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Objective: This study is part of the ODIN‐migraine (Optimization of Diagnostic Instruments in migraine) project. It is a secondary, a priori analysis of previously collected data, and aimed to assess the psychometric properties and factor structure of the Cogniphobia Scale for Headache Disorders (CS‐HD). We aimed to construct a German‐language version and a short version. Background: Cogniphobia is the fear and avoidance of cognitive exertion, which the patient believes triggers or exacerbates headache. High cogniphobia may worsen the course of a headache disorder. Methods: The 15‐item CS‐HD was translated into German and back translated in a masked form by a professional translator. Modifications were discussed and carried out in an expert panel. A cross‐sectional online survey including the CS‐HD and further self‐report questionnaires was conducted in a sample of N = 387 persons with migraine (364/387 [94.1%] female, M = 41.0 [SD = 13.0] years, migraine without aura: 152/387 [39.3%], migraine with aura: 85/387 [22.0%], and chronic migraine: 150/387 [38.8%]). Results: Exploratory factor analysis resulted in two clearly interpretable factors (interictal and ictal cogniphobia). Confirmatory factor analysis yielded an acceptable to good model fit (χ2(89) = 117.87, p = 0.022, χ2/df = 1.32, RMSEA = 0.029, SRMR = 0.055, CFI = 0.996, TLI = 0.995). Item response theory‐based analysis resulted in the selection of six items for the short form (CS‐HD‐6). Reliability was acceptable to excellent (interictal cogniphobia subscale: ω = 0.92 [CS‐HD] or ω = 0.77 [CS‐HD‐6]; ictal cogniphobia subscale: ω = 0.77 [CS‐HD] or ω = 0.73 [CS‐HD‐6]). The pattern of correlations with established questionnaires confirmed convergent validity of both the CS‐HD and the CS‐HD‐6. Conclusion: Both the CS‐HD and the CS‐HD‐6 have good psychometric properties and are suitable for the assessment of cogniphobia in migraine. Plain Language Summary: Cogniphobia is the fear of cognitive exertion, in which the patient believes effortful thinking triggers or exacerbates headache. The Cogniphobia Scale for Headache Disorders (CS‐HD) provides an assessment of this headache specific‐fear. A German version and a six‐item short form of the CS‐HD were developed from an online sample of 387 persons with migraine, and our results showed that this version was suitable. [ABSTRACT FROM AUTHOR]

Plain Language Summary: In the past, research indicated that a parent's mental health symptoms may impact their child's migraine status; however, these studies do not usually hold constant whether the parents themselves have migraine. This study provided new data suggesting that when parents have migraine, the connection between parents' mental health symptoms and their child's migraine status may be less pronounced. Future studies investigating the heritability of migraine and its related mental health conditions may consider this approach when recruiting study participants. [ABSTRACT FROM AUTHOR]

Objective: 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. Background: 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. Methods: 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. Results: 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). Conclusion: 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. [ABSTRACT FROM AUTHOR]

Objective: To determine changes in opioid prescribing among veterans with headaches during the coronavirus disease of 2019 (COVID‐19) pandemic by comparing the stay‐at‐home phase (March 15 to May 30, 2020) and the reopening phase (May 31 to December 31, 2020). Background: Opioid prescribing for chronic pain has declined substantially since 2016; however, changes in opioid prescribing during the COVID‐19 pandemic among veterans with headaches remain unknown. Methods: This retrospective cohort study utilized regression discontinuity in time and difference‐in‐differences design to analyze veterans aged ≥18 years with a previous diagnosis of headache disorders and an outpatient visit to the Veterans Health Administration (VHA) during the study period. We measured the weekly number of opioid prescriptions, the number of days supplied, the daily dose in morphine milligram equivalents (MMEs), and the number of prescriptions with ≥50 morphine equivalent daily doses (MEDD). Results: A total of 81,376 veterans were analyzed with 589,950 opioid prescriptions. The mean (SD) age was 51.6 (13.5) years, 57,242 (70.3%) were male, and 53,464 (65.7%) were White. During the pre‐pandemic period, 323.6 opioid prescriptions (interquartile range 292.1–325.8) were dispensed weekly, with an median (IQR) of 24.1 (24.0–24.4) days supplied and 31.8 (31.2–32.5) MMEs. Transition to stay‐at‐home was associated with a 7.7% decrease in the number of prescriptions (incidence rate ratio [IRR] 1.077, 95% confidence interval [CI] 0.866–0.984) and a 9.8% increase in days supplied (IRR 1.098, 95% CI 1.078–1.119). Similar trends were observed during the reopening period. Subgroup analysis among veterans on long‐term opioid therapy also revealed 1.7% and 1.4% increases in days supplied during the stay‐at‐home (IRR 1.017, 95% CI 1.009–1.025) and reopening phase (IRR 1.014, 95% CI 1.007–1.021); however, changes in the total number of prescriptions, MME/day, or the number of prescriptions >50 MEDD were insignificant. Conclusion: Prescription opioid access was maintained for veterans within VHA during the pandemic. The de‐escalation of opioid prescribing observed prior to the pandemic was not seen in our study. [ABSTRACT FROM AUTHOR]

