Psychophysiological Aspects of Headache
- 44 Downloads
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).
KeywordsCerebral Blood Flow Migraine Patient Vasoactive Substance Brain Serotonin Tension Headache
Unable to display preview. Download preview PDF.
- 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.Frazier, S.H. Psychotherapy of headache. In Friedman, A.P. (Ed.), Research and Clinical Studies in Headache, Vol. 30. Basel: Karger, 1972.Google Scholar
- 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.Dalessio, D.J. Mechanisms of headache. In Friedman, A.P. (Ed.), Headache and Related Pain Syndromes. Philadelphia: Saunders, in press.Google Scholar
- 6.Marshall, J. The regulation of cerebral blood flow—its relationship to migraine. Arch. Neurohiol. 37 (suppl.): 15–25, 1974.Google Scholar
- 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.Friedman, A.P. Characteristics of tension headache. Psychosom. Med. 20:457–61, 1979.Google Scholar
- 11.Lewis, T. Pain. New York: Macmillan, 1942.Google Scholar
- 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.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.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