Design and Validation of Tension Headache Questionnaire in the Iranian Population

Hajloo, Nader; Abdollahzadeh, Hasan; Salmani, Ali; Sharei, Aysan; Farhoudi, Negar

doi:10.30473/hpj.2025.75562.6307

Articles in Press

Document Type : Scientific Research

Authors

¹ Professor. Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

² Associate Professor. Department of Psychology, Payame Noor University, Tehran, Iran

³ Ph.D. Student, Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

⁴ Ph.D. Student, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Kharazmi, Tehran, Iran

⁵ Neurologist, Ardabil University of Medical Sciences, Alavi Hospital, Ardabil, Iran

10.30473/hpj.2025.75562.6307

Abstract

Objective: Tension headache is known as the second most common chronic disease in the world. Tension headaches pose a significantly greater social burden than migraines, especially in chronic cases, and can have significant negative consequences on various aspects of an individual's well-being, including physical, psychological, and social interactions. This type of headache has attracted the attention of many researchers and health professionals due to its prevalence and significant impact on quality of life. Therefore, designing a specific questionnaire can be an important step towards developing related research. The present study aimed to design and validate a tension headache questionnaire in the Iranian population. Method: The present study is a mixed qualitative-quantitative study. The qualitative part of the research was conducted in an inductive manner to extract the items used in developing the questionnaire. In the quantitative part, a descriptive method was used in the form of psychometric studies to examine the validity and reliability of the developed tool. In the qualitative part, the statistical population was all articles extracted from the scientific databases SID, Magiran, and Web of Science, PubMed, Scopus, Cochrane Library, Since direct, and Google scholar between 2000 and 2024. The statistical population of the research in the quantitative part consisted of all people with tension headaches based on the diagnostic criteria of the International Classification of Headache Disorders (ICHD-3) in 2025. The sample of the present study was 240 individuals from four cities selected by purposive sampling method and responded to the Tension Headache Questionnaire (2025), Questionnaire for Measuring Symptoms of Migraine Headache of Najarian (1997) and Psychological Well-Being Scale of Ryff (1989). Internal consistency coefficient, concurrent validity, exploratory and confirmatory factor analysis were used to analyze the data. The data were analyzed using SPSS.₂₆ and LISREL._10.20 software. Results: The results of the internal consistency coefficient showed that this questionnaire and its subscales have adequate reliability (α>0.70). The results of the correlation coefficient showed that the positive relationship between the tension headaches variable and the severity of migraine symptoms (r=0.750, P<0.001) indicates appropriate convergent validity and the negative correlation coefficient between the psychological well-being variable (r=-0.155, P<0.05) indicates appropriate divergent validity. The fit indices of the confirmatory factor analysis model also confirmed the final model of this questionnaire with eight components of factors related to repetition, pain, time, environment, sensitivity, distress tolerance, pressure/tension, and mood (P<0.001). Conclusion: The results of this study showed that the tension headache questionnaire has acceptable validity and reliability in the Iranian society and is well-adapted to the cultural and indigenous characteristics of Iranian patients, which allows for a proper understanding of its items. Using this tool in diagnosing or assessing the severity of tension headaches can have a significant impact and is a suitable self-assessment scale for clinical and research situations.

Keywords

Main Subjects

References

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Health Psychology

Design and Validation of Tension Headache Questionnaire in the Iranian Population

References

References

Articles in Press, Accepted Manuscript
Available Online from 11 March 2026

Design and Validation of Tension Headache Questionnaire in the Iranian Population

References

References

Articles in Press, Accepted Manuscript Available Online from 11 March 2026

Articles in Press, Accepted Manuscript
Available Online from 11 March 2026