• tension-type headache;
  • cognitive models;
  • implicit associations;
  • stress/diathesis model

Objective.—To determine whether tension-type headache (TTH) patients display stronger associations between negative events and headache-related information than headache-free controls.

Background.—Generally, stress/diathesis models are common in clinical research and in the context of TTHs specifically. Data involving stress reactivity processes are compatible with such models. However, it would be of interest to tap the associative cognitive processes that likely mediate such relations.

Methods.—In the present study, we selectively recruited individuals who do (n = 19) and do not (n = 19) suffer from episodic TTHs. We examined implicit associations between negative evaluations and headache-related information through the use of an implicit association test.

Results.—As hypothesized, TTH patients displayed associations between negative evaluations and headache-related information, whereas the control group did not.

Conclusions.—These data provide initial support for a plausible cognitive model for the occurrence of TTHs among predisposed individuals.