Injustice, quality of life, and psychiatric symptoms in people with migraine.

OBJECTIVE: To describe and examine the relationships between perceived injustice, quality of life (QoL), and psychiatric symptoms through a mixed-methods, cross-sectional observational study design in people with migraine. METHOD: Participants completed a series of online quantitative questionnaires, including the Injustice Experience Questionnaire (IEQ). Then, 10 participants took part in qualitative phenomenological interviews. RESULTS: One hundred twenty-seven participants were included in the sample. Correlations revealed higher IEQ scores were strongly associated with lower QoL (r = -.676, p < .001). Higher scores on the IEQ were related to higher migraine attack frequency (r = .403, p < .001), migraine pain intensity (r = .352, p < .001), no association with reports of nausea/vomiting (r = .110, p = .220), and higher report of allodynia symptoms (r = .281, p < .001). Participants who reported a migraine with aura in the past year reported higher IEQ scores than people with no aura in the past year (t[125] = -2.34, p = .02). Higher IEQ scores were associated with higher anxiety (r = .447, p < .001) and depression symptom scores (r = .495, p < .001). The phenomenological interviews revealed 4 core themes describing perceived injustice and QoL with migraine: coping, loss, illness burden, and misunderstanding. CONCLUSION: Higher levels of perceived injustice showed lower levels of QoL, was associated with higher headache frequency attack severity, and rates of depressive and anxiety symptoms. Participants described their QoL similarly, regardless of reported high or low levels of perceived injustice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cogniphobia and neuropsychological functioning in migraine.

OBJECTIVE: Cogniphobia refers to the fear and avoidance of cognitive exertion, believed to cause or exacerbate headache. The objective of the present study was to demonstrate associations between cogniphobia and key fear-avoidance constructs. METHOD: In this cross-sectional study, 72 adults with migraine were recruited from a tertiary headache center. Patients completed the Cogniphobia Scale for Headache Disorders (CS-HD) and a series of self-reported surveys and neuropsychological measures that assessed patient demographics, migraine diagnosis and headache characteristics, current pain severity, emotional state (i.e., anxiety, pain-related fear, and depression), cognitive exertion, and functioning (self-reported disability, self-reported cognitive symptoms, and neuropsychological measures). RESULTS: The CS-HD was associated with greater anxiety (Patient-Reported Outcomes Measurement Information System; PROMIS Anxiety; r = 0.39, p = .001), pain-related fear (PASS-20; ρ = 0.37, p = .002), self-reported cognitive symptoms (ABS; ρ = 0.38, p = .001), self-reported headache disability (HDI; r = 0.28, p = .022), and depression (PROMIS Depression; r = 0.25, p = .039). The CS-HD was also associated with lower scores on neuropsychological measures of semantic fluency (Animal Naming; r = -0.29, p = .015), visual immediate recall memory (RCFT Immediate Recall; r = -0.27, p = .027), visual delayed recall memory (RCFT Delayed Recall; r = -0.36, p = .002), and visual recognition memory (RCFT Recognition; r = -0.42, p < .001), with comparable findings when adjusting for depression and anxiety. CONCLUSION: This study demonstrated associations between cogniphobia and key fear-avoidance constructs. Fear-avoidance constructs, such as cogniphobia, are important constructs to consider when evaluating migraine and neuropsychological functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).