Appraisal of stressful events and coping strategies employed by women with migraine headaches

Numerous factors have been identified as precipitators of migraine headaches. Stress has long been accepted as a primary precipitant of muscle contraction headache and has been more recently acknowledged as a major precipitator of migraine headaches. Although stress has been identified as a major precipitant of migraine headaches, there has been little systematic research to evaluate how migraine headache sufferers manage stressful events. How the individual appraises the stressful event and what coping strategies are employed interact to determine the impact of the event, not the number of stressors alone. There has not been a systematic study that has evaluated whether migraine headache sufferers appraise stressful events differently or employ alternate coping strategies than individuals who do not suffer with headaches.

The purpose of this study was to evaluate whether there were differences in the appraisal and coping styles of women with migraine headaches and whether differences were specific to migraine headache sufferers or more generally effected by the experience of chronic pain. Women with migraine headaches, chronic pain, and no pain problems completed questionnaires that measured hassles that had occurred during the past month and how she had appraised and coped with a specific event.

The hypothesis that stress plays a role in the experience of migraine headache was supported. The women with migraine headaches experienced the same stress levels as the no pain group and appraised the event in a similar way as both the no pain and chronic pain groups. Women with migraine headaches evidenced increased usage of stasis centered coping strategies; problem avoidance, wishful thinking, and social isolation. The experience of stress was not mediated by the number of stressors but by the efficacy of the coping strategies employed. Women with chronic pain showed the same pattern of coping strategies, and an increased stress level as measured by the average severity of hassles. The results of this research support the use of stress management training in the treatment of women with migraine headaches and other chronic pain problems.