Anxiety sensitivity and headache: diagnostic differences, impact, and relations with perceived headache triggers.

Abstract

Anxiety sensitivity (AS), the fear of arousal-related bodily sensations due to beliefs about presumed harmful consequences, predicts fear and avoidance among musculoskeletal pain patients but remains largely unexplored in headache. The aims of this cross-sectional study were to evaluate AS among young adult migraine and tension-type headache sufferers and to assess relations with headache impact and perceived susceptibility to headache triggers. A total of 2350 young adults (72.6% with primary headache; 64.9% female; 22.5% minority) completed measures of AS and headache symptomatology. Generalized linear models assessed relations between AS and ICHD-II diagnosis, headache-related disability, and perceived trigger susceptibility. Canonical correlation analyses quantified relations with headache symptomatology. AS reliably differentiated headache sufferers from those without headache, being highest among chronic migraineurs and episodic migraineurs with aura. AS accounted for 8.4% of variance in headache symptomatology and was most strongly associated with prototypical migraine symptoms. AS predicted headache-related disability and trigger variables, even after controlling for headache frequency and severity. AS accounted for more unique variance in disability than depression and anxiety symptoms combined. AS predicts pain itself, adjustment to pain, and evaluation of factors influencing pain among primary headache sufferers, even after controlling for headache burden. Further study of AS among headache patients is warranted.