Mindfulness and Chronic Headache/Migraine: Mechanisms Explored Through the Fear-Avoidance Model of Chronic Pain

Clin J Pain. 2018 Jul;34(7):638-649. doi: 10.1097/AJP.0000000000000580.

Abstract

Objectives: To replicate a study by Schutze and colleagues on a headache sample, rather than a heterogenous chronic pain sample, investigating whether level of mindfulness predicts key components in the Fear-Avoidance Model of chronic pain (pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability); to investigate the relationships between level of mindfulness and headache/migraine pain intensity, frequency, and duration.

Materials and methods: Participants were 217 individuals who self-reported chronic headache/migraine (51 male, 166 female), aged between 18 and 65 years. Participants completed an online survey measuring demographics, mindfulness, the key components of the Fear-Avoidance Model, and headache pain intensity, duration, and frequency.

Results: Mindfulness had significant negative correlations (P<0.05) with all variables except headache pain intensity and headache frequency. Mindfulness significantly predicted negative affect, pain catastrophizing, fear of pain, pain hypervigilance, and headache duration (P<0.05). Mindfulness remained a significant predictor of negative affect and pain hypervigilance after controlling for other key components and background characteristics (P<0.05). Mindfulness did not moderate the relationship between pain intensity and pain catastrophizing (P=0.204).

Discussion: Findings suggest that mindfulness may be integrated into the Fear-Avoidance Model of chronic pain for individuals with chronic headache/migraine. Directions for future research are discussed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Avoidance Learning
  • Catastrophization
  • Chronic Pain / psychology*
  • Fear
  • Female
  • Headache / psychology*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / psychology*
  • Mindfulness*
  • Models, Theoretical
  • Pain Measurement
  • Young Adult