Acute medication adherence is essential to manage chronic, episodic disorders, including headache. This paper describes the development of a measure of acute medication self-efficacy for headache (AMSE-H). Phase 1: 14 AMSE-H items were generated through qualitative interviews with 21 patients and 15 clinical headache experts. Phase 2: Researchers selected 7 AMSE-H items by examining item performance in 35 headache patients. Phase 3: Migraine patients (n = 161) completed the AMSE-H, and measures of outcome expectancies, perceived access to medication, headache management self-efficacy (n = 58) and a 1-week AMSE-H re-test (n = 103). Content validity was established through input of multiple stakeholder groups during item generation. PCA identified two components: cross-episode self-efficacy (eigenvalue = 3.4) and Episode-Specific Self-Efficacy (eigenvalue = 1.0). These subscales are internally consistent (.73-.80), have low 1-week test-retest reliability (rs = .52-.66), and demonstrated solid construct and discriminant validity. The AMSE-H is brief, theory-driven, focused, socially valid measure acceptable to both patients and providers., Author(s): Elizabeth K. Seng[sup.1] [sup.2] , Robert A. Nicholson[sup.3] [sup.4] , Kenneth A. Holroyd[sup.5] Author Affiliations: (1) Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NYUSA (2) Saul R. Korey [...]

Objective: Job loss is common in multiple sclerosis (MS) and frequently associated with depression, fatigue, and cognitive dysfunction. Identifying these modifiable risk factors and providing "at-risk" women with a neuropsychologically-based intervention may improve employment outcomes. Our study seeks to investigate the utility of a neuropsychologically-based intervention with varying levels of treatment and follow-up, and evaluate treatment and employment outcomes among groups. Method: In this longitudinal, quasi-randomized controlled trial, employed women with MS meeting criteria on screening measures were considered "at-risk" for job instability and randomized to one of two neuropsychological testing interventions (standard-care group received testing and phone feedback of results and recommendations; experimental group received testing and in-person feedback with subsequent care-coordinator calls from a nurse to help coordinate recommendation completion). Participants who did not meet criteria were considered "low-risk" and only followed over time. Results: 56 women in the treatment groups (standard-care = 23; experimental = 33) and 63 women in the follow-only group were analyzed at 1 year. Rates of decreased employment were similar between standard-care (17.4%) and experimental (21.2%) groups (OR =.782, 95% CI.200–3.057). However, the experimental group completed significantly more treatment recommendations, t (53) = −3.237, p =.002. Rates of decreased employment were also similar between the "low-risk" (17.5%) and "at-risk" groups (19.6%), (OR =.721, 95% CI.285–1.826). Conclusion: Employment outcomes were similar at 1 year between treatment groups receiving differing levels of a neuropsychologically-based intervention, however treatment adherence significantly improved in the experimental group. Treatment groups also had similar employment outcomes as compared to a "low-risk," no intervention group, suggesting that engaging in either neuropsychological intervention may have impacted job stability. [ABSTRACT FROM AUTHOR]

Purpose of Review: Tobacco use is associated with significant health consequences especially for people with medical conditions. Although lifestyle strategies (e.g., sleep, diet) are commonly recommended as part of migraine treatment, tobacco-related strategies (e.g., smoking cessation) are rarely included. This review is aimed at elucidating what is known about tobacco use and migraine and at identifying gaps in the research. Recent Findings: The prevalence of smoking is higher among people with migraine, and people with migraine believe that smoking makes migraine attacks worse. There is also evidence that smoking may exacerbate migraine-related consequences (e.g., stroke). Very few studies have examined other aspects of smoking and migraine or tobacco products other than cigarettes. Summary: There are significant gaps in our knowledge of smoking and migraine. More research is needed to understand the relationship of tobacco use to migraine and potential benefits of adding smoking cessation efforts into migraine care. [ABSTRACT FROM AUTHOR]

