Types of Triggers in Migraine – Factor Structure of the Headache Triggers Sensitivity and Avoidance Questionnaire and Development of a New Short Form (<i>HTSAQ‐SF</i>)

Caroli, Anna; Klan, Timo; Gaul, Charly; Kubik, Sonja U.; Martin, Paul R.; Witthöft, Michael

doi:10.1111/head.13896

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…To assess the convergent validity of the FAMI, the following self-report instruments were used in the online survey (each in the German version): (i) Migraine Disability Assessment Scale (MIDAS), 23 (ii) Headache Disability Inventory (HDI), 24 (iii) Headache Impact Test (HIT-6), 25 (iv) Depression Anxiety Stress Scales (DASS), 22 (v) Pain Anxiety Symptom Scale 20 (PASS-20), 26 (vi) Headache Triggers Sensitivity and Avoidance Questionnaire, Short-Form (HTSAQ-SF), 27 (vii) Generalized Anxiety Disorder Screener (GAD-7), 28 (viii) short form of the Headache Management Self-Efficacy Scale (HMSE-G-SF), 29 and (ix) Pain Vigilance and Awareness Questionnaire (PVAQ). 30 For the determination of discriminant validity, the German version of the NEO-Five-Factor Inventor y (30-Item-Shor t-Version [NEO-FFI-30]) was applied.…”

Section: Methodsmentioning

confidence: 99%

Assessing attack‐related fear in headache disorders—Structure and psychometric properties of the Fear of Attacks in Migraine Inventory

et al. 2022

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Objective: This study aimed to develop a self-report questionnaire for the assessment of attack-related fear in migraine, and to determine its factor structure as well as its psychometric properties by the primary analysis of a cross-sectional survey's data.Background: High fear of attacks in migraine increases the burden of disease and is assumed to have a negative impact on the course of the disease. Little is known about the structure and dimensionality of attack-related fear, and a valid instrument for the comprehensive assessment is lacking. Methods: Based on a literature search and interviews with persons with migraine as well as with experienced practitioners, a 46-item self-report questionnaire, the Fear of Attacks in Migraine Inventory (FAMI) was developed. A cross-sectional online survey comprising an assessment of diagnostic criteria of migraine and a battery of questionnaires including the FAMI was conducted (N = 387 persons with migraine, 364/387 [94.1%] women, M = 40.9 [SD = 13.1] years, migraine without aura: 153/387 [39.5%], migraine with aura: 85/387 [22.0%], and chronic migraine: 149/387 [38.5%]). Results: Item selection led to 29 items for the FAMI. Exploratory factor analysis resulted in three clearly interpretable factors (fear of negative consequences; attention and anticipation; fear-avoidance); a confirmatory factor analysis yielded an acceptable to good model fit (χ 2 (3) = 1328.84, p = 0.001, χ 2 /df = 3.55, RMSEA = 0.085, SRMR = 0.073, CFI = 0.98, and TLI = 0.97). Reliability was good (fear-avoidance, ω = 0.85; attention and anticipation, ω = 0.88) to excellent (fear of negative consequences, ω = 0.91). Correlational analyses confirmed the convergent validity of the FAMI.

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Section: Methodsmentioning

confidence: 99%

Assessing attack‐related fear in headache disorders—Structure and psychometric properties of the Fear of Attacks in Migraine Inventory

et al. 2022

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“…This strategy is traditionally implemented alongside general lifestyle measures such as good sleep hygiene, routine meal schedules, and regular exercise. Even though specific programs for identifying risk factors have been developed [ 82 ], some researchers suggest that complete avoidance of risk factors may have detrimental effects, in part driven by trigger sensitization [ 83 , 84 ]. From this, the new behavioral management strategy termed “Learning to Cope with Triggers” emerged [ 85 ].…”

