Pain acceptance as a change mechanism for mindfulness-based cognitive therapy for migraine.
Rachel D Best, Ali Ozmeral, Amy S. Grinberg, Todd A Smitherman, Elizabeth K. Seng
Journal of Behavioral Medicine June 1, 2024 DOI: 10.1007/s10865-024-00475-5 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a randomized controlled trial Longitudinal Peer reviewed |
|---|---|
| Sample size | 60 |
| Population | Adults with migraine |
| Intervention | Mindfulness Based Cognitive Therapy for Migraine (MBCT-M) |
| Duration | One-month post-treatment, with 6-month follow-up for the MBCT-M group |
| Topics | Meditation |
| Keywords | Disability Migraine Pain acceptance |
| Key findings | Change in pain acceptance, particularly the activity engagement component, mediated the relationship between Mindfulness Based Cognitive Therapy for Migraine and reduced headache-related disability. |
Abstract
Migraine is one of the leading causes of disability worldwide. Third wave therapies, such as Mindfulness Based Cognitive Therapy for Migraine (MBCT-M), have proven efficacious in reducing headache-related disability. However, research is needed to better understand the change mechanisms involved in these third-wave therapies. Acceptance is a fundamental component of third wave therapies, and more research is warranted on the role of pain acceptance in MBCT-M. It is also valuable to understand the independent roles of the two components of pain acceptance-pain willingness (PW) and activity engagement (AE). The current study is a secondary analysis of a randomized control trial of MBCT-M. Sixty participants were included in the study (MBCT = 31; WL/TAU = 29). Baseline correlations between overall pain acceptance, PW, AE, and headache-related disability were run. Mixed models assessed change from baseline to one-month post-treatment and treatment-by-time interaction for overall pain acceptance, PW, and AE. Mixed models also assessed maintenance of changes at 6-month follow-up in the MBCT-M group. Longitudinal mediation models assessed whether change in pain acceptance, PW, and AE mediated the relationship between treatment and change in headache-related disability. Pain acceptance, PW, and AE were all negatively correlated with headache-related disability at baseline. Pain acceptance, PW, and AE all significantly increased over time in both the waitlist/ treatment-as-usual group (WL/TAU) and the MBCT-M group. Only AE increased more in the MBCT group than the WL/TAU group. Change in pain acceptance, PW, and AE all significantly mediated the relationship between MBCT and change in headache-related disability. The study supports the importance of pain acceptance, specifically the activity engagement component, in MBCT-M.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 4
- A Critical Review and 10-Year Update on Prospects for a Clinical Science of Mindfulness-Based Intervention Mindfulness July 7, 2026
- Potential mediators of the effects of clinical hypnosis, mindfulness meditation, and pain education on chronic pain in Veterans. Journal of Pain January 6, 2026
- Part Of the Process, or Adverse Event? Considering the Benefits and Potential Risks of Mindfulness-based Interventions for Migraine. Current Pain and Headache Reports September 16, 2025
- A Model of the Protective Value of Mindfulness in the Experience of Chronic Pain: Mediating Role of Pain Catastrophizing Mindfulness September 1, 2025
Cites 5
- Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study ☆ Pain June 4, 2007
- Recruitment, retention, and adherence in a randomized feasibility trial of mindfulness-based stress reduction for patients with migraine. Complementary Therapies in Medicine November 4, 2020
- Does Mindfulness-Based Cognitive Therapy for Migraine Reduce Migraine-Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial Headache: The Journal of Head and Face Pain September 26, 2019
- Mindfulness-based cognitive therapy for headache pain: An evaluation of the long-term maintenance of effects. Complementary Therapies in Medicine August 2017
- The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache. Complementary Therapies in Medicine April 2016