Objective: In this secondary analysis of mobile health headache diary data, we evaluated the relationship between adherence to medication used for the acute treatment of migraine and lifetime history of an anxiety or depression disorder. Background: Medication non‐adherence can produce poor clinical efficacy and may be associated with medication overuse. Medication overuse was defined by taking a migraine‐specific medication (MSM) for ≥10 days/month, an opioid or barbiturate for ≥10 days/month, or a nonsteroidal anti‐inflammatory drug for ≥15 days/month and having ≥15 headache days/month. Extant literature predominantly evaluates fixed‐schedule medication adherence. Little is known about predictors of adherence to as‐needed medication such as those used for the acute treatment of migraine. Methods: Adults with prior migraine diagnosis and at least 4 headache days/month completed baseline questionnaires assessing lifetime history of depression or anxiety disorder diagnoses and were asked to record 90 days of once‐daily electronic headache diaries soliciting: Headache occurrence; symptoms; medication taken, if any, for the acute treatment of migraine; and their pain level (mild, moderate, severe) when the medication was taken. The 193 participants who completed ≥30 days of headache diary were included in this secondary analysis. Results: A MSM was used as the first medication taken on 45.7% (2825/6176) of headache days. Nearly a quarter of the sample (45/193, 23.3%) overused medications for acute treatment of migraine. Medication overuse was more common in patients with a history of an anxiety disorder, odds ratio (OR) 2.01 (95% confidence interval [CI] 1.01–3.69), but this relationship was not significant when headache days were accounted for, OR 2.02 (95% CI 0.83–4.91). Neither a history of a depression disorder, OR 1.40 (95% CI 0.90–2.16), nor an anxiety disorder, OR 1.11 (95% CI 0.71–1.72), was associated with taking medications early; however, duration of self‐monitoring was associated with taking MSM early, OR 1.006 (95% CI 1.004–1.009). Conclusion: Lifetime history of depression and anxiety were not associated with taking a MSM early. Medication overuse may be more common in patients who have both migraine and anxiety. Taking a MSM early improved over time for all participants, even when adjusting for a history of an anxiety and or a depression disorder. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic headache (PTH) is persistent and highly disabling. Cognitive-behavioral therapy for headache (CBT-HA) reduces headache frequency and severity and improves people's quality of life, yet it is underutilized and inaccessible to many. Leveraging technology to deliver evidence-based psychological treatments for headache may address barriers to treatment engagement. Methods/design: This single-arm, single-site pilot trial aims to test the feasibility, acceptability, clinical signal, and cost of a five-session CBT-HA intervention delivered via interactive voice response technology (IVR). Participants will include 35 Veterans with PTH receiving care within VA Connecticut Healthcare System. Participants will complete an intake interview and a 9-item, 30-day electronic headache diary during a baseline run-in period. The same diary will be done again by participants immediately after treatment completion. Following the baseline assessment period, eligible participants will receive CBT-HA via IVR for 10 weeks, including an automated daily assessment of patient-reported outcomes and retrieval of biweekly tailored feedback from a study therapist. In addition, participants will access an electronic patient workbook, and study therapists will visualize patient-reported data through a secure provider dashboard. Participants will complete validated and reliable assessment measures at baseline, immediately post-treatment completion (week 10), and 1-month post-treatment completion (week 14). The primary clinical signal outcome is the change in self-reported headache days from the 30-day baseline run-in period before treatment (weeks −4 to 0) to the 30-day post-treatment completion (weeks 10–14). Paired-samples t -tests will explore changes in outcomes from baseline. All cost analyses will be exploratory and will use micro-costing techniques. Trial Registration: Clinical Trials.gov: NCT05093556. Registered October 26, 2021. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments. Recent Findings: Research for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid uptake of nontraditional modalities for behavioral treatments, particularly telemedicine. Telemedicine has long been considered the answer to several barriers to accessing behavioral treatments, and as a result of COVID-19 significant progress has been made evaluating a variety of telemedicine modalities including synchronous, asynchronous, and mobile health applications. Researchers are encouraged to continue investigating how best to leverage these modalities to improve access to behavioral treatments and to continue evaluating the efficacy of telemedicine compared to traditional in-person care. Summary: Comprehensive pain and headache management should include behavioral treatments to address a variety of behavior change and cognitive targets. Policy changes and advances in telemedicine for behavioral treatments provide the opportunity to address historical barriers limiting access. [ABSTRACT FROM AUTHOR]