Section: Resultsmentioning

confidence: 99%

Is there a causal relationship between stress and migraine? Current evidence and implications for management

et al. 2021

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Background The purpose of this narrative review is to examine the literature investigating a causal relationship between stress and migraine and evaluate its implications for managing migraine. Methods PubMed, PsycINFO and CINAHL were searched from 1988 to August 2021, identifying 2223 records evaluating the relationship between stress and migraine. Records were systematically screened. All potentially relevant records were thematically categorized into six mechanistic groups. Within each group the most recent reports providing new insights were cited. Results First, studies have demonstrated an association of uncertain causality between high stress loads from stressful life events, daily hassles or other sources, and the incidence of new-onset migraine. Second, major stressful life events seem to precede the transformation from episodic to chronic migraine. Third, there is some evidence for changes in levels of stress as a risk factor for migraine attacks. Research also suggests there may be a reversed causality or that stress-trigger patterns are too individually heterogeneous for any generalized causality. Fourth, migraine symptom burden seems to increase in a setting of stress, partially driven by psychiatric comorbidity. Fifth, stress may induce sensitization and altered cortical excitability, partially explaining attack triggering, development of chronic migraine, and increased symptom burden including interictal symptom burden such as allodynia, photophobia or anxiety. Finally, behavioral interventions and forecasting models including stress variables seem to be useful in managing migraine. Conclusion The exact causal relationships in which stress causes incidence, chronification, migraine attacks, or increased burden of migraine remains unclear. Several individuals benefit from stress-oriented therapies, and such therapies should be offered as an adjuvant to conventional treatment and to those with a preference. Further understanding the relationship between stress, migraine and effective therapeutic options is likely to be improved by characterizing individual patterns of stress and migraine, and may in turn improve therapeutics.

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“…A German adaptation of this questionnaire (HTSAQ‐G) is available 62 . A short form of the questionnaire has been developed (HTSAQ‐SF), and a factor analysis of the questionnaire has been completed 63 . An app for recording headaches and triggers has been developed and evaluated for use in conjunction with the HTSAQ 64 …”

Section: How Do Triggers Acquire the Capacity To Precipitate Headaches?mentioning

confidence: 99%

Triggers of Primary Headaches: Issues and Pathways Forward

Martin

2020

Headache

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The triggers of primary headaches have considerable significance for our understanding and management of headache and migraine. Triggers explain the variance in headaches – why they occur when they do. Trigger management is generally viewed as an important component of a comprehensive treatment approach for headaches. Historically, however, triggers have not had a prominent place in the headache literature. This situation began to change 20 to 30 years ago, and the pace of change has increased exponentially in recent times. Nevertheless, the field is beset with issues that have held it back from achieving more. This review will focus on elaborating those issues with the goal of suggesting ways forward. The first issue considered will be the definition of a trigger, and how specific triggers are labeled. Consideration will then be given to a classification system for triggers. The review will discuss next the evidence relating to whether self‐reported triggers can, indeed, precipitate headaches, and how the capacity to elicit headaches may be acquired or extinguished. Attention will be given to the very important clinical issue of trigger management. Finally, the pathways forward will be proposed. Perhaps the most useful thing to accomplish at this point in time would be agreement on a definition of headache triggers, a list of triggers, and a classification system for triggers. This would greatly assist in comparing research on triggers from different research groups as well as eliminating some of the issues identified in this review. An authoritative body such as the American Headache Society or the International Headache Society, could establish a multidisciplinary committee that would complete these tasks. Consideration should also be given to incorporating triggers into the International Classification of Headache Disorders as an axis or via the use of codes, as this would raise the profile of triggers in assessment and management.

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Types of Triggers in Migraine – Factor Structure of the Headache Triggers Sensitivity and Avoidance Questionnaire and Development of a New Short Form (HTSAQ‐SF)

Cited by 11 publications

References 18 publications

Assessing attack‐related fear in headache disorders—Structure and psychometric properties of the Fear of Attacks in Migraine Inventory

Assessing attack‐related fear in headache disorders—Structure and psychometric properties of the Fear of Attacks in Migraine Inventory

Is there a causal relationship between stress and migraine? Current evidence and implications for management

Triggers of Primary Headaches: Issues and Pathways Forward

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