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06-05-2020

Defense Mechanisms, Dissociation, Alexithymia and Childhood Traumas in Chronic Migraine Patients

Auteurs: Filiz Özsoy, İrem Taşcı

Gepubliceerd in: Journal of Rational-Emotive & Cognitive-Behavior Therapy | Uitgave 1/2021

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Abstract

Objective

The aim of the present study was to investigate the childhood traumas, dissociation and alexithymia levels and defense mechanisms used by migraine patients.

Materials and Methods

This study included 100 patients diagnosed with migraine-type headaches according to the International Pain Association criteria. Of these 100 patients, 66 (66%) had chronic migraine, 24 (24%) episodic migraine without aura and 10 (10%) episodic migraine with aura. In addition, a control group of 90 age- and gender-matched healthy subjects was also included in the study. All participants completed a Standardized Sociodemographic Data Collection Form, and were administered multiple scales including Beck Depression Inventory, Toronto Alexithymia Scale, Childhood Traumas Questionnaire, the Defensive Style Questionnaire and the Dissociative Experiences Scale.

Findings

The patients had significantly higher dissociation scores and were found to more likely employ immature defense mechanisms compared to healthy controls (p < 0.001 for both). Similarly, the alexithymia scores for the emotional abuse and neglect subdimensions and the total alexithymia scores were higher in the patient group compared to the control group (p < 0.001 for all).

