Psychological generators of stress-headaches

Abstract

Psychological stress triggers headaches, but how this happens is unclear. To explore this, 38 migraine sufferers, 28 with tension-type headache (T-TH) and 20 controls rated nausea, negative affect, task-expectancies and headache at 5-min intervals during an aversive 20-min mental arithmetic task with a fixed failure rate. Blood pressure and pulse rate were measured every 3 min and salivary cortisol was sampled before and after the task. Multiple regression analysis indicated that irritation, anxiety and the absence of sluggishness (i.e., alertness) independently predicted increases in headache intensity during the task (p < .001), but increases in headache were unrelated to changes in cardiovascular activity or cortisol. Changes that preceded headache onset were explored in repeated measures ANOVAs, comparing those who developed headache with those who did not. In general, nausea, negative affect and self-efficacy expectancies were higher in participants who went on to develop headache than in those who remained headache-free (p < .05 to p < .001). Together, these findings suggest that headache developed when participants overextended themselves during a stressful task, adopting an information processing style which impeded emotional adjustment to changing situational demands. Learning to modify perceptions of threat, and adopting a more flexible, less outcome-dependent processing style, might help to prevent headache from spiralling upward.

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References

  1. Andrews, N., Strong, J., & Meredith, P. (2015). Overactivity in chronic pain: Is it a valid construct? Pain, 156, 1991–2000.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Arntz, A., & Schmidt, A. (1989). Perceived control and the experience of pain. In A. Steptoe & A. Appels (Eds.), Stress, personal control and health (pp. 131–162). Chichester: Wiley.

    Google Scholar 

  3. Bandura, A., O’Leary, A., Taylor, C. B., Gauthier, J., & Gossard, D. (1987). Perceived self-efficacy and pain control: Opioid and nonopioid mechanisms. Journal of Personality and Social Psychology, 53, 563–571.

    CAS  Article  PubMed  Google Scholar 

  4. Berry, J. K., & Drummond, P. D. (2014). Does attachment anxiety increase vulnerability to headache? Journal of Psychosomatic Research, 76, 113–120. doi:10.1016/j.jpsychores.2013.11.018

    Article  PubMed  Google Scholar 

  5. Brandtstadter, J., & Renner, G. (1990). Tenacious goal pursuit and flexible goal adjustment: Explication and age-related analysis of assimilative and accommodative strategies of coping. Psychology and Aging, 5, 58–67.

    CAS  Article  PubMed  Google Scholar 

  6. Breslau, N., & Rasmussen, B. K. (2001). The impact of migraine: Epidemiology, risk factors, and co-morbidities. Neurology, 56, S4–12.

    CAS  Article  PubMed  Google Scholar 

  7. Cathcart, S., Bhullar, N., Immink, M., Della Vedova, C., & Hayball, J. (2012). Pain sensitivity mediates the relationship between stress and headache intensity in chronic tension-type headache. Pain Research and Management, 17, 377–380.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cathcart, S., Petkov, J., Winefield, A. H., Lushington, K., & Rolan, P. (2010). Central mechanisms of stress-induced headache. Cephalalgia, 30, 285–295. doi:10.1111/j.1468-2982.2009.01917.x

    CAS  Article  PubMed  Google Scholar 

  9. De Benedittis, G., & Lorenzetti, A. (1992). The role of stressful life events in the persistence of primary headache: Major events vs. daily hassles. Pain, 51, 35–42.

    Article  PubMed  Google Scholar 

  10. de Ridder, D., & Kuijer, R. (2006). Managing immediate needs in the pursuit of health goals: The role of coping in self-regulation. In D. de Ridder & J. de Wit (Eds.), Self-regulation in health behavior (Chapter 7). Chichester: Wiley.

    Google Scholar 

  11. Di Sabato, F., Buonfiglio, M., & Mandillo, S. (2013). Analytic information processing style in migraineurs. Neurological Sciences, 34, 1145–1150. doi:10.1007/s10072-012-1193-8

    Article  PubMed  Google Scholar 

  12. Drummond, P. D. (1982). Extracranial and cardiovascular reactivity in migrainous subjects. Journal of Psychosomatic Research, 26, 317–331.

