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Mindfulness and Chronic Headache/Migraine

Mechanisms Explored Through the Fear-Avoidance Model of Chronic Pain

Komandur, Biyanka, MPsych(Clin)*; Martin, Paul R., DPhil; Bandarian-Balooch, Siavash, PhD*

The Clinical Journal of Pain: July 2018 - Volume 34 - Issue 7 - p 638–649
doi: 10.1097/AJP.0000000000000580
Original Articles

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.

*Griffith University

School of Applied Psychology, Menzies Health Institute, Griffith University, Qld, Australia

The authors declare no conflict of interest.

Reprints: Paul R. Martin, DPhil, School of Applied Psychology, Griffith University, Mount Gravatt Campus, 176 Messines Ridge Road, Qld 4122, Australia (e-mail:

Received June 13, 2017

Received in revised form December 10, 2017

Accepted December 15, 2017

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