Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.
Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
Headache. 2023 Nov-Dec;63(10):1403-1411. doi: 10.1111/head.14627. Epub 2023 Sep 18.
This study is a secondary analysis evaluating changes in cognitive fusion and pain catastrophizing over 8 weeks of mindfulness-based cognitive therapy for migraine (MBCT-M) intervention versus waitlist/treatment as usual.
Migraine is a common disabling neurological condition. MBCT-M combines elements of cognitive behavioral therapy with mindfulness-based approaches and has demonstrated efficacy in reducing migraine-related disability.
A total of 60 adults with migraine completed a 30-day run-in before randomization into a parallel design of either eight weekly individual MBCT-M sessions (n = 31) or waitlist/treatment as usual (n = 29): participants were followed for 1 month after. Participants completed the Pain Catastrophizing Scale (PCS) and the Cognitive Fusion Questionnaire (CFQ) at Months 0, 1, 2, and 4.
The PCS scores decreased more in the MBCT-M group (mean [SD] at baseline = 22.5 [9.6]; at Month 4 = 15.1 [8.8]) than in the waitlist/treatment as usual group (mean [SD] at baseline = 24.9 [9.0]; at Month 4 = 22.5 [10.4]) from Month 0 to 4 (β = -7.24, p = 0.001, 95% confidence interval [CI] -11.39 to -3.09). The CFQ (mean [SD] baseline = 27.6 [8.0]; at Month 4 = 25.0 [8.0]) did not change significantly from Month 0 to 4 (β = -1.2, p = 0.482, 95% CI -4.5 to 2.1). Parallel mediation analyses indicated that decreases in the PCS and CFQ together (β = -6.1, SE = 2.5, 95% CI -11.6 to -1.8), and the PCS alone (β = -4.8, SE = 2.04, 95% CI -9.1 to -1.1), mediated changes in headache disability in the MBCT-M treatment completer group (n = 19).
In this study, pain catastrophizing showed strong promise as a potential mechanism of MBCT-M. Future research should continue to explore cognitive appraisal changes in mindfulness-based interventions.
本研究是一项二级分析，评估了正念认知疗法（MBCT-M）干预与等待/常规治疗相比，在 8 周内认知融合和疼痛灾难化的变化。
偏头痛是一种常见的致残性神经疾病。MBCT-M 将认知行为疗法的元素与正念方法相结合，已证明在减少偏头痛相关残疾方面具有疗效。
共有 60 名偏头痛成年人在随机分配到 8 周个体 MBCT-M 课程（n=31）或等待/常规治疗（n=29）的平行设计之前完成了 30 天的预试验：参与者在 1 个月后随访。参与者在第 0、1、2 和 4 个月完成疼痛灾难化量表（PCS）和认知融合问卷（CFQ）。
与等待/常规治疗相比，MBCT-M 组的 PCS 评分下降更多（基线时的平均值[标准差]为 22.5[9.6]；第 4 个月时为 15.1[8.8]）（从第 0 个月到第 4 个月，β= -7.24，p=0.001，95%置信区间[CI] -11.39 至 -3.09）。CFQ（平均值[标准差]基线=27.6[8.0]；第 4 个月=25.0[8.0]）从第 0 个月到第 4 个月没有明显变化（β= -1.2，p=0.482，95%CI -4.5 至 2.1）。平行中介分析表明，PCS 和 CFQ 的共同下降（β= -6.1，SE=2.5，95%CI -11.6 至 -1.8）和 PCS 单独下降（β= -4.8，SE=2.04，95%CI -9.1 至 -1.1），在 MBCT-M 治疗完成者组（n=19）中调节了头痛残疾的变化。
在这项研究中，疼痛灾难化显示出作为 MBCT-M 潜在机制的强大潜力。未来的研究应继续探索正念干预中的认知评估变化。