Conclusion

These results indicated that migraine patients had a higher prevalence of childhood traumas, tended to have higher alexithymia, depression and dissociation scores, and were likely to employ immature defense mechanisms compared to healthy individuals. Based on these findings, we suggest that extensive evaluation of migraine patients by healthcare practitioners could be highly beneficial to better understand their clinical features, discover and treat their hidden psychiatric comorbidities, provide better assistance for these patients and improve their functionality.
Literatuur
go back to reference American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
go back to reference Andrews, G., Singh, M., & Bond, M. (1993). The defense style questionnaire. The Journal of Nervous and Mental Disease, 181, 246–256.PubMed Andrews, G., Singh, M., & Bond, M. (1993). The defense style questionnaire. The Journal of Nervous and Mental Disease, 181, 246–256.PubMed
go back to reference Antonaci, F., Nappi, G., Galli, F., Manzoni, G. C., Calabresi, P., & Costa, A. (2011). Migraine and psychiatric comorbidity: A review of clinical findings. The Journal of Headache and Pain, 12, 115–125.PubMedPubMedCentral Antonaci, F., Nappi, G., Galli, F., Manzoni, G. C., Calabresi, P., & Costa, A. (2011). Migraine and psychiatric comorbidity: A review of clinical findings. The Journal of Headache and Pain, 12, 115–125.PubMedPubMedCentral
go back to reference Ashina, S., Bendtsen, L., Lyngberg, A. C., Lipton, R. B., Hajiyeva, N., & Jensen, R. (2015). Prevalence of neck pain in migraine and tension-type headache: A population study. Cephalalgia, 35(3), 211–219.PubMed Ashina, S., Bendtsen, L., Lyngberg, A. C., Lipton, R. B., Hajiyeva, N., & Jensen, R. (2015). Prevalence of neck pain in migraine and tension-type headache: A population study. Cephalalgia, 35(3), 211–219.PubMed
go back to reference Ashina, S., Serrano, D., Lipton, R. B., et al. (2012). Depression and risk of transformation of episodic to chronic migraine. The Journal of Headache and Pain, 13, 615–624.PubMedPubMedCentral Ashina, S., Serrano, D., Lipton, R. B., et al. (2012). Depression and risk of transformation of episodic to chronic migraine. The Journal of Headache and Pain, 13, 615–624.PubMedPubMedCentral
go back to reference Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty item Toronto Alexithymia Scale–I: Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(23–32), 18. Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty item Toronto Alexithymia Scale–I: Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(23–32), 18.
go back to reference Baskin, S. M., Lipchik, G. L., & Smitherman, T. A. (2006). Mood and anxiety disorders in chronic headache. Headache, 46(3), 76–87. Baskin, S. M., Lipchik, G. L., & Smitherman, T. A. (2006). Mood and anxiety disorders in chronic headache. Headache, 46(3), 76–87.
go back to reference Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.PubMed Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.PubMed
go back to reference Bernstein, D. P., Fink, L., Handelsman, L., et al. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151, 1132–1136. Bernstein, D. P., Fink, L., Handelsman, L., et al. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151, 1132–1136.
go back to reference Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174, 727–735.PubMed Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174, 727–735.PubMed
go back to reference Bottiroli, S., Galli, F., Viana, M., Sances, G., & Tassorelli, C. (2018). Traumatic experiences, stressful events, and alexithymia in chronic migraine with medication overuse. Frontiers in Psychology, 9, 704.PubMedPubMedCentral Bottiroli, S., Galli, F., Viana, M., Sances, G., & Tassorelli, C. (2018). Traumatic experiences, stressful events, and alexithymia in chronic migraine with medication overuse. Frontiers in Psychology, 9, 704.PubMedPubMedCentral
go back to reference Cevoli, S., Giannini, G., Favoni, V., Pierangeli, G., & Cortelli, P. (2012). Migraine and sleep disorders. Neurological Sciences, 33(1), 43–46. Cevoli, S., Giannini, G., Favoni, V., Pierangeli, G., & Cortelli, P. (2012). Migraine and sleep disorders. Neurological Sciences, 33(1), 43–46.