Background: Stigma is increasingly recognized as an important social feature of living with migraine. Methods: Adults with migraine recruited from neurology offices completed the validated Stigma Scale for Chronic Illnesses 8‐item version (SSCI‐8); two outcome measures (the Migraine Disability Assessment [MIDAS] and the Migraine‐Specific Quality of Life Questionnaire v 2.1 [MSQ]); and measures of allodynia (Allodynia Symptom Checklist [ASC‐12]), pain cognition (Pain Catastrophizing Scale [PCS]), and psychiatric symptoms (Patient Reported Measurement Information System Anxiety [PROMIS‐A] and Depression [PROMIS‐D]). Pearson and Spearman correlations evaluated bivariate relationships, and linear (MSQ) and logistic (MIDAS Severe Disability, scores ≥21) regressions evaluated the unique variance associated with SSCI‐8 beyond other study variables. Conditional process analysis evaluated mediation hypotheses between study variables. Results: Participants (n = 121) reported levels of stigma on par with other chronic illnesses (SSCI‐8 M = 53.0, standard deviation [SD] = 7.8), with 25/127 (19.6%) reporting clinically significant levels of stigma (SSCI‐8 T‐score ≥ 60). Higher SSCI‐8 scores were associated with higher monthly headache day frequency (r = 0.35), MIDAS (ρ = 0.41), ASC‐12 (r = 0.24, p < 0.01), PCS (r = 0.46), both PROMIS‐A (r = 0.43) and D (r = 0.42), and lower MSQ subscale scores (Role Restriction r = −0.50; Role Prevention r = −0.48; Emotion Function r = −0.50), all ps <0.001 unless otherwise noted. The SSCI‐8 contributed significantly beyond migraine symptoms and other psychological factors for MSQ Emotion Function (5% unique variance) and MIDAS Severe Disability (6% of unique variance). The SSCI‐8 mediated relationships between headache frequency and the MSQ subscales and MIDAS Severe Disability. The PCS mediated relationships between the SSCI‐8 and MSQ subscales. The PROMIS‐D mediated relationships between the SSCI‐8 and MSQ Role Restriction and MSQ Role Prevention. Conclusions: Migraine stigma has medium to large associations with migraine outcomes and psychiatric symptoms and is independently associated with migraine disability and emotion‐related quality of life. Migraine stigma is an important contributor to the relationship between headache frequency and migraine outcomes. [ABSTRACT FROM AUTHOR]

The article discusses the validation of a migraine diagnostic screening tool, ID-migraine-Mx, in Latin-American Spanish. The study compares its operating characteristics in English and Spanish and explores the potential for a policy recommendation for migraine screening. Accurate screening is crucial to improve outcomes for people with migraine.

The article offers insights into the social impact of migraine and discusses the choices society has in responding to this problem. It highlights the interconnectedness of individuals with migraine and the potential benefits of accommodating their needs, such as increased productivity and improved well-being for everyone.

