Mindfulness and Chronic Headache/Migraine: Mechanisms Explored through the Fear-Avoidance Model of Chronic Pain

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(1) To replicate a study by Schutze, Rees, Preece, and Schutze (2010) on a headache sample, rather than a heterogeneous chronic pain sample, investigating whether level of mindfulness predicts key components in the fear-avoidance model of chronic pain (pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability); (2) to investigate the relationships between level of mindfulness and headache/migraine pain intensity, frequency, and duration.


Participants were 217 self-reported chronic headache/migraine sufferers (51 male, 166 female), aged between 18 and 65 years. Participants completed an online survey measuring demographics, mindfulness, the key components of the fear-avoidance model, and headache pain intensity, duration, and frequency.


Mindfulness had significant negative correlations (P<0.05) with all variables except headache pain intensity and headache frequency. Mindfulness significantly predicted negative affect, pain catastrophizing, fear of pain, pain hypervigilance, and headache duration (P<0.05). Mindfulness remained a significant predictor of negative affect and pain hypervigilance after controlling for other key components and background characteristics (P<0.05). Mindfulness did not moderate the relationship between pain intensity and pain catastrophizing (P=0.204).


Findings suggest that mindfulness may be integrated into the fear-avoidance model of chronic pain for chronic headache/migraine sufferers. Directions for future research are discussed.

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