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A COMPARISON OF HEADACHE AND NON-HEADACHE SUFFERERS ON MEASURES OF SOCIAL SUPPORT AND MENTAL HEALTH PROBLEMS

HJ Teoh, PhD (UWA), M.Psychol.Clinical (Hons) (UNSW)
CL Tam, PhD (UKM), MA (UKM)

Assoc Prof Dr Teoh Hsien-Jin (hjteoh@sunway.edu.my) and Dr Tam Cai Lian (cltam@sunway.edu.my) are from the Dept of Psychology, School of Health and Natural Sciences, Sunway University College, Malaysia

Address for correspondence: Assoc Prof Dr Teoh Hsien-Jin. No. 5, Jalan Universiti, Bandar Sunway, 46150 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 03-74918622, Fax: 03-56358633. Email: hjteoh@sunway.edu.my

INTRODUCTION

Headaches are a commonly reported problem in today’s society. When people experience headaches, there is a tendency for them to feel upset and irritable, especially when the pain becomes unbearable. Given this scenario, there may be a possibility that headache sufferers, as compared with non-headache sufferers, may generally be experiencing poorer mental health, due to the pain they are experiencing. In addition to this, having a headache often elicits sympathy in others, thus prompting more support from those around. Therefore, there may also be a possibility that headache sufferers, do not just have poorer mental health, but may also be the recipients of more social support, as compared with non-headache sufferers. This study has been set up to investigate the relationship between headaches, mental health and social support. The literature review that follows first defines headaches, mental health and social support. Following this, it provides some evidence about research that investigates the differences in mental health and social support amongst headache and non-headache sufferers. The literature review then concludes with several hypotheses on what the researchers expect to find from the study.

A headache is often described by sufferers and having persistent sensations of head pain which are caused by a band being tightened around the head. This pain usually occurs in the front or on both sides of the head. The pain develops gradually and may last for hours, weeks, or even months.

Headache may be the most commonly reported bodily complaints. Frequent tension-type headaches are now thought to be maintained primarily by a central nervous system (CNS) dysfunction, not solely by input from peripheral nerves in contracted facial, neck, and shoulder muscles.¹ Surveys indicate that between 50% and 70% of adults experience headaches, 40% of which are tension headaches.² The Headache Classification Sub-Committee of the International Headache Society divided headaches into several major categories.³ The most common types of headaches are vascular headaches of the migraine type, muscle-contraction headaches, and combined headaches.  These different headaches are described as follows:

Vascular headaches of the migraine type vary widely in intensity, frequency and duration. The attacks are commonly unilateral in onset, are usually associated with anorexia and sometimes with nausea and vomiting. In some cases, these headaches are associated with, conspicuous sensory, motor, and mood disturbances. However, this does not cause permanent changes in the cranial arteries.⁴ Muscle-concentration headache, also known as “tension headaches”, are experienced as sensations of tightness, pressure, or constriction. It is associated with sustained contraction of skeletal muscles which are not caused by permanent structural change. Usually, the tension headache appears to be the individual’s reaction during life stress.⁴ A combined headache refers to combinations of both vascular headache of the migraine type and muscle-contraction headache. These two headaches may occur in one episode.⁴

There is some evidence that headaches may be caused by poor mental health, and vice-versa.  In a study of 500 migrainous patients, they found that 13% had anxiety symptoms, and one third had depression at times other than their migraine attack.  In another study, Price and Blackwell⁵ administered an anxiety scale to 31 migraineurs and 26 non-headache sufferers as controls and found significantly higher scores in the former group. Results indicated that the migraineurs showed greater anxiety and these support the results provided for earlier reports that migraineurs are more anxious than non-headache controls.⁶ Many researchers using other mental health instruments also noted higher levels of anxiety amongst headache sufferers.⁷

It has also been suggested that mental health problems such as anxiety and depression can precipitate or aggravate headaches. Headache sufferers are often described as obsessive, perfectionist, anxious, and unable to express emotion.⁶

A variety of studies also suggest that there is a link between headaches and social support.  Martin and Soon⁸ reported differences between headache and control groups in terms of availability and adequacy of attachment of social integration using the Multidimentional Scale of Perceived Social Support. The headache groups reported less social support compared with the control group.  Martin and Soon ⁸ also found that headache sufferers were significantly less satisfied with the support available to them and scored lower on all four types of functional support measured in the study: appraisal support, esteem support, belonging support, and tangible support.

The literature review so far has indicated that headache sufferers, as compared with non-headache sufferers, tend to experience higher levels of anxiety and depression. In addition, they also tend to have higher support from their families.  Many of these populations have been clinical populations. However, would populations, experiencing headaches taken from a non-clinical community sample have the same results? Thus, the purpose of this study is to investigate the differences of mental health and social support among the headache sufferers and non-headache sufferers amongst a non-clinical community sample. The specific research questions of the study were:

1. To identify any differences in mental health among people with headache and no headache.
2. To identify any differences in social support among people with headache and no headache.

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