Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress

Kökönyei, Gyöngyi and Szabo, Edina and Kocsel, Natália and Édes, Andrea E. and Eszlari, Nora and Pap, Dorottya and Magyar, Máté and Kovacs, Dávid and Zsombok, Terézia and Elliott, Rebecca and Anderson, I. M. and Deakin, J. F. William and Bagdy, György and Juhász, Gabriella (2016) Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress. Psychology & Health, 31 (12). pp. 1481-1497. ISSN 0887-0446

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Abstract

The relationship between migraine and psychological distress has been consistently reported in cross-sectional and longitudinal studies. We hypothesised that a stable tendency to perseverative thoughts such as rumination would mediate the relationship between migraine and psychological distress. Design and Main Outcomes Measures: Self-report questionnaires measuring depressive rumination, current psychological distress and migraine symptoms in two independent European population cohorts, recruited from Budapest (N = 1139) and Manchester (N = 2004), were used. Structural regression analysis within structural equation modelling was applied to test the mediational role of brooding and reflection, the components of rumination, between migraine and psychological distress. Sex, age and lifetime depression were controlled for in the analysis. RESULTS: Migraine predicted higher brooding and reflection scores, and brooding proved to be a mediator between migraine and psychological distress in both samples, while reflection mediated the relationship significantly only in the Budapest sample. CONCLUSIONS:Elevated psychological distress in migraine is partially attributed to ruminative response style. Further studies are needed to expand our findings to clinical samples and to examine how rumination links to the adjustment to migraine.

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