    CAS  Article  PubMed  Google Scholar 

  13. Drummond, P. D., & Granston, A. (2004). Facial pain increases nausea and headache during motion sickness in migraine sufferers. Brain, 127, 526–534. doi:10.1093/brain/awh061

    Article  PubMed  Google Scholar 

  14. Drummond, P. D., & Granston, A. (2005). Painful stimulation of the temple induces nausea, headache and extracranial vasodilation in migraine sufferers. Cephalalgia, 25, 16–22. doi:10.1111/j.1468-2982.2004.00810.x

    CAS  Article  PubMed  Google Scholar 

  15. Drummond, P. D., & Passchier, J. (2006). Psychological mechanisms in migraine. In J. Olesen, P. Goadsby, N. Ramadan, P. Tfelt Hansen, & K. Welch (Eds.), The headaches (3rd ed., pp. 385–392). Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  16. Fernandez, E. (2002). Anxiety, depression and anger in pain: Research findings and clinical options. Dallas, TX: Advanced Psychological Resrouces.

    Google Scholar 

  17. Fiedler, K. (2000). Towards an integrative account of affect and cognition phenomena using the BIAS computer algorithm. In J. P. Forgas (Ed.), Feeling and thinking: The role of affect and social cognition (pp. 163–185). Mahwah, NJ: Erlbaum.

    Google Scholar 

  18. Fiedler, K. (2001). Affective influences on social information processing. In J. P. Forgas (Ed.), The handbook of affect and social cognition (pp. 163–185). Mahwah, NJ: Erlbaum.

    Google Scholar 

  19. Fox, S. D., Flynn, E., & Allen, R. H. (2011). Mindfulness meditation for women with chronic pelvic pain: a pilot study. Journal of Reproductive Medicine, 56, 158–162.

    PubMed  Google Scholar 

  20. French, D. J., Holroyd, K. A., Pinell, C., Malinoski, P. T., O’Donnell, F., & Hill, K. R. (2000). Perceived self-efficacy and headache-related disability. Headache, 40, 647–656.

    CAS  Article  PubMed  Google Scholar 

  21. Frew, A. K., & Drummond, P. D. (2007). Negative affect, pain and sex: The role of endogenous opioids. Pain, 132, S77–S85. doi:10.1016/j.pain.2007.04.010

    CAS  Article  PubMed  Google Scholar 

  22. Frew, A. K., & Drummond, P. D. (2008). Stress-evoked opioid release inhibits pain in major depressive disorder. Pain, 139, 284–292. doi:10.1016/j.pain.2008.04.022

    CAS  Article  PubMed  Google Scholar 

  23. Harrigan, J. A., Kues, J. R., Ricks, D. F., & Smith, R. (1984). Moods that predict coming migraine headaches. Pain, 20, 385–396.

    CAS  Article  PubMed  Google Scholar 

  24. Headache Classification Committee of the International Headache Society. (2013). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia, 33, 629–808. doi:10.1177/0333102413485658

    Article  Google Scholar 

  25. Hemper, K. (2008). Headache in adolescents: Prevention and complementary therapies. http://www.medscape.com/viewprogram/17068?src=rss

  26. Houtveen, J. H., & Sorbi, M. J. (2013). Prodromal functioning of migraine patients relative to their interictal state—An ecological momentary assessment study. PLoS ONE, 8, e72827. doi:10.1371/journal.pone.0072827

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  27. Kalman, B. A., & Grahn, R. E. (2004). Measuring salivary cortisol in the behavioral neuroscience laboratory. Journal of Undergraduate Neuroscience, 2, A41–A49.

    Google Scholar 

  28. Karlson, C. W., Litzenburg, C. C., Sampilo, M. L., Rapoff, M. A., Connelly, M., Bickel, J. L., et al. (2013). Relationship between daily mood and migraine in children. Headache, 53, 1624–1634. doi:10.1111/head.12215

    Article  PubMed  PubMed Central  Google Scholar 

  29. Koolhaas, J., Bartolomucci, A., Buwalda, B., de Boer, S., Flügge, G., Korte, S., et al. (2011). Stress revisited: A critical evaluation of the stress concept. Neuroscience and Biobehavioral Reviews, 35, 1291–1301. doi:10.1016/j.neubiorev.2011.02.003