go back to reference Colovic, O., Tosevski, D. L., Mladenovic, I. P., Milosavljevic, M., & Munjiza, A. (2016). Defense mechanisms in “pure” anxiety and “pure” depressive disorders. The Journal of Nervous and Mental Disease, 204, 746–751.PubMed Colovic, O., Tosevski, D. L., Mladenovic, I. P., Milosavljevic, M., & Munjiza, A. (2016). Defense mechanisms in “pure” anxiety and “pure” depressive disorders. The Journal of Nervous and Mental Disease, 204, 746–751.PubMed
go back to reference Demiryürek, E. Ö., Demiryürek, B. E., Tekin, A., Güzey, Y. A., Güngen, B. D., & Erdoğan, S. (2017). The association between childhood traumatic events and headache-related parameters in patients with migraine: A cross-sectional study in turkish population. Archives of Neuropsychiatry, 54, 291–294.PubMedPubMedCentral Demiryürek, E. Ö., Demiryürek, B. E., Tekin, A., Güzey, Y. A., Güngen, B. D., & Erdoğan, S. (2017). The association between childhood traumatic events and headache-related parameters in patients with migraine: A cross-sectional study in turkish population. Archives of Neuropsychiatry, 54, 291–294.PubMedPubMedCentral
go back to reference Dikmen, P. Y., Aysevener, E. O., Kosak, S., Aydınlar, E. I., & Kocaman, A. S. (2017). Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients. Acta Neurologica Belgica, 16, 1–8. Dikmen, P. Y., Aysevener, E. O., Kosak, S., Aydınlar, E. I., & Kocaman, A. S. (2017). Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients. Acta Neurologica Belgica, 16, 1–8.
go back to reference Dodick, D. W. (2009). Review of comorbidities and risk factors for the development of migraine complications (infarct and chronic migraine). Cephalalgia, 29(3), 7–14.PubMed Dodick, D. W. (2009). Review of comorbidities and risk factors for the development of migraine complications (infarct and chronic migraine). Cephalalgia, 29(3), 7–14.PubMed
go back to reference Fornaro, M., & Stubbs, B. (2015). A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder. Journal of Affective Disorders, 178, 88–97.PubMed Fornaro, M., & Stubbs, B. (2015). A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder. Journal of Affective Disorders, 178, 88–97.PubMed
go back to reference Freud, A. (2004). Ben ve savunma mekanizmaları. (Y. Erim, Trans.). İstanbul: Metis Publications. Freud, A. (2004). Ben ve savunma mekanizmaları. (Y. Erim, Trans.). İstanbul: Metis Publications.
go back to reference Frewen, P. A., Lanius, R. A., Dozois, D. J., et al. (2008). Clinical and neural correlates of alexityhymia in posttraumatic stress disorder. Journal of Abnormal Psychology, 117, 171–181.PubMed Frewen, P. A., Lanius, R. A., Dozois, D. J., et al. (2008). Clinical and neural correlates of alexityhymia in posttraumatic stress disorder. Journal of Abnormal Psychology, 117, 171–181.PubMed
go back to reference Fuller-Thomson, E., Baker, T. M., & Brennenstuhl, S. (2010). Investigating the association be-tween childhood physical abuse and migraine. Headache, 50, 749–760.PubMed Fuller-Thomson, E., Baker, T. M., & Brennenstuhl, S. (2010). Investigating the association be-tween childhood physical abuse and migraine. Headache, 50, 749–760.PubMed
go back to reference Galli, F., Caputi, M., Sances, G., Vegni, E., Bottiroli, S., Nappi, G., et al. (2017). Alexithymia in chronic and episodic migraine: A comparative study. Journal of Mental Health, 26, 192–196.PubMed Galli, F., Caputi, M., Sances, G., Vegni, E., Bottiroli, S., Nappi, G., et al. (2017). Alexithymia in chronic and episodic migraine: A comparative study. Journal of Mental Health, 26, 192–196.PubMed
go back to reference Gordon-Smith, K., Forty, L., Chan, C., et al. (2015). Rapid cycling as a feature of bipolar disorder and comorbid migraine. Journal of Affective Disorders, 175, 320–324.PubMedPubMedCentral Gordon-Smith, K., Forty, L., Chan, C., et al. (2015). Rapid cycling as a feature of bipolar disorder and comorbid migraine. Journal of Affective Disorders, 175, 320–324.PubMedPubMedCentral
go back to reference Güleç, H., Köse, S., Yazıcı Güleç, M., et al. (2009). Psychometric properties of the Turkish version 20 item Toronto alexithymia scala: According to cut-off score. Klinik Psikiyatri, 19, 213–219. Güleç, H., Köse, S., Yazıcı Güleç, M., et al. (2009). Psychometric properties of the Turkish version 20 item Toronto alexithymia scala: According to cut-off score. Klinik Psikiyatri, 19, 213–219.
