Pain-related avoidance and endurance behaviour in migraine: an observational study
Abstract Background The role of avoidance and endurance behaviour is well established in chronic musculoskeletal pain, but less is known about its significance in migraine. Methods The Avoidance-Endurance Questionnaire behavioural subscales, the Pain Disability Index (PDI), the Migraine Disability A...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | The Journal of Headache and Pain |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s10194-019-0962-7 |
| _version_ | 1818187976386019328 |
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| author | Ruth Ruscheweyh Diana Pereira Monika I. Hasenbring Andreas Straube |
| author_facet | Ruth Ruscheweyh Diana Pereira Monika I. Hasenbring Andreas Straube |
| author_sort | Ruth Ruscheweyh |
| collection | DOAJ |
| description | Abstract Background The role of avoidance and endurance behaviour is well established in chronic musculoskeletal pain, but less is known about its significance in migraine. Methods The Avoidance-Endurance Questionnaire behavioural subscales, the Pain Disability Index (PDI), the Migraine Disability Assessment Scale (MIDAS) and the Hospital Anxiety and Depression Scale (HADS) were obtained from 128 migraine patients (90 episodic, 38 chronic). Sixty nine of them were re-evaluated after 3–6 months. Results At baseline, there were positive relations between avoidance (especially social avoidance behaviour) and pain-related disability as assessed by the PDI (Wald χ2 [1] = 32.301, p < 0.001) and the MIDAS (Wald χ2 [1] = 14.387, p < 0.001). A negative relation of endurance behaviour with PDI scores did not survive multiple regression analysis. In addition, there was a positive relation of social avoidance with the HADS depression score (Wald χ2 [1] = 3.938, p = 0.047) and a negative relation of endurance (especially the humour-distraction subscale) with the HADS anxiety score (Wald χ2 [1] = 6.163, p = 0.013). Neither avoidance nor endurance were related to headache intensity or frequency, or to a diagnosis of episodic vs. chronic migraine. 3–6 months after treatment at our headache centre, headache frequency, intensity and pain-related disability were significantly improved (all p < 0.01) while avoidance and endurance were unchanged. Conclusions This indicates that improvement in headache frequency and disability can be achieved in the absence of changes in avoidance or endurance behaviour. However, because of its significant link to headache-related disability, avoidance behaviour (especially social avoidance) should be investigated as a potential additional target of migraine therapy. |
| first_indexed | 2024-12-11T23:19:35Z |
| format | Article |
| id | doaj.art-c49d91795d2745cfb0208b3c8995e907 |
| institution | Directory Open Access Journal |
| issn | 1129-2369 1129-2377 |
| language | English |
| last_indexed | 2024-12-11T23:19:35Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | The Journal of Headache and Pain |
| spelling | doaj.art-c49d91795d2745cfb0208b3c8995e9072022-12-22T00:46:23ZengBMCThe Journal of Headache and Pain1129-23691129-23772019-01-012011910.1186/s10194-019-0962-7Pain-related avoidance and endurance behaviour in migraine: an observational studyRuth Ruscheweyh0Diana Pereira1Monika I. Hasenbring2Andreas Straube3Department of Neurology, Ludwig Maximilians UniversityDepartment of Neurology, Ludwig Maximilians UniversityDepartment of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of BochumDepartment of Neurology, Ludwig Maximilians UniversityAbstract Background The role of avoidance and endurance behaviour is well established in chronic musculoskeletal pain, but less is known about its significance in migraine. Methods The Avoidance-Endurance Questionnaire behavioural subscales, the Pain Disability Index (PDI), the Migraine Disability Assessment Scale (MIDAS) and the Hospital Anxiety and Depression Scale (HADS) were obtained from 128 migraine patients (90 episodic, 38 chronic). Sixty nine of them were re-evaluated after 3–6 months. Results At baseline, there were positive relations between avoidance (especially social avoidance behaviour) and pain-related disability as assessed by the PDI (Wald χ2 [1] = 32.301, p < 0.001) and the MIDAS (Wald χ2 [1] = 14.387, p < 0.001). A negative relation of endurance behaviour with PDI scores did not survive multiple regression analysis. In addition, there was a positive relation of social avoidance with the HADS depression score (Wald χ2 [1] = 3.938, p = 0.047) and a negative relation of endurance (especially the humour-distraction subscale) with the HADS anxiety score (Wald χ2 [1] = 6.163, p = 0.013). Neither avoidance nor endurance were related to headache intensity or frequency, or to a diagnosis of episodic vs. chronic migraine. 3–6 months after treatment at our headache centre, headache frequency, intensity and pain-related disability were significantly improved (all p < 0.01) while avoidance and endurance were unchanged. Conclusions This indicates that improvement in headache frequency and disability can be achieved in the absence of changes in avoidance or endurance behaviour. However, because of its significant link to headache-related disability, avoidance behaviour (especially social avoidance) should be investigated as a potential additional target of migraine therapy.http://link.springer.com/article/10.1186/s10194-019-0962-7MigraineFear-avoidanceDisability |
| spellingShingle | Ruth Ruscheweyh Diana Pereira Monika I. Hasenbring Andreas Straube Pain-related avoidance and endurance behaviour in migraine: an observational study The Journal of Headache and Pain Migraine Fear-avoidance Disability |
| title | Pain-related avoidance and endurance behaviour in migraine: an observational study |
| title_full | Pain-related avoidance and endurance behaviour in migraine: an observational study |
| title_fullStr | Pain-related avoidance and endurance behaviour in migraine: an observational study |
| title_full_unstemmed | Pain-related avoidance and endurance behaviour in migraine: an observational study |
| title_short | Pain-related avoidance and endurance behaviour in migraine: an observational study |
| title_sort | pain related avoidance and endurance behaviour in migraine an observational study |
| topic | Migraine Fear-avoidance Disability |
| url | http://link.springer.com/article/10.1186/s10194-019-0962-7 |
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