Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Psychology

First Advisor

Todd Smitherman

Second Advisor

Danielle Maack

Third Advisor

Scott Gustafson

Relational Format



Migraine is the most debilitating neurological disorder worldwide and is associated with high economic and psychological costs. Common behavioral strategies for coping with migraine include avoidance of stimuli believed to precipitate an attack, though literature suggests that avoidance behaviors may serve to exacerbate migraine-symptoms and increase disability. Although the incorporation of trigger avoidance in modern conceptualizations of headache-related disability represents a more comprehensive understanding of disability occurring outside of migraine attacks (interictally), extant literature has emphasized trigger avoidance to the exclusion of other factors. Learning principles suggest stimuli that exacerbate migraine may take on similar eliciting properties as pain and result in conditioned fear and avoidance interictally. The present study aimed to experimentally investigate interictal avoidance of migraine-related stimuli (i.e., light and noise) between individuals with migraine and non-headache controls and to quantify relations among avoidance behavior, fear of pain, trigger status, and headache-related disability in a young adult, non-treatment seeking population. The main hypotheses were that individuals with migraine endorsing sensitivity to light or sound would engage in greater interictal behavioral avoidance of these stimuli than non-headache controls, and that these effects would persist after controlling for trigger status. Further, it was hypothesized that, among those with migraine, fear of pain would moderate behavioral avoidance across tasks, and avoidance behaviors would be positively associated with headache-related disability.

Available for download on Thursday, December 14, 2023