Depression and disability in migraine: the role of pain acceptance and values-based action

Migraine is a complex neurological disorder that substantially impairs a person’s functioning and is often comorbid with depression. Currently, little is known about psychological coping strategies that may underlie disability and depression in patients with migraine. This study examines concurrent relations between depression and disability on the one hand and pain acceptance and values-based action on the other hand in patients with migraine. Ninety-three patients with migraine and depressive symptoms—being evaluated for a larger project examining the impact of a behavioral intervention on depression in patients with migraine—completed measures of depression, disability, pain acceptance, and values-based action. Using multiple regression analyses, the contributions of pain acceptance and values-based action to depression and disability were assessed. Low pain acceptance was strongly associated with depression and disability (r s 2 = .15–.37) in these patients. Low pain acceptance also explained unique variance in disability, beyond that of depression. Values-based action related modestly to depression and disability (r s 2 = .02–.07). Pain acceptance can contribute to our understanding of psychological health and functioning. An important next step would be to examine whether targeting acceptance in treatment of patients with migraine would lead to improvements in their mental health and functioning.