A headache chronicle: The daily recording of headaches and their correlates

Correlational analysis cannot reveal whether negative feelings are the cause or consequence of headache pain, but it is plausible to infer that reporting both pain and feelings may have revealed to some participants the connections between their emotions and their headaches and thereby stimulated helpful changes.

Abstract

We have developed a headache chronicle—a booklet in which patients record pain, treatment, interference with activities, nausea and personal feelings on a day-to-day basis over a four-week period. In a study of daily self-reporting, we mailed the chronicle to patients known to have headaches. The results have been analyzed for patients' reactions to the chronicle, the effects of self-reporting on headache pain, and the relation between personal feelings and the occurrence of pain. A total of 177 female and 57 male volunteers returned usable chronicles: 38% reported that use of the chronicle was helpful, 8% thought it a hindrance and 69% thought that the information it contained would be helpful to their physicians. To evaluate how completing the chronicle affected the description of headaches, we compared the first and second two-week periods. The average levels of headache pain and negative feelings decreased significantly. Most of the decrease originated with the male participants, and individuals who reported changes in pain tended to report associated changes in feelings. This relationship was strongest among participants who reported that the chronicle was helpful. The level of headache pain correlated most with feeling 'run down or tired' and least with feeling 'misunderstood or not appreciated', and overall, women were much more likely than men to report more than one unpleasant emotional feeling or somatic symptom. Correlational analysis cannot reveal whether negative feelings are the cause or consequence of headache pain, but it is plausible to infer that reporting both pain and feelings may have revealed to some participants the connections between their emotions and their headaches and thereby stimulated helpful changes.