Perceived self-efficacy and headache-related disability

Background.-Headache-specific self-efficacy refers to patients' confidence that they can take actions that prevent headache episodes or manage headache-related pain and disability. According to social cognitive theory, perceptions of self-efficacy influence an individual's adaptation to persistent headaches by influencing cognitive, affective, and physiological responses to headache episodes as well as the initiation and persistence of efforts to prevent headache episodes. Objective.-The objective of the present study was to construct and validate a brief measure of headache specific self-efficacy and to examine the relationship between self-efficacy and headache-related disability. Methods.-A sample of 329 patients seeking treatment for benign headache disorders completed the Headache Management Self-Efficacy Scale and measures of headache-specific locus of control, coping, psychological distress, and headache-related disability. A subset of 262 patients also completed 4 weeks of daily headache recordings. Results.-As predicted, patients who were confident they could prevent and manage their headaches also believed that the factors influencing their headaches were potentially within their control. In addition, self-efficacy scores were positively associated with the use of positive psychological coping strategies to both prevent and manage headache episodes and negatively associated with anxiety. Multiple regression analyses revealed that headache severity, locus-of-control beliefs, and self-efficacy beliefs each explained independent variance in headache-related disability.