PAIN STATE AS ARTIFACT IN THE PSYCHOLOGICAL-ASSESSMENT OF RECURRENT HEADACHE SUFFERERS

The finding that recurrent headache sufferers, particularly tension he adache sufferers, obtain higher scores on psychological symptom measur es than controls was replicated in 262 recurrent (tension, mixed, and migraine) headache sufferers and 26 controls. However, closer examinat ion of the data revealed that psychological symptoms were elevated onl y in patients who experienced head pain at the time of assessment. Thi s finding raises the possibility that previously reported elevations i n psychological symptoms have resulted from uncontrolled differences i n the pain state of respondents. Retrospective reports of headache act ivity also were related to pain state. In contrast, a measure of perce ived control of factors affecting headaches was unrelated to pain stat e. As a result, locus of control (but not psychological symptoms) succ essfully differentiated recurrent headache sufferers from controls eve n when headache sufferers were tested when pain free. These results su ggest that psychological symptom measures may yield misleading results when used with individuals with pain disorders.