Background. Chronic tension-type headache is the primary headache with the highest prevalence. The present study is aimed at analyzing the associations between patient self-efficacy and headache impact with pain characteristics, kinesiophobia, anxiety sensitivity, and physical activity levels in subjects with chronic tension-type headache. Materials and Methods. An observational descriptive study was carried out. A total sample of 42 participants was recruited at university environment with diagnosis of tension-type headache. Headache characteristics (frequency, intensity, and duration), physical activity levels, pain related-self-efficacy, kinesiophobia, anxiety sensitivity, and headache impact were measured. Results. The HIT-6 ( 61.05 ± 6.38 ) score showed significant moderate positive correlations with the ASI-3 score ( 17.64 ± 16.22 ; r = 0.47 ) and moderate negative correlations with the self-efficacy in the domains of pain management ( 31.9 ± 10.28 ; r = − 0.43 ) and coping with symptoms ( 53.81 ± 14.19 ; r = − 0.47 ). ASI-3 score had a negative large correlation with self-efficacy in the domains of pain management ( r = − 0.59 ), physical function ( 53.36 ± 7.99 ; r = − 0.55 ), and coping with symptoms ( r = − 0.68 ). Physical activity levels showed positive moderate correlations with the self-efficacy in the domain of physical function ( r = 0.41 ). Linear regression models determined that the self-efficacy and anxiety sensitivity with showed a significant relationship with the HIT-6 score ( R 2 = 0.262 ; p = 0.008 ) and with the ASI-3 score ( R 2 = 0.565 ; p < 0.001 ). In addition, no correlations were found between pain intensity, duration or frecuency with psychosocial factors, or headache impact. Conclusions. The present study showed that patients with chronic tension-type headache had a great negative impact on daily tasks and physical activity levels, which were associated with higher anxiety levels and lower self-efficacy.

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