Objective: This article systematically reviews the empirical literature examining the efficacy of digital headache management interventions for patients with a primary headache disorder. Background: Digital headache management interventions provide opportunities to improve access to behavioral headache interventions to underserved groups. Methods: A systematic search of PubMed, Scopus, and EBSCO (PsycInfo, Education Research Complete, ERIC, Health Source: Nursing/Academic Edition, Psychology and Behavioral Sciences Collection) and reference review was conducted. Included studies had to recruit a sample with a primary headache diagnosis, be a randomized controlled trial including a digital component, assess a headache outcome (i.e., frequency, duration, severity, intensity, disability) or quality of life, and be published in English. Two authors independently extracted data for included studies. The methodological quality of studies was assessed using the revised Cochrane risk‐of‐bias tool. Results: Thirteen studies with unique interventions met inclusion criteria. More than half of the studies were pilots; however, nearly 70% (9/13) demonstrated significant between‐group or within‐group improvements on one or more headache‐related outcomes. All interventions included some form of relaxation training and the majority were delivered via interactive website. While fewer than half the studies report participant race and/or ethnicity, of those that do, 83% (5/6) reported a predominately White/Caucasian sample. Conclusions: Efficacy testing of digital headache interventions is in its infancy with the majority of these studies relying on pilot studies with small samples comprised of homogenous patient populations. Interactive websites were the most common digital medium to deliver digital headache management interventions and have demonstrated promising results. Further testing using large‐scale randomized controlled trials and exploration of other digital tools is warranted. Future studies with more diverse samples are needed to inform health equity of digital headache interventions. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the utilization of telehealth for headache services within the Veterans Health Administration's facilities housing a Headache Centers of Excellence and multiple stakeholder's perspectives to inform future telehealth delivery. Background: Telehealth delivery of headache treatment may enhance patient access to headache care, yet little is known about the utilization or patient and provider perceptions of telehealth for veterans with headache. Methods: This mixed‐methods study analyzed multiple data sources: (1) administrative data, which included 58,798 patients with medically diagnosed headache disorders, documented in at least one outpatient visit, from August 2019 through September 2020 from the 12 Veterans Health Administration's facilities with a Headache Center of Excellence and (2) qualitative semistructured interviews with 20 patients and 43 providers 6 months before the coronavirus disease 2019 (COVID‐19) pandemic, and 10 patients and 20 providers 6 months during the beginning of the pandemic. Results: During the pandemic, in‐person visits declined from 12,794 to 6099 (52.0%), whereas video (incidence rate ratio [IRR] = 2.05, 95% confidence interval [CI] = 1.66, 2.52), and telephone visits (IRR = 15.2, 95% CI = 10.7, 21.6) significantly increased. Utilization differed based on patient age, race/ethnicity, and rurality. Patients and providers perceived value in using telehealth, yet had limited experience with this modality pre‐pandemic. Providers preferred in‐person appointments for initial encounters and telehealth for follow‐up visits. Providers and patients identified benefits and challenges of telehealth delivery, often relying on multiple delivery methods for telehealth to enhance patient engagement. Conclusions: The uptake of telehealth delivery of headache‐related care rapidly expanded in response to the pandemic. Patients and providers were amenable to utilizing telehealth, yet also experienced technological barriers. To encourage equitable access to telehealth and direct resources to those in need, it is crucial to understand patient preferences regarding in‐person versus telehealth visits and identify patient groups who face barriers to access. [ABSTRACT FROM AUTHOR]

Background and Objective: Comprehensive headache care involves numerous specialties and components that have not been well documented or standardized. This study aimed to elicit best practices and characterize important elements of care to be provided in multidisciplinary headache centers. Methods: Qualitative, semi‐structured telephone interviews with a purposive sample of headache neurology specialists from across the US, using open‐ended questions. Interviews were recorded, transcribed, and coded. Coded data were further analyzed using immersion/crystallization techniques for final interpretation. Results: Mean years providing headache care was 17.7 (SD = 10.6). Twelve of the 13 participants held United Council for Neurologic Subspecialties headache certification. Six described their practice site as providing multidisciplinary headache care. Participants explained most of their patients had seen multiple doctors over many years, and had tried numerous unsuccessful treatments. They noted patients with chronic headache frequently present with comorbidities and become stigmatized. All participants asserted successful care depends on taking time to talk with and listen to patients, gain understanding, and earn trust. All participants believed multidisciplinary care is essential within a comprehensive headache center, along with staffing enough headache specialists, implementing detailed headache intake and follow‐up protocols, and providing the newest medications, neuromodulation devices, botulinum toxin injections, monoclonal antibodies, nerve blocks and infusions, and treatment from a health psychologist. Other essential services for a headache center are other behavioral health practitioners providing cognitive behavioral therapy, mindfulness, biofeedback and pain management; and autonomic neurology, neuropsychology, vestibular audiology, sleep medicine, physical therapy, occupational therapy, exercise physiology, speech therapy, nutrition, complementary integrative health modalities, and highly trained support staff. Conclusion: While headache neurology specialists form the backbone of headache care, experts interviewed for this study maintained their specialty is just one of many types of care needed to adequately treat patients with chronic headache, and this is best provided in a comprehensive, multidisciplinary center. [ABSTRACT FROM AUTHOR]

