title: Ecological momentary assessment of the relationship between headache pain intensity and pain interference in women with migraine and obesity.
abstract: Background While pain intensity during migraine headache attacks is known to be a determinant of interference with daily activities, no study has evaluated: (a) the pain intensity-interference association in real-time on a per-headache basis, (b) multiple interference domains, and (c) factors that modify the association. Methods Participants were 116 women with overweight/obesity and migraine seeking behavioral treatment to lose weight and decrease headaches in the Women's Health and Migraine trial. Ecological momentary assessment, via smartphone-based 28-day headache diary, and linear mixed-effects models were used to study associations between pain intensity and total- and domain-specific interference scores using the Brief Pain Inventory. Multiple factors (e.g. pain catastrophizing (PC) and headache management self-efficacy (HMSE)) were evaluated either as independent predictors or moderators of the pain intensity-interference relationship. Results Pain intensity predicted degree of pain interference across all domains either as a main effect (coeff = 0.61-0.78, p < 0.001) or interaction with PC, allodynia, and HMSE ( p < 0.05). Older age and greater allodynia consistently predicted higher interference, regardless of pain intensity (coeff = 0.04-0.19, p < 0.05). Conclusions Pain intensity is a consistent predictor of pain interference on migraine headache days. Allodynia, PC, and HMSE moderated the pain intensity-interference relationship, and may be promising targets for interventions to reduce pain interference.
authors.affiliation: 1 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, USA.
authors.forename: J Graham
authors.initials: JG
authors.lastname: Thomas
authors.affiliation: 2 Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, USA.
authors.forename: Jelena
authors.initials: J
authors.lastname: Pavlovic
authors.affiliation: 2 Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
authors.affiliation: 3 Department of Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Roth
authors.affiliation: 1 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, USA.
authors.forename: Lucille
authors.initials: L
authors.lastname: Rathier
authors.affiliation: 1 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: O'Leary
authors.affiliation: 2 Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, USA.
authors.forename: Dawn C
authors.initials: DC
authors.lastname: Buse
authors.affiliation: 1 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, USA.
authors.forename: E Whitney
authors.initials: EW
authors.lastname: Evans
authors.affiliation: 1 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, USA.
authors.forename: Dale S
authors.initials: DS
authors.lastname: Bond
mesh_terms: D000293:Adolescent; D000328:Adult; D058443:Catastrophization / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D000072860:Ecological Momentary Assessment; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D012237:Rhode Island / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D016387:Women's Health / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Migraine; ecological momentary assessment; obesity; pain intensity; pain interference