go back to reference Hisli-Sahin, N. (1988). Beck Depresyon Envanterinin geçerliği üzerine bir çalışma. Psikoloji Dergisi, 6, 118–126. Hisli-Sahin, N. (1988). Beck Depresyon Envanterinin geçerliği üzerine bir çalışma. Psikoloji Dergisi, 6, 118–126.
go back to reference Honkalampi, K., Koivumaa-Honkanen, H., Hintikka, J., et al. (2004). Do stressful life-events or sociodemographic variables associate with depression and alexithymia among a general population? A 3-year follow-up study. Comprehensive Psychiatry, 45, 254–260.PubMed Honkalampi, K., Koivumaa-Honkanen, H., Hintikka, J., et al. (2004). Do stressful life-events or sociodemographic variables associate with depression and alexithymia among a general population? A 3-year follow-up study. Comprehensive Psychiatry, 45, 254–260.PubMed
go back to reference Karşıkaya, S., Kavakcı, Ö., Kuğu, N., & Güler, A. S. (2013). Post-traumatic stress disorder in migraine patients: Migraine, trauma and alexithymia. Nöro Psikiyatr Arşivi, 50, 263. Karşıkaya, S., Kavakcı, Ö., Kuğu, N., & Güler, A. S. (2013). Post-traumatic stress disorder in migraine patients: Migraine, trauma and alexithymia. Nöro Psikiyatr Arşivi, 50, 263.
go back to reference Kucukgoncu, S., Ornek, F. Y., Cabalar, M., Bestepe, E., & Yayla, V. (2004). Childhood trauma and dissociation in tertiary care patients with migraine and tension type headache: a controlled study. Journal of Psychosomatic Research, 77, 40–44. Kucukgoncu, S., Ornek, F. Y., Cabalar, M., Bestepe, E., & Yayla, V. (2004). Childhood trauma and dissociation in tertiary care patients with migraine and tension type headache: a controlled study. Journal of Psychosomatic Research, 77, 40–44.
go back to reference Louter, M. A., Piipers, J. A., Wardenaar, K. J., et al. (2015). Symptom dimensions of affective disorders in migraine patients. Journal of Psychosomatic Research, 79, 458–463.PubMed Louter, M. A., Piipers, J. A., Wardenaar, K. J., et al. (2015). Symptom dimensions of affective disorders in migraine patients. Journal of Psychosomatic Research, 79, 458–463.PubMed
go back to reference Nickel, R., & Egle, U. T. (2006). Psychological defense styles, childhood adversities and psychopathology in adulthood. Child Abuse and Neglect, 30, 157–170.PubMed Nickel, R., & Egle, U. T. (2006). Psychological defense styles, childhood adversities and psychopathology in adulthood. Child Abuse and Neglect, 30, 157–170.PubMed
go back to reference Peck, K. R., Smitherman, T. A., & Baskin, S. M. (2015). Traditional and alternative treatments for depression: Implications for migraine management. Headache, 55, 351–355.PubMed Peck, K. R., Smitherman, T. A., & Baskin, S. M. (2015). Traditional and alternative treatments for depression: Implications for migraine management. Headache, 55, 351–355.PubMed
go back to reference Peres, M. F. P., Mercante, J. P., Tobo, P. R., Kamei, H., & Bigal, M. E. (2017). Anxiety and depression symptoms and migraine: A symptom-based approach research. The Journal of Headache and Pain, 18, 37.PubMedPubMedCentral Peres, M. F. P., Mercante, J. P., Tobo, P. R., Kamei, H., & Bigal, M. E. (2017). Anxiety and depression symptoms and migraine: A symptom-based approach research. The Journal of Headache and Pain, 18, 37.PubMedPubMedCentral
go back to reference Peterlin, B. L., Ward, T. N., Lidicker, J. R., & Levin, M. (2007). A retrospective, comparative study on the frequency of abuse in migraine and chronic daily headache. Headache, 47, 397–401.PubMed Peterlin, B. L., Ward, T. N., Lidicker, J. R., & Levin, M. (2007). A retrospective, comparative study on the frequency of abuse in migraine and chronic daily headache. Headache, 47, 397–401.PubMed
go back to reference Price, D. D., McGrath, P. A., Rafii, A., & Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17, 45–56.PubMed Price, D. D., McGrath, P. A., Rafii, A., & Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17, 45–56.PubMed
go back to reference Şar, V., Öztürk, E., & İkikardeş, E. (2012). Çocukluk Çağı Ruhsal Travma Ölçeğinin Türkçe Uyarlamasının Geçerlilik ve Güvenilirliği. Türkiye Klinikleri Journal of Medical Sciences, 32, 1054–1063. Şar, V., Öztürk, E., & İkikardeş, E. (2012). Çocukluk Çağı Ruhsal Travma Ölçeğinin Türkçe Uyarlamasının Geçerlilik ve Güvenilirliği. Türkiye Klinikleri Journal of Medical Sciences, 32, 1054–1063.