Purpose of Review: To describe the most recent findings related to lifestyle behaviors and migraine. Recent Findings: An individualized conceptualization of how lifestyle factors impact migraine activity has increased our understanding of the role of behavioral interventions for episodic migraine. Healthy diets of several types have been associated with migraine attack reduction, whereas disruptions in diet like skipping meals are associated with migraine attack onset. Both aerobic activity and lower intensity yoga interventions show promise for migraine prevention. Sleep disruption has been associated with migraine day and may have a bi-directional relationship. Both increases and decreases in stress have been associated with migraine activity. Summary: Evidence is converging around the principle that highly unusual disruptions in daily routine are particularly associated with migraine attack onset and that a consistent healthy lifestyle is a key feature of effective behavioral migraine prevention strategies. [ABSTRACT FROM AUTHOR]

The present study examines relationships between pain, mental health symptoms, and medication adherence in adult smokers living with HIV. Sixty-eight adult HIV-positive smokers taking antiretroviral medication completed a survey measuring medication adherence, mental health symptoms, and pain. The presence of pain, OR = 3.81, 95% CI (1.19, 12.14), higher pain severity, OR = 1.22, 95% CI (1.05, 1.41), and higher anxiety, OR = 1.09, 95% CI (1.03, 1.14) were associated with inferior medication adherence (MMAS-8 score <6). Anxiety mediated the relationships between presence of pain (ab =.56, BCa CI (0.05, 1.61)) and pain severity (ab =.09, BCa CI (0.01, 0.24)) and medication adherence. The results of this study suggest that pain and anxiety are factors that significantly contribute to medication nonadherence and thus are important areas of assessment by clinicians treating adult smokers living with HIV. [ABSTRACT FROM AUTHOR]

The article reports on a study exploring the links between airborne hazards and headache disorders. It focuses on the impact of heavy exposure to secondhand cigarette smoke, demonstrates a doubled odds of severe headaches or migraines in individuals who have never smoked cigarettes, highlighting the need for further research to understand the clinical implications and potential distinct clinical entities associated with long-term exposure to airborne environmental toxins like cigarette smoke.

Purpose Of Review: Cluster headache is a highly disabling primary headache disorder characterized by severe pain and autonomic features. We present the existing body of literature on psychological factors associated with cluster headache and recommendations to address gaps in current clinical care with regards to psychological treatments for cluster headache.Recent Findings: People with cluster headache often endorse depressive symptoms, are more likely than the general population to report suicidal ideation and behaviors, and experience significantly decreased quality of life. Psychological treatments such as Acceptance and Commitment Therapy may be particularly valuable for patients with cluster headache given that they are transdiagnostic in nature and can therefore simultaneously address the disease burden and common psychiatric comorbidities that present. Greater understanding of the debilitating nature of cluster headache and behavioral interventions that seek to reduce the burden of the disease and improve the quality of life of people with cluster headache is paramount. [ABSTRACT FROM AUTHOR]

The article looks at the factors to consider to facilitate participation in headache medicine research among underrepresented groups in the U.S. Topics discussed include the emergence of African Americans as the groups that are less likely to access the medical system for treatment of headache, requirement for clinical trials funded by the National Institutes of Health (NIH) to include participants of diverse race, and role of implicit biases in inadequate access to migraine treatment.

Persons living with HIV/AIDS (PLWH) report very high prevalences of cigarette smoking, and there are racial/ethnic disparities in smoking consequences and quit outcomes. In this exploratory pilot study, we examined racial/ethnic differences in perceived risks and benefits of quitting cigarette smoking among 97 adult PLWH in the Bronx, New York (Hispanic, 53.6%; African American, 46.4%). Compared to African American PLWH, Hispanic PLWH reported greater endorsement of overall risks and benefits and risks of negative affect, difficulty concentrating, social ostracism, loss of enjoyment, and cravings. It may be useful to incorporate risks and benefits of quitting into smoking treatment for African American and Hispanic PLWH. [ABSTRACT FROM AUTHOR]

The article presents the discussion on behavioral treatments working for migraine prevention. Topics include providing separate estimates for each dose and route of administration of each triptan; resulting from progressive muscle relaxation, autogenic training, behavioral management, cognitive behavioral therapy (CBT), biofeedback, mindfulness-based interventions, and hypnosis; and cognitive behavioral therapies leading to reductions in attacking frequency and disability.

