[Coping with stress and pain in migraine patients.]

During a semi-structured interview 82 migraine patients were asked biographical and illnessrelated questions. They completed psychological instruments on coping behavior (Stressverarbeitungsfragebogen), self-concept (Frankfurter Selbstkonzeptskalen), attributional style (IE-SV-F), illness behavior, and illness-related attributions (Tübinger Attributions-fragebogen). The theoretical background of this research is a cognitive model of coping with stress and illness. The results support the interrelations between coping with stress and coping with illness assumed in the model. They justify considering coping with illness to be scopespecific coping behavior. Furthermore, the results emphasize the importance of cognitive processes for stress-coping in general, as well as for illness-related coping behavior. With regard to personality variables, migraineurs, as compared with healthy persons, show to a larger extent coping strategies that are apt to maintain rather than to reduce stress, such as resignation, withdrawal, and avoidance behavior. They also have a more unfavorable selfconcept of achievement, emotional stability and selfassertiveness, lower self-esteem and a more external pattern of causal attributions. Some of the pain behavior strategies could be identified as being focused on illness (guarding behavior, avoidance and social withdrawal, resignation and complaint); only the attempt to relax is regarded as being focused on health. Migraine patients show a preference neither for medical nor psychological causal attributions of their illness but score significantly higher on medical than psychological control attributions. The results have implications for psychological therapy.