Complexities in life stress-dysfunction relationships: a case in point-tension headache

The purpose of this study was twofold: (1) to evaluate the role of disregulation in tension headache and (2) to demonstrate how disregulation may lead to erroneous inferences about the etiological role of stress in tension headache. A headache group (N = 25; ages 18 to 30) and a control group (N = 25; ages 10 to 25) matched for sex and roughly equated for psychopathology and self-report life stress was selected after screening 1219 undergraduate students. Measures of self-reported acute stress and headache status, vigilance performance, frontalis EMG, and peripheral temperature were obtained. Both groups were assessed before, during, and after a stressful hour-long vigilance task. The results provide the frequently sought but rarely, if ever, obtained support for Schwartz's disregulation model. As disregulation was apparent with respect to both self-report acute stress and life stress, the results also suggest that reliance on self-report measures of life stress in studies of the physical outcomes of life stress may conceal the process by which life events results in physical dysfunction.