The development of a comprehensive headache diary--verbal descriptor scales

A headache diary was developed to allow the ongoing assessment of subjective and behavioural components of headache pain. A modified version of Philips & Hunter's (1981) pain behaviour checklist which assesses three types of pain behaviour was incorporated for the latter. A scale based on pain descriptors was developed for the subjective component. This scale was factor analysed to reveal five aspects of headache pain, two reactive and three sensory. When the descriptors were scaled it was found that the amount of pain represented by some words was significantly greater in headache than non-headache subjects. Within each descriptor factor, the words do not appear to vary in intensity, with the exception of one reactive factor which appears to reflect overall evaluation of pain. Internal validity of the diary was investigated showing distinctive patterns of association between the subjective factors, pain behaviour, and pain intensity. External validity was assessed by the use of the diary in an intervention study and in delineating differences between migraine and tension headache groups.