Exploring Psychological Factors Involved in Cluster Headache Pain - Results

Please note that recruitment for this study is now complete and the results are below.

The University of East Anglia carried out a study exploring psychological factors involved in cluster headache pain. Helena, a trainee clinical psychologist at UEA, who carried out the study, has now completed this work and has produced a poster which summarises her findings, see PDF link below.  She has also had an article accepted in the International Journal of Clinical Practice, available here: https://onlinelibrary.wiley.com/doi/10.1155/ijcp/5004925

Below is an abstract of her article:

"If We Had Blood Pouring Out of Our Eyeballs, People Would Notice"; a Qualitative Exploration into the Psychological Experience of Cluster Headache

Background

The primary headache disorder, Cluster Headache (CH), is known as one of the most painful conditions a human can experience. This study aimed to explore the psychological experience of living with CH, both during acute headache attacks and between attacks.

Methods

Semi-structured interviews were conducted with 13 adults with episodic or chronic CH. Interviews were carried out via Microsoft Teams or the telephone. Qualitative interview data was analysed using Reflective Thematic Analysis through a critical realist lens. Participants also completed the Pain Self Efficacy Questionnaire and Pain Catastrophising Scale.

Results

Reflective Thematic Analysis resulted in five themes emerging related to the psychological experience of CH: “Darkness”, “Battling”, “Shifting”, “Control”, and “Despair”. Psychological experiences during the acute attack appeared distinct from experiences of the condition between attacks. The psychological experience was impacted by how long participants had lived with the condition, and by whether they had the episodic or chronic form. Individuals living with the chronic form of CH reported increased despair and depression, due to lack of respite from the pain. In contrast, individuals living with Episodic CH were less despairing due to pain-free periods, but highlighted the uncertainty that comes with bout periods disrupting their life.

Conclusion

Living with CH is a complex and challenging psychological experience. Further research to identify how psychological processes may maintain distress and exacerbate pain could help establish a psychological model of CH. Such a model could, in turn, enable exploration of psychological techniques to support individuals during and between CH attacks. Authors also call for research to explore how to increase visibility of CH.