Who is in charge when I have a headache? Brazilian version of the Headache-Specific Locus of Control Scale

ABSTRACT

Background: Headache-Specific Locus of Control (LOC) refers to individuals’ beliefs about their control over the onset, course and consequences of headaches. LOC beliefs have been associated with depression, coping strategies, headache-related disability and treatment outcomes. Objective: To test the cross-cultural adaptation and psychometric properties of a Brazilian version of the Headache-Specific Locus of Control Scale (HSLC). Methods: One hundred and thirty-four migraine outpatients completed the HSLC and provided measurements of psychopathological symptoms, pain catastrophizing, depression, anxiety, quality of life and headache-related disability. Results: The three-factor structure of the HSLC (LOC-P, LOC-C and LOC-I) was confirmed in the Brazilian sample. The instrument showed good internal consistency, with Cronbach's α of 0.77 for total HSLC and 0.70, 0.83 and 0.87, for LOC-P, LOC-C and LOC-I, respectively. LOC-C correlated with headache frequency and headache intensity. Along with headache intensity, depression and pain catastrophizing, LOC-I accounted for 45% of the variance (adjusted R²=0.45; F=12.97; p<0.01) in headache-related disability. Conclusions: The Brazilian version of the HSLC is a valid and reliable measure of headache-specific LOC beliefs. It is important to consider the balance between the three LOCs for each individual, instead of interpreting them separately.

RESUMO

Introdução: O lócus de controle específico para a dor de cabeça (LOC) refere-se às crenças dos indivíduos acerca de seu controle sobre o início, o curso e as consequências das dores de cabeça. As crenças sobre LOC têm sido associadas à depressão, às estratégias de enfrentamento, à incapacidade relacionada às dores de cabeça e aos resultados do tratamento. Objetivo: Testar a adaptação transcultural e as propriedades psicométricas de uma versão brasileira da Escala de Lócus de Controle Específico para Dor de Cabeça (HSLC). Método: Cento e trinta e quatro pacientes ambulatoriais com enxaqueca completaram a HSLC e medidas de sintomas psicopatológicos, catastrofização da dor, depressão, ansiedade, qualidade de vida e incapacidade relacionada à dor de cabeça. Resultados: A estrutura de 3 fatores da HSLC (LOC-P, LOC-C e LOC-I) foi confirmada na amostra brasileira. O instrumento demonstrou boa consistência interna, com α de Cronbach de 0,77 para HSLC total e de 0,70, 0,83 e 0,87 para LOC-P, LOC-C e LOC-I, respectivamente. LOC-C correlacionou-se com a frequência e a intensidade da dor de cabeça. Acompanhado de intensidade da dor de cabeça, depressão e catastrofização da dor, o LOC-I foi responsável por 45% da variância (R² ajustado=0,45; F=12,97; p<0,01) na incapacidade relacionada à dor de cabeça. Conclusões: A versão brasileira da HSLC é uma medida válida e confiável de crenças de LOC específicas para dor de cabeça. É importante considerar o equilíbrio entre os três LOCs para cada indivíduo, em vez de interpretá-los separadamente.

Keywords:

Migraine Disorders - Validation Study - Depression - Anxiety - Catastrophization

Palavras-chave:

Transtornos de Enxaqueca - Estudo de Validação - Depressão - Ansiedade - Catastrofização

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