Psychophysiological Aspects of Headache

  • Arnold P. Friedman


Any discussion of the nature of headache brings to the forefront its psychological aspects. That emotional disturbances may cause headache is accepted, although the exact mechanism by which emotions gain access to the structures that react painfully is still undetermined. Headache of psychological origins may produce symptoms in two different ways: indirectly, as a symbolic attempt to solve a problem, or directly, as alterations of specific physiological functions. These alterations are very often the physiologic expression of an existing emotional-feeling or -tension state. The mechanisms by which functional headaches are produced include (1) changes in cranial blood vessels, (2) sustained muscle contraction of the neck and/or scalp, (3) alterations in glandular function, and (4) conversion of psychological conflict into physical symptoms, as is seen in cases of conversion hysteria. In the latter, psychic energy derived from repression is converted into a physical symptom or sign (1).


Cerebral Blood Flow Migraine Patient Vasoactive Substance Brain Serotonin Tension Headache 
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  1. 1.
    Kolb, L. C. Psychiatric and psychogenic factors in headache. In Friedman, A. P. & Merrit, H. H (Eds.), Headache: Diagnosis and Treatment. Philadelphia; Davis, 1959.Google Scholar
  2. 2.
    Frazier, S.H. Psychotherapy of headache. In Friedman, A.P. (Ed.), Research and Clinical Studies in Headache, Vol. 30. Basel: Karger, 1972.Google Scholar
  3. 3.
    Ad hoc committee on classification of headache. Classification of headache. Arch. Neurol. 6: 173–176, 1962.CrossRefGoogle Scholar
  4. 4.
    Friedman, A.P. The infinite variety of migraine. In Smith, R. (Ed.), Background to Migraine, Vol. 1. London: Heinemann Medical, 1970.Google Scholar
  5. 5.
    Dalessio, D.J. Mechanisms of headache. In Friedman, A.P. (Ed.), Headache and Related Pain Syndromes. Philadelphia: Saunders, in press.Google Scholar
  6. 6.
    Marshall, J. The regulation of cerebral blood flow—its relationship to migraine. Arch. Neurohiol. 37 (suppl.): 15–25, 1974.Google Scholar
  7. 7.
    Edmeads, J. Cerebral blood flow in migraine headache. Headache 17: 148–52, 1977.PubMedCrossRefGoogle Scholar
  8. 8.
    Sakai, F. & Meyer, J.S. Abnormal cerebrovascular reactivity in patients with migraine and cluster headache. Headache 19: 251–66, 1979.CrossRefGoogle Scholar
  9. 9.
    Lance, J.W. Migraine. In Matthews, W.G. & Glaser, G.H. (Eds.), Recent Advances in Clinical Neurology. Edinburgh: Churchill Livingstone, 1978.Google Scholar
  10. 10.
    Friedman, A.P. Characteristics of tension headache. Psychosom. Med. 20:457–61, 1979.Google Scholar
  11. 11.
    Lewis, T. Pain. New York: Macmillan, 1942.Google Scholar
  12. 12.
    Hinsey, J.C. Observation on the inervation of blood vessels in skeletal muscle. J. Comp. Neurol. 47: 23, 1928.CrossRefGoogle Scholar
  13. 13.
    Liebeskin, J.C. Pain modulation by central nervous system stimulation. In Bonica, J.J. (Eds.), Advances in Pain Research and Therapy, Proceedings of the First Worid Congress on Pain, Florence. New York: Raven, 1976.Google Scholar
  14. 14.
    Sternbach, R. A., Janowsky, D. S., Huey, L. Y., & Segal, D.S. Effects of altering brain serotonin activity on human chronic pain. In Bonica, J. J. (Eds.), Advances in Pain Research and Therapy, Proceedings of the First World Congress on Pain, Florence. New York: Raven Press, 1976.Google Scholar
  15. 15.
    Basbaum, A. I., Clanton, C. H., & Fields, H. L. Opiate and stimulus-produced analgesia: function anatomy of a medullospinal pathway. Proc. Natl. Acad. Sci. USA 73: 4,685–88, 1976Google Scholar

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© Spectrum Publications, Inc. 1982

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  • Arnold P. Friedman

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