go back to reference Savilahti, E. M., Haravuori, H., Rytilä-Manninen, M., Lindberg, N., Kettunen, K., & Marttunen, M. (2018). High beck depression inventory 21 scores in adolescents without depression are associated with negative self-image and immature defense style. Psychiatry Research, 263, 61–68.PubMed Savilahti, E. M., Haravuori, H., Rytilä-Manninen, M., Lindberg, N., Kettunen, K., & Marttunen, M. (2018). High beck depression inventory 21 scores in adolescents without depression are associated with negative self-image and immature defense style. Psychiatry Research, 263, 61–68.PubMed
go back to reference Silberstein, S. D., Olesen, J., & Bousser, M. G. (2005). Headache classification subcommittee of the international headache society. ‘The international classification of headache disorders’. Cephalalgia, 25, 1–151. Silberstein, S. D., Olesen, J., & Bousser, M. G. (2005). Headache classification subcommittee of the international headache society. ‘The international classification of headache disorders’. Cephalalgia, 25, 1–151.
go back to reference Taycan, O., Özdemir, A., & Erdoğan, S. (2017). Alexithymia and somatization in depressed patients: The role of the type of somatic symptom attribution. Archives of Neuropsychiatry, 54, 99–104.PubMedPubMedCentral Taycan, O., Özdemir, A., & Erdoğan, S. (2017). Alexithymia and somatization in depressed patients: The role of the type of somatic symptom attribution. Archives of Neuropsychiatry, 54, 99–104.PubMedPubMedCentral
go back to reference Tietjen, G. E., Brandes, J. L., Digre, K. B., et al. (2007). History of child-hood maltreatment is associated with comorbid depression in women with migraine. Neurology, 69, 959–968.PubMed Tietjen, G. E., Brandes, J. L., Digre, K. B., et al. (2007). History of child-hood maltreatment is associated with comorbid depression in women with migraine. Neurology, 69, 959–968.PubMed
go back to reference Tietjen, G. E., Brandes, J. L., Peterlin, B. L., et al. (2010). Childhood maltreatment and migraine (part I). Prevalence and adult revictimization: A multicenter headache clinic survey. Headache, 50, 20–31.PubMed Tietjen, G. E., Brandes, J. L., Peterlin, B. L., et al. (2010). Childhood maltreatment and migraine (part I). Prevalence and adult revictimization: A multicenter headache clinic survey. Headache, 50, 20–31.PubMed
go back to reference Tütüncü, R., & Hüseyin, G. H. (2011). Kronik ağrı, psikolojik etmenler ve depresyon/Chronic pain, psychological factors and depression. Dicle Medical Journal, 38, 257–262. Tütüncü, R., & Hüseyin, G. H. (2011). Kronik ağrı, psikolojik etmenler ve depresyon/Chronic pain, psychological factors and depression. Dicle Medical Journal, 38, 257–262.
go back to reference Üçler, S. (2018). Migren ve Gerilim Tipi Baş Ağrılarında Patofizyoloji. Turkiye Klinikleri Journal of Neurology Special Topics, 11, 21–27. Üçler, S. (2018). Migren ve Gerilim Tipi Baş Ağrılarında Patofizyoloji. Turkiye Klinikleri Journal of Neurology Special Topics, 11, 21–27.
go back to reference Yargıç, İ., Tutkun, H., & Şar, V. (1995). The reliability and validity of the Turkish version of the dissociative experiences scale. Dissociation, 8, 10–13. Yargıç, İ., Tutkun, H., & Şar, V. (1995). The reliability and validity of the Turkish version of the dissociative experiences scale. Dissociation, 8, 10–13.
go back to reference Yılmaz, N., Gençöz, T., & Ak, M. (2007). Savunma biçimleri testinin psikometrik özellikleri: güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi, 18, 1–10. Yılmaz, N., Gençöz, T., & Ak, M. (2007). Savunma biçimleri testinin psikometrik özellikleri: güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi, 18, 1–10.
go back to reference Zhang, L., Wang, X., Zhu, Y., et al. (2017). Selective impairment of decision making under ambiguity in alexithymia. BMC Psychiatry, 17, 378.PubMedPubMedCentral Zhang, L., Wang, X., Zhu, Y., et al. (2017). Selective impairment of decision making under ambiguity in alexithymia. BMC Psychiatry, 17, 378.PubMedPubMedCentral
Metagegevens
Titel
Defense Mechanisms, Dissociation, Alexithymia and Childhood Traumas in Chronic Migraine Patients
Auteurs
Filiz Özsoy
İrem Taşcı
Publicatiedatum
06-05-2020
Uitgeverij
Springer US
Gepubliceerd in
Journal of Rational-Emotive & Cognitive-Behavior Therapy / Uitgave 1/2021
Print ISSN: 0894-9085
Elektronisch ISSN: 1573-6563
DOI
https://doi.org/10.1007/s10942-020-00357-0

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