Purpose Of Review: This review surveys our current understanding of the impact of parental migraine on children. Understanding the impact of migraine on others in a family unit is critical to describing the full burden of migraine and to developing psychosocial supportive interventions for patients and their families.Recent Findings: Having a parent with migraine is associated with several early developmental features including infant colic. Adolescent children of parents with migraine self-report their parent's migraine interferes with school and activities and events. Further, migraine is perceived to impact the relationship between the parent and child. Having a parent with migraine increases a child's risk of having migraine, and having more severe migraine disease. However, children with migraine whose parent also has migraine appear to receive more early and aggressive treatment. The impact of migraine extends beyond the parent with migraine and influences children across biological, psychological, and social domains. [ABSTRACT FROM AUTHOR]

Objective: To evaluate feasibility and acceptability of a neuropsychologically-based vocational intervention with increased follow-up support for women with multiple sclerosis. Design: Single-blinded parallel-group randomized controlled trial with 12-month follow-up. Setting: Tertiary-care multiple sclerosis center. Participants: Forty-nine employed women with multiple sclerosis meeting criteria on measures of cognitive dysfunction (Symbol Digit Modalities Test), fatigue (Fatigue Severity Scale), and/or depression (Beck Depression Inventory/Patient Health Questionnaire). Interventions: Participants received either neuropsychological testing and phone feedback regarding findings and tailored recommendations (standard-care treatment), or testing, in-person feedback, and two calls from a care-coordinator (experimental treatment). Measures: Feasibility measures included enrollment and attrition rates, and compliance to recommendations at 12-months between groups. Acceptability was evaluated by participants' report of benefit from interventions. Secondary analyses included evaluation of symptom changes (cognition, fatigue, depression) from baseline to 12-months. Results: Of 49 women meeting screening measure thresholds, 44 were randomized to treatment groups (attrition: standard-care = 8, experimental = 6), and 30 completed the study (standard-care = 14, experimental = 16). Recommendation adherence rates did not significantly differ between standard-care and experimental groups (31% vs 49%). However, 16/16 experimental participants at least partially completed given recommendations as compared to 8/14 in the standard-care group. Participants across groups (97%) reported benefit from participation. No significant differences in symptom outcomes between groups at 12-months. Conclusion: In-person feedback and care-coordinator calls were feasible and acceptable additions to a neuropsychological intervention and may serve to increase recommendation adherence. Given high drop-out rate, particularly prior to testing, future research may explore avenues to improve completion rates and maximize benefits of such interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine the influences of depression and anxiety on headache‐related disability in people with episodic migraine or chronic migraine. Background: Depression and anxiety are common comorbidities in people with migraine, especially among those with chronic migraine. Methods: This cross‐sectional analysis of data from the longitudinal, internet‐based Chronic Migraine Epidemiology and Outcomes Study assessed sociodemographic and headache features, and headache‐related disability (Migraine Disability Assessment Scale). Four groups were defined based on scores from validated screeners for depression (9‐item Patient Health Questionnaire) and anxiety (7‐item Generalized Anxiety Disorder Scale): depression alone, anxiety alone, both, or neither. Results: Respondents (N = 16,788) were predominantly women (74.4% [12,494/16,788]) and white (84.0% [14,044/16,788]); mean age was 41 years. Depression was more likely in persons with chronic migraine vs episodic migraine (56.6% [836/1476] vs 30.0% [4589/15,312]; P <.001), as were anxiety (48.4% [715/1476] vs 28.1% 4307/15,312]; P <.001) and coexisting depression and anxiety (42.0% [620/1476] vs 20.8% [3192/15,312]; P <.001). After controlling for headache frequency and other covariates, depression alone, and anxiety alone were associated with 56.0% (rate ratio [RR], 1.56; 95% confidence interval [CI], 1.46‐1.66) and 39.0% (RR, 1.39; 95% CI, 1.30‐1.50) increased risks of moderate/severe migraine‐related disability (both P <.001), respectively; the combination had an even greater effect on risk of moderate/severe disability (79.0% increase; RR, 1.79; 95% CI, 1.71‐1.87; P <.001). Conclusions: Depression alone and anxiety alone are associated with greater headache‐related disability after controlling for sociodemographic and headache features. Coexisting depression and anxiety are more strongly associated with disability than either comorbidity in isolation. Interventions targeting depression and anxiety as well as migraine itself may improve headache‐related disability in people with migraine. [ABSTRACT FROM AUTHOR]