Acceptance, appraisals, and coping in relation to migraine headache: an evaluation of interrelationships using daily diary methods
Electrodiagnostic studies produce both anxiety and pain, which can prevent adequate examination and limit the usefulness of test results. This study examined the spontaneous coping strategies used to manage the pain and anxiety experienced during electrodiagnostic testing. Fifty patients (26 women and 24 men) evaluated in our electrodiagnostic laboratory were administered visual analogue scale (VAS) pain and anxiety measures and the Spielberger State-Trait Anxiety Inventory (STAI) before the procedure. Immediately after the procedure, subjects reported pain, anxiety, and coping strategies used during electrodiagnostic testing using the VAS, the STAI, and a situation-specific version of the Coping Strategies Questionnaire (CSQ-S). The CSQ-S appears to be a valid and reliable measure of spontaneous coping strategies. Multiple-regression analyses revealed that frequent use of catastrophizing, diverting attention, and coping self-statement strategies was significantly and positively correlated with pain, whereas reinterpreting pain was significantly and negatively associated with pain. Judgments of control over pain were also significantly and negatively associated with anxiety experienced during electrodiagnostic studies. Physicians' ratings of pain and anxiety were highly correlated with patients' self-reports. This study suggests that ineffective coping strategies may enhance the pain and anxiety experienced during electromyography. Alternatively, teaching subjects active self-control skills and increasing patients' self-efficacy beliefs may help manage this situation-specific acute anxiety and, possibly, the associated pain.