    CAS  Article  PubMed  Google Scholar 

  30. Leistad, R. B., Sand, T., Nilsen, K. B., Westgaard, R. H., & Stovner, L. J. (2007a). Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache. BMC Neurology, 7, 23. doi:10.1186/1471-2377-7-23

    Article  PubMed  PubMed Central  Google Scholar 

  31. Leistad, R. B., Stovner, L. J., White, L. R., Nilsen, K. B., Westgaard, R. H., & Sand, T. (2007b). Noradrenaline and cortisol changes in response to low-grade cognitive stress differ in migraine and tension-type headache. The Journal of Headache and Pain, 8, 157–166. doi:10.1007/s10194-007-0384-9

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  32. Leventhal, H., Brissette, I., & Leventhal, E. (2003). The common-sense model of self-regulation of health and illness. In L. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 42–65). Abingdon: Routledge.

    Google Scholar 

  33. Lipton, R., Stewart, W., Diamond, S., Diamond, M., & Reed, M. (2001). Prevalence and burden of migraine in the United States: Data from the American Migraine Study II. Headache, 41, 646–657.

    CAS  Article  PubMed  Google Scholar 

  34. Marlowe, N. (1998). Self-efficacy moderates the impact of stressful events on headache. Headache, 38, 662–667. doi:10.1046/j.1526-4610.1998.3809662.x

    CAS  Article  PubMed  Google Scholar 

  35. Martin, P. R. (2016). Stress and primary headache: Review of the research and clinical management. Current Pain and Headache Reports, 20, 45. doi:10.1007/s11916-016-0576-6

    Article  PubMed  Google Scholar 

  36. Martin, P. R., Nathan, P. R., Milech, D., & van Keppel, M. (1988). The relationship between headaches and mood. Behaviour Research and Therapy, 26, 353–356.

    CAS  Article  PubMed  Google Scholar 

  37. Martin, P. R., & Teoh, H. J. (1999). Effects of visual stimuli and a stressor on head pain. Headache, 39, 705–715.

    CAS  Article  PubMed  Google Scholar 

  38. Martin, P. R., & Theunissen, C. (1993). The role of life event stress, coping and social support in chronic headaches. Headache, 33, 301–306.

    CAS  Article  PubMed  Google Scholar 

  39. Massey, E. K., Garnefski, N., Gebhardt, W. A., & van der Leeden, R. (2009). Daily frustration, cognitive coping and coping efficacy in adolescent headache: A daily diary study. Headache, 49, 1198–1205. doi:10.1111/j.1526-4610.2009.01492.x

    Article  PubMed  Google Scholar 

  40. McCaffrey, R. J., Goetsch, V. L., Robinson, J., & Isaac, W. (1986). Differential responsivity of the vasomotor response system to a “novel” stressor. Headache, 26, 240–242.

    CAS  Article  PubMed  Google Scholar 

  41. Montagna, P., Pierangeli, G., & Cortelli, P. (2010). The primary headaches as a reflection of genetic darwinian adaptive behavioral responses. Headache, 50, 273–289. doi:10.1111/j.1526-4610.2009.01584.x

    Article  PubMed  Google Scholar 

  42. Noseda, R., Constandil, L., Bourgeais, L., Chalus, M., & Villanueva, L. (2010). Changes of meningeal excitability mediated by corticotrigeminal networks: A link for the endogenous modulation of migraine pain. Journal of Neuroscience, 30, 14420–14429. doi:10.1523/JNEUROSCI.3025-10.2010

    CAS  Article  PubMed  Google Scholar 

  43. Noseda, R., Kainz, V., Borsook, D., & Burstein, R. (2014). Neurochemical pathways that converge on thalamic trigeminovascular neurons: Potential substrate for modulation of migraine by sleep, food intake, stress and anxiety. PLoS ONE, 9, e103929. doi:10.1371/journal.pone.0103929

    Article  PubMed  PubMed Central  Google Scholar 

  44. Panksepp, J. (1998). Affective neuroscience: The foundations of human and animal emotions. Oxford: Oxford University Press.

    Google Scholar 

  45. Passchier, J., van der Helm-Hylkema, H., & Orlebeke, J. F. (1984). Psychophysiological characteristics of migraine and tension headache patients. Differential effects of sex and pain state. Headache, 24, 131–139.

    CAS  Article  PubMed  Google Scholar 

  46. Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication and self-regulation. New York City, NY: W.W. Norton & Co.

