{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T02:28:22Z","timestamp":1781749702137,"version":"3.54.5"},"reference-count":58,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007318","name":"Yeshiva University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007318","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23 NS096107"],"award-info":[{"award-number":["K23 NS096107"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate relationships between psychiatric symptoms, acceptance, and migraine\u2010related disability in a sample of people with migraine presenting at a tertiary care headache center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine is a chronic disease that can be severely disabling. Despite a strong theoretical basis and evidence in other pain conditions, little is known about relationships between acceptance, psychiatric symptoms, and migraine\u2010related disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ninety patients with physician\u2010diagnosed migraine completed surveys assessing demographics, headache symptoms, severe migraine\u2010related disability (Migraine Disability Assessment Scale total score dichotomized at\u2009\u2265\u200921), depression (Patient Health Questionnaire\u20109) and anxiety symptoms (Generalized Anxiety Disorder\u20107), and acceptance (Chronic Pain Acceptance Questionnaire; subscales: Pain Willingness and Activity Engagement).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants (77.8% white, non\u2010Hispanic; 85.6% women; and 50.0% with a graduate level education) reported an average headache pain intensity of 6.7\/10 (SD\u2009=\u20092.0). One\u2010third (36.0%) reported chronic migraine, and half (51.5%) reported severe migraine\u2010related disability. Lower acceptance was associated with severe migraine\u2010related disability, t(54)\u2009=\u20094.13,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001. Higher activity engagement was associated with lower average headache pain intensity (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2212.30,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.011). Higher acceptance was associated with lower levels of depression (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2212.48,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and anxiety symptoms (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2212.37,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.003). Pain willingness and activity engagement serially mediated relationships between depression symptoms and severe migraine\u2010related disability (indirect effect\u2009=\u20090.05, 95% CI\u2009=\u20090.01, 0.15), and between anxiety symptoms and severe migraine\u2010related disability (indirect effect\u2009=\u20090.12, 95% CI\u2009=\u20090.02, 0.31).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results provided preliminary support for a theoretical pathway by which psychiatric symptoms may influence migraine\u2010related disability, in part, through their relationships with pain willingness and activity engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.13325","type":"journal-article","created":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T15:03:28Z","timestamp":1529507008000},"page":"859-872","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Acceptance, Psychiatric Symptoms, and Migraine Disability: An Observational Study in a Headache Center"],"prefix":"10.1111","volume":"58","author":[{"given":"Elizabeth K.","family":"Seng","sequence":"first","affiliation":[{"name":"Ferkauf Graduate School of Psychology Yeshiva University New York NY USA"},{"name":"Saul R. 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