The Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ-G): Development and Psychometric Evaluation of a German Adaptation

Background: The avoidance of headache triggers may lead to developing a primary headache disorder. Novel behavioral treatment approaches referring to this phenomenon propose a differentiated handling of potential headache triggers. In order to support therapy evaluation and planning for primary headaches, the Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ) was developed in the English-speaking area. Patients and Methods: The HTSAQ was translated into German. Its psychometric properties were established using a sample of consecutive patients (n = 204) of the Migraine and Headache Clinic Konigstein. Results: The HTSAQ-G shows good internal consistency (alpha = 0.96) and test-retest reliability (r = 0.88). According to expectations, there were medium positive correlations between triggers sensitivity and avoidance and depression, anxiety, stress, and impairment due to pain (r = 0.29 to 0.47) and negative correlations with acceptance of pain (r = -0.27 to -0.42). Conclusions: The results of this study support the use of the German adaptation of the HTSAQ as a reliable and valid measure of sensitivity to headache triggers and avoidance of headache triggers. The HTSAQ-G can be of use both evaluating behavioral treatment approaches and therapy planning for primary headaches in the German language area. Future studies should examine the factor structure of the HTSAQ-G using exploratory and confirmatory factor analysis in order to identify possible different types of triggers. (c) 2019 S. Karger AG, Basel