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The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire.
Headache. 2017 Feb; 57(2):236-254.H

Abstract

OBJECTIVE

The purpose of this study was to evaluate the psychometric properties of the newly developed Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ) designed to measure variables relating to the Trigger Avoidance Model of Headaches.

BACKGROUND

The Trigger Avoidance Model of Headaches proposes that one pathway to developing a primary headache disorder is through the avoidance of headache triggers, resulting in an increase in trigger potency through sensitization. Conversely, prolonged exposure to certain triggers may reduce a potential trigger's ability to precipitate a headache. This model has led to an alternative approach to trigger management being proposed called Learning to Cope with Triggers, which advocates the desensitization of certain headache triggers through controlled exposure, while supporting avoidance of those triggers that are detrimental to health and wellbeing. To be able to evaluate predictions based on the Trigger Avoidance Model of Headaches and to investigate the effectiveness of Learning to Cope with Triggers, psychometrically sound measures of trigger sensitivity and trigger avoidance are needed.

METHOD

A convenience sample of 376 participants (87.5% female; 64.1% European descent) was recruited for the online study which consisted of a battery of measures including the HTSAQ, Brief Headache Screen, Pain Anxiety Symptoms Scale, Pain Sensitivity Questionnaire, Chronic Pain Acceptance Questionnaire, and demographic items. With an interval of 2-6 weeks, a subsample of participants (n = 201) completed the HTSAQ for a second time. The mean age of the sample was 31.4 years (SD = 12.8). The most common headache diagnoses (based on the Brief Headache Screen) were migraine (chronic = 62; episodic = 160), followed by medication-overuse headache (n = 87). The remaining participants (n = 67) were diagnosed as having episodic less severe headache (most likely tension-type headache).

RESULTS

Reliability was assessed through internal consistency and test-retest reliability over a period of 2-6 weeks, and both were excellent (alpha > .80). Strong construct validity was demonstrated by the measure's scale scores being significantly correlated in theoretically consistent ways with the Pain Sensitivity Questionnaire, Pain Anxiety Symptoms Scale, and Chronic Pain Acceptance Questionnaire. As the Trigger Avoidance Model of Headaches would predict, correlations between the HTSAQ Sensitivity scales and the Avoidance scale were strong (P < .001), and participants with chronic migraine had significantly higher HTSAQ scores than those with episodic headaches.

CONCLUSION

The findings support the use of the HTSAQ as a valid and reliable tool for assessing sensitivity to headache triggers and avoidance of headache triggers. Further research examining the factor structure of the HTSAQ is warranted.

Authors+Show Affiliations

School of Applied Psychology, Griffith University, Brisbane, Australia.School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27753075

Citation

Kubik, Sonja U., and Paul R. Martin. "The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire." Headache, vol. 57, no. 2, 2017, pp. 236-254.
Kubik SU, Martin PR. The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire. Headache. 2017;57(2):236-254.
Kubik, S. U., & Martin, P. R. (2017). The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire. Headache, 57(2), 236-254. https://doi.org/10.1111/head.12940
Kubik SU, Martin PR. The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire. Headache. 2017;57(2):236-254. PubMed PMID: 27753075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire. AU - Kubik,Sonja U, AU - Martin,Paul R, Y1 - 2016/10/18/ PY - 2016/08/09/accepted PY - 2016/10/19/pubmed PY - 2017/4/18/medline PY - 2016/10/19/entrez KW - assessment KW - avoidance KW - migraine KW - sensitivity KW - tension-type headache KW - triggers SP - 236 EP - 254 JF - Headache JO - Headache VL - 57 IS - 2 N2 - OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the newly developed Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ) designed to measure variables relating to the Trigger Avoidance Model of Headaches. BACKGROUND: The Trigger Avoidance Model of Headaches proposes that one pathway to developing a primary headache disorder is through the avoidance of headache triggers, resulting in an increase in trigger potency through sensitization. Conversely, prolonged exposure to certain triggers may reduce a potential trigger's ability to precipitate a headache. This model has led to an alternative approach to trigger management being proposed called Learning to Cope with Triggers, which advocates the desensitization of certain headache triggers through controlled exposure, while supporting avoidance of those triggers that are detrimental to health and wellbeing. To be able to evaluate predictions based on the Trigger Avoidance Model of Headaches and to investigate the effectiveness of Learning to Cope with Triggers, psychometrically sound measures of trigger sensitivity and trigger avoidance are needed. METHOD: A convenience sample of 376 participants (87.5% female; 64.1% European descent) was recruited for the online study which consisted of a battery of measures including the HTSAQ, Brief Headache Screen, Pain Anxiety Symptoms Scale, Pain Sensitivity Questionnaire, Chronic Pain Acceptance Questionnaire, and demographic items. With an interval of 2-6 weeks, a subsample of participants (n = 201) completed the HTSAQ for a second time. The mean age of the sample was 31.4 years (SD = 12.8). The most common headache diagnoses (based on the Brief Headache Screen) were migraine (chronic = 62; episodic = 160), followed by medication-overuse headache (n = 87). The remaining participants (n = 67) were diagnosed as having episodic less severe headache (most likely tension-type headache). RESULTS: Reliability was assessed through internal consistency and test-retest reliability over a period of 2-6 weeks, and both were excellent (alpha > .80). Strong construct validity was demonstrated by the measure's scale scores being significantly correlated in theoretically consistent ways with the Pain Sensitivity Questionnaire, Pain Anxiety Symptoms Scale, and Chronic Pain Acceptance Questionnaire. As the Trigger Avoidance Model of Headaches would predict, correlations between the HTSAQ Sensitivity scales and the Avoidance scale were strong (P < .001), and participants with chronic migraine had significantly higher HTSAQ scores than those with episodic headaches. CONCLUSION: The findings support the use of the HTSAQ as a valid and reliable tool for assessing sensitivity to headache triggers and avoidance of headache triggers. Further research examining the factor structure of the HTSAQ is warranted. SN - 1526-4610 UR - https://www.unboundmedicine.com/medline/citation/27753075/The_Headache_Triggers_Sensitivity_and_Avoidance_Questionnaire:_Establishing_the_Psychometric_Properties_of_the_Questionnaire_ L2 - https://doi.org/10.1111/head.12940 DB - PRIME DP - Unbound Medicine ER -