Date of Award
8-1-2022
Document Type
Dissertation
Degree Name
Ph.D. in Psychology
First Advisor
Todd A. Smitherman
Second Advisor
John Young
Third Advisor
Laura Dixon
School
University of Mississippi
Relational Format
dissertation/thesis
Abstract
Migraine is the third most common medical condition across the globe and a leading cause of years lived with disability due to its considerable burden. The burden is further compounded by the high prevalence of psychological comorbidities and the influence of other psychological factors on functioning. Examinations of migraine within the fear-avoidance model suggest that fear of pain (FOP) promotes maladaptive avoidance and escape behaviors, which contribute to headache-related disability. Limited research demonstrates that those with migraine engage in avoidant emotion-regulation (ER) strategies but has overlooked ER abilities beyond acceptance. The current study aimed to investigate ER in individuals with migraine within the context of the fear-avoidance model. A nationwide Mturk sample of 411 adults (62% migraine, 38% non-headache controls) was utilized to assess ER and headache-related variables. Results indicated that those with migraine reported greater overall difficulties in ER abilities than controls, t(409) = 4.88, p < .001. These differences were contingent upon psychological distress and sex (β = 7.23, ∆R2 = .01, SE = 2.38, t = 3.04, p = .003). Specifically, males with migraine and low psychological distress reported more difficulties in ER abilities than females with migraine, whereas, at high levels of psychological distress, males with migraine reported less difficulties with ER abilities than females with migraine. This interaction was not observed in controls. Regarding ER strategies, those with migraine reported less use of cognitive reappraisal compared to controls, t(409) = 2.24, p = .03, but did not differ in emotional suppression. In those with migraine, difficulties in ER abilities was associated with FOP beyond psychological distress and sex (R2∆ = 3.9%; ∆F(1, 251) = 13.45, p < .001), but not with pain severity, headache frequency, or headache-related disability. Higher FOP mediated the positive relationship between pain severity and disability (simple mediation; ab = .56, 95% CI [.31, .83]), but difficulties in ER abilities did not mediate this same relationship while holding FOP constant (parallel mediation; a2b2 = .001; 95% CI [-.05, .06]). Overall, the findings suggest the role of ER abilities within the FAM may be through the dysregulation of FOP that contributes to disability via emotional outcomes (e.g., psychological distress).
Recommended Citation
Protti, Tracy, "Emotion Regulation in Migraine" (2022). Electronic Theses and Dissertations. 2395.
https://egrove.olemiss.edu/etd/2395
Concentration/Emphasis
Clinical Psychology