Pain-related Fear is Associated with Cognitive Task Avoidance: Exploration of the Cogniphobia Construct in a Recurrent Headache Sample

Pain-related fear is related to self-reported avoidance of physical activities that might induce pain (kinesiophobia), as well as diminished physical performance in non-headache chronic pain. A related concept, cogniphobia,'' has been proposed by others, which suggests that individuals high in headache-related fear will avoid cognitive tasks (by putting forth less effort) in an attempt to minimize the risk of bringing on or exacerbating existing headache symptoms. In the present study we explored the psychological, cognitive, and behavioral correlates of cogniphobia in 74 young adults with frequent headaches. Latent variable analysis of the cogniphobia measure revealed a component focused on fear of headache pain and avoidance of behaviors that would induce pain, which was related to sustained attention performance, performance on a symptom validity measure, and pressure pain threshold on the head, consistent with existing kinesiophobia research in non-headache pain. Results have implications for neuropsychological assessment in headache; pain-related fear may be related to diminished effort on neuropsychological tasks.