{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:08:52Z","timestamp":1787807332016,"version":"build-2784847793"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009658","name":"American Pain Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009658","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA266995"],"award-info":[{"award-number":["R01CA266995"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","award":["K23AT008406"],"award-info":[{"award-number":["K23AT008406"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","award":["R01AT011005"],"award-info":[{"award-number":["R01AT011005"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","award":["R01AT011502"],"award-info":[{"award-number":["R01AT011502"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS096107"],"award-info":[{"award-number":["K23NS096107"]}],"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":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To understand the mechanisms of mindfulness' impact on migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Promising mindfulness research demonstrates potential benefit in migraine, but no data\u2010driven model exists from the lived experiences of patients that explains the mechanisms of mindfulness in migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Semi\u2010structured qualitative interviews were conducted with adults with migraine who participated in two mindfulness\u2010based stress reduction (MBSR) clinical trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a043). Interviews were audio\u2010recorded, transcribed, and summarized into a framework matrix with development of a master codebook. Constructivist grounded theory approach was used to identify themes\/subthemes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants who learned mindfulness techniques through MBSR experienced altered pain perception, altered response to migraine attacks and disease, increased awareness of external and internal experiences, improved overall well\u2010being, and group benefits. Mindfulness resulted in earlier stress\u2010body awareness and increased interoceptive awareness resulting in earlier attack recognition, leading to earlier and more effective management. Interictal factors of self\u2010blame, guilt, and stigma decreased while migraine acceptance, hope, empowerment, self\u2010efficacy, and self\u2010compassion increased. Improved emotion regulation resulted in decreased fear of migraine, pain catastrophizing, anticipatory anxiety, and pain reactivity. Although taught as prevention, mindfulness was used both acutely and prophylactically. We created a conceptual model hypothesizing that MBSR skills led to an infusion of mindfulness in daily life, resulting in altered pain perception and experience, ultimately leading to improvement in overall well\u2010being, which may positively feed back to the infusion of mindfulness in daily life. The therapeutic benefit of learning mindfulness in a group setting may moderate these effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified several new potential mechanisms of mindfulness' effect on migraine. After learning MBSR skills, participants reported altered pain and migraine perception and experiences. Increased stress\u2010body and interoceptive awareness resulted in earlier migraine awareness and treatment. Mindfulness may target important interictal factors that affect disease burden such as fear of migraine, pain catastrophizing, and anticipatory anxiety. This is the first data\u2010driven study to help elucidate the mechanisms of mindfulness on migraine from patient voices and can help direct future research endeavors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14481","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T11:39:00Z","timestamp":1677584340000},"page":"390-409","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Mechanisms of mindfulness in patients with migraine: Results of a qualitative study"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2344-0004","authenticated-orcid":false,"given":"Paige M.","family":"Estave","sequence":"first","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlyn","family":"Margol","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Summerlyn","family":"Beeghly","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reid","family":"Anderson","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Shakir","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Coffield","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Byrnes","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Seng","sequence":"additional","affiliation":[{"name":"Psychology Albert Einstein College of Medicine, Yeshiva University  Bronx New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Gardiner","sequence":"additional","affiliation":[{"name":"Family Medicine Center for Mindfulness and Compassion  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9860-3699","authenticated-orcid":false,"given":"Rebecca Erwin","family":"Wells","sequence":"additional","affiliation":[{"name":"Neurology Wake Forest University School of Medicine  North Carolina Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102416667023"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2020.1715212"},{"key":"e_1_2_11_4_1","volume-title":"Resource Utilization and Costs of Care for Treatment of Chronic Headache","author":"Archibald N","year":"1999"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13642"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2020.20100"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-016-9844-2"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13657"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001860"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12420"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.7090"},{"key":"e_1_2_11_12_1","volume-title":"Full Catastrophe Living: Using the Wisdom of your Body and Mind to Face Stress, Pain, and Illness","author":"Kabat\u2010Zinn J","year":"1990"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/pr9.0000000000000759"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691611419671"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.14151"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S0304-3959(02)00048-9","article-title":"Reproducibility of pain measurement and pain perception","volume":"98","author":"Rosier EM","year":"2002","journal-title":"Pain"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/0304-3959(94)90097-3","article-title":"A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales","volume":"56","author":"Price DD","year":"1994","journal-title":"Pain"},{"key":"e_1_2_11_18_1","volume-title":"Constructing Grounded Theory: A Practical Guide through Qualitative Analysis","author":"Charmaz K","year":"2006"},{"key":"e_1_2_11_19_1","volume-title":"The Coding Manual for Qualitative Researchers","author":"Saldana J","year":"2016"},{"key":"e_1_2_11_20_1","volume-title":"16th Annual ResearchTalk Qualitative Research Summer Intensive","author":"Hamilton AB","year":"2019"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12201"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06080-5"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0853-y"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1188\/14.Onf.545-547"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732316665344"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0048230"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20237"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/hrp.0000000000000277"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(03)00573-7"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1747-5341-6-6"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2012.06.008"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e31818f52ee"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5791-10.2011"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-020-00890-8"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4328-15.2016"},{"key":"e_1_2_11_36_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/0163-8343(82)90026-3","article-title":"An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results","volume":"4","author":"Kabat\u2010Zinn J","year":"1982","journal-title":"Gen Hosp Psychiatry"},{"key":"e_1_2_11_37_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/BF00845519","article-title":"The clinical use of mindfulness meditation for the self\u2010regulation of chronic pain","volume":"8","author":"Kabat\u2010Zinn J","year":"1985","journal-title":"J Behav Med"},{"key":"e_1_2_11_38_1","volume-title":"A Meta\u2010Ethnography of Patients' Experience of Chronic Non\u2010Malignant Musculoskeletal Pain","author":"Toye F","year":"2013"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.02012"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073858415601369"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417727535"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2012.04.002"},{"key":"e_1_2_11_43_1","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1212\/WNL.94.15_supplement.773","article-title":"Mindfulness as an adjunctive treatment strategy for reduction of migraine pain during a single office visit","volume":"94","author":"Baker V","year":"2020","journal-title":"Neurology"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000005857"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2007.00789.x"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000009473"},{"key":"e_1_2_11_47_1","first-page":"334","article-title":"The effectiveness of 12\u2010week tai chi training in the prophylaxis of episodic migraine: a pilot randomized controlled trial in Chinese women","volume":"37","author":"Xie YJ","year":"2017","journal-title":"Cephalalgia"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001865"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10615-021-00812-0"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1679-5"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.02589"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691617709589"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijoy.IJOY_15_20"},{"key":"e_1_2_11_54_1","first-page":"1","article-title":"Online mindfulness may target psychological distress and mental health during COVID\u201019","volume":"9","author":"Farris SR","year":"2021","journal-title":"Glob Adv Health Med"},{"key":"e_1_2_11_55_1","volume-title":"The Theory and Practice of Group Psychotherapy","author":"Yalom ID","year":"1995"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14481","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/head.14481","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T08:59:19Z","timestamp":1762073959000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,28]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/head.14481"],"URL":"https:\/\/doi.org\/10.1111\/head.14481","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,28]]},"assertion":[{"value":"2022-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}