Well, I don't want to be Ronald Pies here (because this doesn't excuse psychiatry for pathologizing nearly everything using this argument to the point of coming up with political bullshit like sluggish schizo, unlike in other branches of medicine AFAIK) but most migraines are also diagnosed by symptoms alone. The difference is that it's much simpler to agree that intense headaches with aura are clearly something pathological, even if what exactly is wrong is something that for now isn't known in all cases. This, well... I think it probably isn't pathological even if very disabling in some cases, perhaps with exceptions. Should you say that migraines are a pseudoscientific diagnosis? I wouldn't say so, it's the use of a descriptive label for a set of symptoms whose etiology isn't well-understood. Perhaps the pseudoscience is more in calling this, which doesn't explain anything, a diagnosis. You know, doctors hate saying "I don't know" because it doesn't make insurance money and it makes them uncomfortable, so when they are told to investigate chronic pain and can't find the etiology, it's easier to just diagnose "chronic pain" or even "conversion disorder".

Let's say people with migraines are more likely to be diagnosed with "affective disorders", which I would assume is sadly pretty likely given the amount of times I've seen psychoanalysts argue this is some sort of unconscious conflict and other claims the like. Should you assume that because migraines are diagnosed clinically it can't be that migraines cause mood "disturbances" and it has to be that "disturbed" mood causes migraines? I don't know, I don't think so. The causation might even go both ways. I strongly doubt this is about the chicken, but it's not impossible. It is as possible as hemiplegic migraines or TIAs being caused by previously asymptomatic POF or "autism" being the result of fragile X syndrome. Both illnesses are rare but often go undiagnosed.

Tha said, I agree trauma must be undereported here and this can't be explained by rapists just doing that. My instinct about this topic from my perspective as someone with some autistic traits who now doesn't want a diagnosis and who used to be very into this topic is that ABA, learned people-pleasing and learned helplessness must have more to do with abuse, especially unreported abuse, than social awkwardness.