Electronic Theses and Dissertations

Date of Award

8-1-2022

Document Type

Dissertation

Degree Name

Ph.D. in Psychology

First Advisor

Todd A. Smitherman

Second Advisor

Laura Johnson

Third Advisor

Aaron Lee

School

University of Mississippi

Relational Format

dissertation/thesis

Abstract

Migraine is the most disabling of the common primary headache disorders and is the sixth most prevalent disease worldwide. Migraine contributes greatly to economic, healthcare, and personal burden. Psychological factors, including depression, anxiety disorders, and stress, further compound functional impact of migraine and contribute to avoidant coping behaviors in anticipation of or during migraine. Traditional behavioral interventions for migraine include biofeedback, relaxation training, and cognitive behavioral therapy (CBT) targeting stress management, coping skills training, and control over pain. Contrastingly, acceptance-based approaches to headache management are those in which individuals learn to mitigate the influence of pain-related experiences on their general functioning without controlling pain itself. Acceptance-based approaches encompass Acceptance and Commitment Therapy (ACT) and mindfulness-based practices, which have shown promise in improving broad functioning and disability among individuals with headache. Despite a growing body of research examining acceptance-based interventions for headache broadly and migraine specifically, no meta-analytic review of ACT interventions for headache exists. To date, two meta-analytic reviews examining mindfulness-based practices among individuals with headache found conflicting results regarding efficacy of these approaches, and both possessed several methodological flaws. The present study aimed to systematically and quantitatively review the literature related to efficacy of acceptance-based interventions among adults with migraine. Random-effects meta-analyses were performed using RevMan 5.4 meta-analytic software. Acceptance-based interventions yielded significant improvements in disability (SMD = -0.38, 95% CI = -0.56 to -0.20; I2 = 25%, p = .20) but not in medication use (SMD = -0.25, 95% CI: -0.57 to 0.06; I2 = 0%, p = .82) or headache frequency (SMD = -0.16, 95% CI = -0.37 to 0.05; I2 = 0%, p = .73). Subgroup (e.g., intervention type, migraine diagnosis) and sensitivity (i.e., risk of bias) analyses were performed to better understand significant heterogeneity present among analyses. Results suggest that acceptance-based interventions are effective in improving disability among adults with migraine and are a viable non-pharmacological treatment option, in addition to well-established behavioral migraine management approaches, for patients seeking functional improvement.

Concentration/Emphasis

Clinical Psychology

Available for download on Wednesday, October 30, 2024

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