Stress-coping in migraine.

During a total of six months weekly measurements of coping with every-day life stresses were obtained from 29 migraine patients. Four issues were investigated: (1) the relation between daily stresses and the occurrence of migraine attacks; (2) the associations between ways of stress-coping and attack occurrence; (3) the effects on stress-coping of two behavior therapeutic methods, relaxation training and stress-coping training; (4) the clinical utility of pre-training measurement of stress-coping. the results yield evidence that both threat as a form of every-day stress and 'depressive reaction' as a way to cope with threat are significantly related to the occurrence of migraine attacks. In general the effects of training on stress-coping appeared to be rather small. Three coping strategies changed as a result of both regimens taken together: 'tackling the problem actively' increased, while 'avoidance' and (quite tenuous) 'depressive reaction' decreased. Although relaxation training contributed most to these outcomes, no significant between-group differences were found. Divergent baseline per-subject patterns of stress-coping suggest that individual differences must be acknowledged. A sensible clinical usage of stress-coping data in our view requires that inferences are based on individual rather than group outcomes. Also, one cannot afford to neglect the actual and often idiosyncratic context of stress-coping.