Illness behavior and chronic headache.

Illness behavior was examined in chronic headache sufferers within the context of the psychobiological or severity model of headache. A Procrustes factor analytic procedure demonstrated the appropriateness of using the existing IBQ factor structure with chronic headache patients. The dimensions of illness behavior were not found to be related to headache diagnosis (muscle contraction, migraine, combined) nor to topographical properties of head pain which are used to infer diagnosis (forehead, bilateral, sides, unilateral). Headache patients who experienced the greatest amount of headache activity during a 21-day self-observation period were found to view their disorder in somatic as opposed to psychological terms. A comparison of patients with continuous pain and patients with episodic pain provided additional support for the somatic-psychological distinction. Patients with continuous head pain viewed their disorder in somatic terms and also scored higher on the dimension of denial than did patients with episodic pain. Taken together these data demonstrated the utility of examining psychological components of the chronic headache syndrome from a severity perspective.