Headache sufferers‘drawings reflect distress, disability and illness

Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Journal of psychosomatic research (Impact Factor: 2.74). 06/2009; 66(5):465-70. DOI: 10.1016/j.jpsychores.2008.09.006
Source: PubMed


Drawings have recently been used with patients with heart problems to assess their perceptions of their illness. This study aimed to investigate whether drawings could be a useful way to assess headache patients' perceptions of their headaches and their reactions.
In a cross-sectional study, 65 university students who experienced persistent headaches were asked to draw a picture of how their headaches usually affected them. Drawings were assessed in three ways: they were categorized based on content; their size was measured; and image analysis software assessed their darkness. Associations between drawings, illness perceptions, mood, and health outcomes were assessed.
Twenty-seven people drew an external force to the head and these people had greater ratings of average pain and were more likely to attribute their headache to stress. Darker drawings were associated with greater emotional distress and lower vitality. Larger drawing size was associated with perceptions of worse consequences, worse symptoms, worse emotional representations, lower vitality, higher pain, and more days of restricted activity, lower happiness, and higher sadness.
Drawings offer an additional way to assess peoples' experience of their headaches and reflect illness perceptions and distress. People draw how they see themselves experiencing their headache and often include expressions and reactions. The inclusion of force to the head, darker drawings, and larger drawings are associated with worse perceptions of the headache and higher pain. Drawings may be a useful way for clinicians to understand patients' experience of pain.

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Available from: Arden L Corter, Oct 09, 2015
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    • "Qualitative analysis Each drawing was qualitatively assessed by identifying the prominent aspects of the drawings ( in line with previous assessments of patient drawings ( Broadbent et al . , 2009 ) ) . These initial assessments were used to develop a coding framework of the fea - tures depicted in the drawings , which was then applied independently to each drawing by two researchers ( SS and NS ) . Comparison of the coding indicated relatively few dis - crepancies . The few areas of disagreement included : definitions / descript"
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    ABSTRACT: Objective: This pilot study investigated the use of patient drawings to explore patient experiences of symptoms of melanoma prior to healthcare use. Design: Patients (n=63) with melanoma were interviewed within 10 weeks of diagnosis. Participants were asked to draw what their melanoma had looked like when they first noticed it, and to make additional drawings to depict changes as it developed. Main outcome measure: The size and features of the drawings were compared between participants and with clinical data (thickness of the melanoma; histological diameter; clinical photographs). Results: 84% of participants were able to produce at least one drawing. This facilitated discussion of their lesion and recall of events on the pathway to diagnosis. Common features of the drawings related to the view, presence of shading, inclusion of sections, and the shape and border of the lesion. There was potential for disparity between the details in awareness resources and the perceptions of patients. The drawings resembled the clinical photographs and the size of the drawings was positively associated with the histological diameter, but did not differ according to tumour thickness. Conclusion: Asking patients to make drawings of their melanoma appears to be an acceptable, inclusive, feasible and insightful methodological tool.
    Psychology and Health 02/2015; 30(9):1-30. DOI:10.1080/08870446.2015.1016943 · 2.13 Impact Factor
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    • "Visual Representations of Pain Recently , researchers have begun to explore the use of visual representations as an aid to pain communication . Patients ' drawings of their headaches have been found to contain detailed information about features of the pain such as location and quality ( Broadbent , Niederhoffer , Hague , Corter , & Reynolds , 2009 ) , and clinicians are able to dif - ferentiate with some success between migraine and nonmi - graine headaches based on these images ( Stafstrom et al . , 2002 ; Wojaczynska - Stanek , Koprowski , Wróbel , & Gola , 2008 ) . "
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    ABSTRACT: Despite the importance of effective pain communication, talking about pain represents a major challenge for patients and clinicians because pain is a private and subjective experience. Focusing primarily on acute pain, this article considers the limitations of current methods of obtaining information about the sensory characteristics of pain and suggests that spontaneously produced "co-speech hand gestures" may constitute an important source of information here. Although this is a relatively new area of research, we present recent empirical evidence that reveals that co-speech gestures contain important information about pain that can both add to and clarify speech. Following this, we discuss how these findings might eventually lead to a greater understanding of the sensory characteristics of pain, and to improvements in treatment and support for pain sufferers. We hope that this article will stimulate further research and discussion of this previously overlooked dimension of pain communication.
    Health Communication 01/2014; 30(1). DOI:10.1080/10410236.2013.836070 · 0.97 Impact Factor
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    • "Pain drawings (PDs) are widely used to record subjective pain symptoms. In addition to good history taking, physical examinations, and results of biomedical tests, they can support to differentiate several types of local pain syndromes, such as chronic low back pain [1,2], chronic shoulder pain [3], neurogenic pain [4], and headaches [5]. "
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    ABSTRACT: Background Pain drawings are a diagnostic adjunct to history taking, clinical examinations, and biomedical tests in evaluating pain. We hypothesized that somatoform-functional pain, is mirrored in distinctive graphic patterns of pain drawings. Our aim was to identify the most sensitive and specific graphic criteria as a tool to help identifying somatoform-functional pain. Methods We compared 62 patients with somatoform-functional pain with a control group of 49 patients with somatic-nociceptive pain type. All patients were asked to mark their pain on a pre-printed body diagram. An investigator, blinded with regard to the patients’ diagnoses, analyzed the drawings according to a set of numeric or binary criteria. Results We identified 13 drawing criteria pointing with significance to a somatoform-functional pain disorder (all p-values ≤ 0.001). The most specific and most sensitive criteria combination for detecting somatoform-functional pain included the total number of marks, the length of the longest mark, and the presence of symmetric patterns. The area under the ROC-curve was 96.3% for this criteria combination. Conclusion Pain drawings are an easy-to-administer supplementary technique which helps to identify somatoform-functional pain in comparison to somatic-nociceptive pain.
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