Mark A. Lumleya, Jennifer L. Huffmana, Lisa J. Rapporta, Sheena K. Aurorab, Lisa L. Norrisb, Mark W. Kettererc SEL- OTHER- migraine activity

Question 1

• What is headache activity positively related to?

Answer 1

○ Negative emotional states
○ Eg anxiety + depression
Migraine headache predicted by prior depression

Question 2

• How can self-reports of negative emotions artificially inflate the correlations observed between self-reported negative emotions and health status?

Answer 2

○ Broad trait of neuroticism
○ Transdiagnostic symptoms
- Timing of assessment can = bias results

Question 3

• What are transdiagnostic symptoms?

Answer 3

○ Symptom overlap between the self-reported emotion measure + health measure
§ Eg depression + anxiety measures include the symptoms of the health condition being studies

Question 4

• What are the 3 limitations the model of emotional expression (Kennedy-Moore + Watson) outlines of self-reports of negative emotions?

Answer 4

1. Some may repress and are unconsciously motivated to minimise the recognition + report of negative affect - protect self-worth?
   2. Alexithymia patients
   3. Some willingly suppress reports of negative emotions - concerns of stigmatization, social desirability?
   ○ Seem to have gender differences

Question 5

• What does alexithymia mean?

Answer 5

○ Confused about their emotional state

○ Unable to accurately label their internal emotional experience

Question 6

• What, however, is good about self-reports?

Answer 6

○ Can reduce observed correlations via reports of patients of their negative emotions

Question 7

• What alternative is there to patient’s self-reports of negative emotions in the diagnosis of headaches?

Answer 7

○ Reports from collateral informants

○ Usually used for children + cognitively impaired adults

Question 8

• What research is there to support the use of reports from collateral informants?

Answer 8

○ Cardiovascular disease - reports of significant others about patient’s emotional states are better predictors of disease-relevant measurement vs patient’s self-reports
○ Same for coronary artery disease, atypical chest pain + 5 year follow up
○ But gender difference also seen here

Question 9

• What is the aim of the study?

Answer 9

○ Assess patient’s negative emotions via self-reports + independent reports from significant others
○ Examined correlates of migraine activity and the two negative emotions report
○ Test whether the self/other-reports of males + females negative emotion differed in their relationship to migraine activity

Question 10

• What was the procedure of the study?

Answer 10

○ Self-report collected = base line
○ Other-report collected
○ 3 months following baseline assessment, prospective reports of migraine activity collected

Question 11

• What were measured and using what?

Answer 11

○ Self-report of negative emotions - Hospital Anxiety and Depression (HAD)
§ Self-reported negative emotions score = avg of anxiety + depression scores
○ Other-reported negative emotions - Ketterer Stress Symptom Frequency Checklist (KSSFC)
§ Frq of patient’s symptoms of anxiety + depression + anger during the past year
§ Other-reported negative emotions score = KSSFC avg of both anxiety + depression scale
○ At baseline + 3-month follow up
§ Migraine frq - recall + report number of days during the prior 3 months they xp migraine headache
§ Pain severity - report “most” + “least” + “avg” pain during the last week + “current” pain

Question 12

• What did they find?

Answer 12

○ Self + other reported negative emotion correlated moderately w/ each other
○ Both self + other reported negative emotion correlated positively w/ migraine frq at both baseline + follow up
○ Pain severity - other-reported negative emotions larger vs self-reported negative emotions
○ Gender differences:
§ Other-reported negative emotion significantly correlated w/ both migraine frq + pain severity for women vs self-reported emotion
§ Men’s other-reported negative emotion was inversely related to migraine frq + pain severity (but not statistically significant)

Question 13

○ What did they conclude from the findings?

Answer 13

§ Patient’s reports of own negative emotions were positively, but weakly, associated w/ both the frq of migraines + severity of pain
§ Migraine headache activity more strongly associated w/ other’s reports vs self
□ Pain severity more so than frequency
§ Validity of other’s reports may differ substantially for men + women

Question 14

• What potential explanation is there for why there is a weak relationship between self-reported negative emotions and migraine activity?

Answer 14

○ Lack of introspection + reporting limitations of patients

Question 15

• Why did the paper speculate that emotional inhibition actually exacerbates migraine activity in men?

Answer 15

Men who suppressed expression of negative emotions (preventing recognition) = higher migraine activity vs open display

Question 16

• What is an explanation for why there is a distinction between self- and other- reported negative emotion for pain severity?

Answer 16

Mechanism linking negative emotion with the two migraine activity measures differs

Question 17

• What is an explanation for why there is a less distinction between self- and other- reported negative emotion for headache frq?

Answer 17

○ Variation in causality

§ Negative emotions trigger migraines or the other way around???

Question 18

• What are the limitations of the study?

Answer 18

○ Only 15 male patients
○ Could look into other emotions, esp anger which has been associated with migraine patients
○ Use of 2 different negative emotion measures for self- and other-
○ Daily diaries maybe vs retrospective summaries of pain + negative affect
○ Didn’t asses directly the limitations + biases of self-report