Headache-Specific Locus of Control Scale (HSLC): A Full Guide for Researchers and Clinicians
Published
The Headache-Specific Locus of Control Scale (HSLC) is a 33-item measure of headache beliefs. Learn its three subscales, scoring, versions and evidence.
Introduction
The Headache-Specific Locus of Control Scale (HSLC) is a 33-item self-report scale that assesses what people with recurrent headaches believe controls the onset, course and relief of their headaches: their own behavior, health care professionals or chance. Nancy J. Martin, Kenneth A. Holroyd and Donald B. Penzien published it in 1990.
The HSLC appeared in Headache: The Journal of Head and Face Pain and has received more than 170 citations. This guide explains its subscales, scoring, versions and evidence.
Key Features of the Headache-Specific Locus of Control Scale (HSLC)
Purpose and Use
The HSLC measures beliefs about the determinants and control of headache occurrence and relief, including the influence of:
The person's own behaviors and responsesHealth care professionals and medical treatmentChance or fateTarget Population
The HSLC was developed for adults with recurrent headaches. Later validation work includes adult populations: the Danish validation involved headache patients, and the Dutch validation included participants aged 18 to 55.
Structure
The HSLC has 33 items in three subscales of 11 items each:
Subscale
Belief that headaches are controlled by
Items
Internal
One's own behavior
11
Health Care Professionals
Doctors and medical treatment
11
Chance
Chance or fate
11
Scoring Method
Items are rated on a 5-point scale: 1 = strongly disagree, 2 = moderately disagree, 3 = neutral, 4 = moderately agree and 5 = strongly agree.
Subscale scores: sum the 11 items in each subscale, for a range of 11 to 55.Higher scores indicate stronger endorsement of that locus-of-control belief. No cut-off scores are reported.
Administration Format
The HSLC is a self-report questionnaire.
Applications of the Headache-Specific Locus of Control Scale (HSLC)
The HSLC supports several uses:
Behavioral medicine research: studying beliefs about headache control.Pain psychology: exploring how control beliefs relate to headache pain and mood.Languages and availability
The HSLC has been used and validated in several languages:
Arabic: study of locus of control, headache pain and depressionDutch: translation and validation (HSLC-DV), with the questionnaire in the article's appendixDanish: a validation in headache patients has been reportedThe original article is available from Wiley.
Reliability and Validity
The HSLC showed good internal consistency, acceptable three-week test–retest reliability, and construct and incremental validity in a relatively young sample of people with recurrent headaches.
Validation studies:
The Headache-Specific Locus of Control Scale: adaptation to recurrent headaches (1990): study linkPsychometric characteristics of the HSLC (1992): study linkCross-sectional evaluation of the psychometric properties of the HSLC in people with migraine (2019): study linkDutch translation and validation of the HSLC (2018): study linkLimitations and Considerations
Keep these points in mind:
Development sample: the original sample was relatively young.No cut-offs: no cut-off scores are reported, so use the subscales as continuous measures.Headache-specific: the scale is designed for recurrent headache, not other pain conditions.Other Versions And Related Questionnaires
A short form, the Headache-Specific Locus of Control Scale–Short Form 9 (HSLC-SF9), is available.
These questionnaires are related:
Multidimensional Health Locus of Control (MHLC) ScalesInternal-External Locus of Control Scale (I-E Scale)To measure headache impact and disability, see the ResRef guides to the Headache Impact Test-6 (HIT-6) and the Migraine Disability Assessment (MIDAS)Additional Resources
The original article on ResearchGate: linkFor inquiries, contact Kenneth A. Holroyd, Distinguished Professor Emeritus of Psychology, Ohio University, at holroyd@ohio.edu.Browse more headache questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Headache-Specific Locus of Control Scale measure?The HSLC measures whether people with recurrent headaches believe their headaches are controlled by their own behavior, by health care professionals, or by chance, across three 11-item subscales.
How is the HSLC scored?Each of the 33 items is rated from 1 (strongly disagree) to 5 (strongly agree). The 11 items in each subscale are summed, giving scores from 11 to 55, where higher scores mean stronger endorsement of that belief.
Is there a short form of the HSLC?Yes. The Headache-Specific Locus of Control Scale–Short Form 9 (HSLC-SF9) is a shorter version of the original 33-item scale.
Who should complete the HSLC?The HSLC was developed for adults with recurrent headaches. Validations include headache patients in Denmark and adults aged 18 to 55 in the Netherlands.
A Word from ResRef About the Headache-Specific Locus of Control Scale (HSLC)
The HSLC is a headache-specific self-report measure designed to assess beliefs about whether headache onset, course and relief are influenced by personal behavior, health care professionals or chance. It demonstrated good internal consistency, acceptable three-week test–retest reliability, and construct and incremental validity in a relatively young sample of recurrent headache sufferers.
References
Martin, N. J., Holroyd, K. A., & Penzien, D. B. (1990). The Headache‐Specific Locus of Control Scale: Adaptation to Recurrent Headaches. Headache: The Journal of Head and Face Pain, 30(11), 729–734. https://doi.org/10.1111/j.1526-4610.1990.hed3011729.xVandeCreek, L., Min, D., & O'Donnell, F. (1992). Psychometric Characteristics of the Headache‐Specific Locus of Control Scale. Headache: The Journal of Head and Face Pain, 32(5), 239–241. https://doi.org/10.1111/j.1526-4610.1992.hed3205239.xGrinberg, A. S., & Seng, E. K. (2019). Cross‐Sectional Evaluation of the Psychometric Properties of the Headache‐Specific Locus of Control Scale in People With Migraine. Headache: The Journal of Head and Face Pain, 59(5), 701–714. https://doi.org/10.1111/head.13485Heath, R. L., Saliba, M., Mahmassani, O., Major, S. C., & Khoury, B. A. (2008). Locus of control moderates the relationship between headache pain and depression. The Journal of Headache and Pain, 9(5), 301–308. https://doi.org/10.1007/s10194-008-0055-5Willekens, M. C., Postel, D., Keesenberg, M. D. M., & Lindeboom, R. (2018). Dutch Translation and Validation of the Headache-Specific Locus of Control Scale (HSLC-DV). Pain Research and Management, 2018, 1–9. https://doi.org/10.1155/2018/3046235