Abstract
The purpose of this study was two fold: to determine whether different headache types have different personality and affective styles and to explore the relationship between headache diagnoses and treatment outcome. A total of 63 subjects participated consisting of 19 muscle-contraction, 28 migraine and 16 combination sufferers. Patients took the Millon Behavioral Health Inventory and the Multiple Affect Adjective Checklist "Today" before commencing treatment at a private neurological headache center. During treatment patients recorded frequency, duration and severity of headaches on a monthly calendar. After treatment patients retook the Multiple Affect Adjective Checklist and completed a Treatment Satisfaction Questionnaire. Treatment consisted of standard pharmocological therapy lasting four weeks. Statistical results failed to provide strong support for the headache personality theory, however a trend showing individual headache personality types was apparent. Muscle-contraction subjects showed a preponderance of dependent, agreeable personality styles. The migraineurs exhibited confident, outgoing characteristics. The combination subjects were anxious, moody and irritable. In all groups at least one third of the subjects were moody, irritable, and emotionally labile. Significant differences did occur on measures of affect and psychogenic attitudes. The migraine group reported the lowest levels of depression, somatic anxiety and recent stress followed by the muscle-contraction group and the combination group. On treatment outcome measures all groups showed improvement in frequency but no change in severity. The muscle-contraction subjects' depression levels significantly improved post-treatment. Overall, the results imply that combination headache sufferers are in the greatest psychological distress and show little improvement with treatment. Muscle-contraction sufferers demonstrated the greatest psychological improvement post-treatment suggesting the availability of personal resources. The migraineurs initially presented themselves as the healthiest group psychologically but were indistinguishable from the others post-treatment. These patients appear to lack the skills necessary for availing themselves of a treatment program.