Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Psychology



First Advisor

Todd A. Smitherman

Second Advisor

Marc Showalter

Third Advisor

Kelly G. Wilson

Relational Format



According to the World Health Report 2001, mental and neurological disorders account for 30.80% of healthy years of life lost to disability; migraine alone accounts for 1.40% of that percentage. In addition to the functional impairment the attacks cause, migraine frequently co-occurs with other psychiatric disorders and is associated with other psychological factors. Related psychological factors include avoidance of negative private events (experiential avoidance) and persistent behaviors that are counterproductive to one's personal values. Recent studies of patients with other forms of chronic pain suggest that these behaviors are associated with poor functioning and that techniques fostering "psychological flexibility" may enhance functioning and quality of life. However, the roles of psychological flexibility and its component constructs have yet to be explored in migraine specifically. The purpose of this study was to examine the relationship between two components of psychological flexibility (acceptance and values-based action) and headache-related variables in treatment-seeking patients with migraine. One hundred three adult patients participated in the study (mean age = 41.45 years [SD = 11.92]; 88.24% female; 91.17% Caucasian). All participants had a physician diagnosis of migraine: 53.39% with episodic migraine without aura, 18.44% with episodic migraine with aura, and 28.16% with chronic migraine. A series of hierarchical multiple regressions was used to assess relations between acceptance/values-based action and headache variables. As expected, acceptance of pain and engaging in values-based action were significantly associated with lower migraine disability and lower pain severity, although these constructs were not significantly associated with frequency of headache or medical visits. These findings suggest that perhaps psychological flexibility is more strongly linked to functional improvement or pain perception than to pain-related symptoms. Clinical implications of this study include awareness of the benefits of psychological flexibility for migraine patients and potential therapeutic techniques to foster psychological flexibility as an adjunct to medical treatment.


Emphasis: Clinical Psychology

Included in

Psychology Commons



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