Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




Since the formal proposal by the Ad Hoc Committee on the Classification of Headache (1962) which identified muscle contraction (or tension) headache as a distinct headache diagnosis, numerous attempts have been made to validate the purported etiological mechanism. Results of these investigations, while failing to consistently distinguish tension headache sufferers from either normals or other headache type sufferers on various psychological and psychophysiological measures, have pointed to a lack of homogeneity within this diagnostic category. The present study was intended to identify two distinct subgroups of tension headache sufferers. Tension headache sufferers exhibiting significant EMG increments from a headache-free state to a headache state were compared to sufferers failing to show such increments and to normal controls. The results indicated that headache subjects with EMG increments during headache were more similar to headache free subjects on psychological measures of illness behavior and health locus of control than those individuals without the EMG increments. In addition, all three groups could be classified with a high degree of accuracy based on psychophysiological response patterns to stress. Results are interpreted as confirmatory of the presence of two tension headache subgroups, one with the expected muscular involvement and another with, perhaps, more psychogenic involvement.