    Google Scholar 

  47. Price, D. (1999). Psychological mechanisms of pain and analgesia (Vol. 15). Seattle: IASP Press.

    Google Scholar 

  48. Schoonan, G., Evers, D., Ballieux, B., Geus, E., de Kloet, E., Terwindt, G., et al. (2007). Is stress a trigger factor for migraine? Psychoneuroendocrinology, 32, 532–538.

    Article  Google Scholar 

  49. Schramm, S., Moebus, S., Lehmann, N., Galli, U., Obermann, M., Bock, E., et al. (2015). The association between stress and headache: A longitudinal population-based study. Cephalalgia, 35, 853–863.

    Article  PubMed  Google Scholar 

  50. Shirtcliff, E. A., Granger, D. A., Schwartz, E., & Curran, M. J. (2001). Use of salivary biomarkers in biobehavioral research: Cotton-based sample collection methods can interfere with salivary immunoassay results. Psychoneuroendocrinology, 26, 165–173.

    CAS  Article  PubMed  Google Scholar 

  51. Siegel, D. J. (2012). Pocket guide to interpersonal neurobiology: An integrative handbook of the mind. NY: WW Norton.

    Google Scholar 

  52. Smith, A. P. (2016). Acute tension-type headaches are associated with impaired cognitive function and more negative mood. Frontiers in Neurology. doi:10.3389/fneur.2016.00042

    Google Scholar 

  53. Spierings, E. L., Ranke, A. H., & Honkoop, P. C. (2001). Precipitating and aggravating factors of migraine versus tension-type headache. Headache, 41, 554–558.

    CAS  Article  PubMed  Google Scholar 

  54. Spierings, E. L., Sorbi, M., Maassen, G. H., & Honkoop, P. C. (1997). Psychophysical precedents of migraine in relation to the time of onset of the headache: The migraine time line. Headache, 37, 217–220.

    CAS  Article  PubMed  Google Scholar 

  55. Stronks, D. L., Tulen, J. H., Verheij, R., Boomsma, F., Fekkes, D., Pepplinkhuizen, L., et al. (1998). Serotonergic, catecholaminergic, and cardiovascular reactions to mental stress in female migraine patients. A controlled study. Headache, 38, 270–280.

    CAS  Article  PubMed  Google Scholar 

  56. Viana, M., & Nappi, G. (2014). Chronobiological correlates of headache: Three decades on. Functional Neurology, 29, 213–214.

    PubMed  PubMed Central  Google Scholar 

  57. Villanueva, L. (2012). How does migraine attack stop? Headache, 52, 188. doi:10.1111/j.1526-4610.2011.02079.x

    Article  PubMed  Google Scholar 

  58. Wiech, K., Ploner, M., & Tracey, I. (2008). Neurocognitive aspects of pain perception. Trends in Cognitive Sciences, 12, 306–313. doi:10.1016/j.tics.2008.05.005

    Article  PubMed  Google Scholar 

  59. Witkiewitz, K., & Marlatt, G. A. (2007). Modeling the complexity of post-treatment drinking: It’s a rocky road to relapse. Clinical Psychology Review, 27, 724–738. doi:10.1016/j.cpr.2007.01.002

    Article  PubMed  PubMed Central  Google Scholar 

  60. Wolff, H. (1963). Headache and other head pain (2nd ed.). New York, NY: Oxford University Press.

    Google Scholar 

  61. Zautra, A. (2003). Emotions, stress and health. Oxford: Oxford University Press.

    Google Scholar 

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Authors

Contributions

JKMB collected the data, ran statistical analyses and wrote the first draft. PDD designed the study, ran statistical analyses and contributed to the manuscript.

Corresponding author

Correspondence to Peter D. Drummond.

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Juanita Berry and Peter Drummond declare that they have no conflict of interest.

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All procedures performed in this study involving human participants were in accordance with the National Statement on Ethical Conduct in Human Research in Australia, and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

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Berry, J.K.M., Drummond, P.D. Psychological generators of stress-headaches. J Behav Med 41, 109–121 (2018). https://doi.org/10.1007/s10865-017-9872-9

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Keywords

  • Psychological stress
  • Negative affect
  • Migraine
  • Tension-type headache
  • Efficacy expectancies