 959–968.

    PubMed  Google Scholar 

  • Tietjen, G. E., Brandes, J. L., Peterlin, B. L., et al. (2010). Childhood maltreatment and migraine (part I). Prevalence and adult revictimization: A multicenter headache clinic survey. Headache, 50, 20–31.

    PubMed  Google Scholar 

  • Tütüncü, R., & Hüseyin, G. H. (2011). Kronik ağrı, psikolojik etmenler ve depresyon/Chronic pain, psychological factors and depression. Dicle Medical Journal, 38, 257–262.

    Google Scholar 

  • Üçler, S. (2018). Migren ve Gerilim Tipi Baş Ağrılarında Patofizyoloji. Turkiye Klinikleri Journal of Neurology Special Topics, 11, 21–27.

    Google Scholar 

  • Yargıç, İ., Tutkun, H., & Şar, V. (1995). The reliability and validity of the Turkish version of the dissociative experiences scale. Dissociation, 8, 10–13.

    Google Scholar 

  • Yılmaz, N., Gençöz, T., & Ak, M. (2007). Savunma biçimleri testinin psikometrik özellikleri: güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi, 18, 1–10.

    Google Scholar 

  • Zhang, L., Wang, X., Zhu, Y., et al. (2017). Selective impairment of decision making under ambiguity in alexithymia. BMC Psychiatry, 17, 378.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Filiz Özsoy.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Özsoy, F., Taşcı, İ. Defense Mechanisms, Dissociation, Alexithymia and Childhood Traumas in Chronic Migraine Patients. J Rat-Emo Cognitive-Behav Ther 39, 101–113 (2021). https://doi.org/10.1007/s10942-020-00357-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10942-020-00357-0

Keywords

Navigation