{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:19:50Z","timestamp":1788427190257,"version":"build-2803163510"},"reference-count":66,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess patterns of statistical associations among migraine stigma, psychological factors, and disability during the active migraine attack phase (the ictal disability burden) and in between attacks (the interictal disability burden).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous work suggests perceived stigma toward migraine is an important contributor to migraine disability. Yet, it is currently unclear how migraine stigma is connected to disability and vice versa. Psychological distress factors (i.e., perceived stress, anxiety symptoms, depression symptoms, and pain catastrophizing) are putative variables that might contribute to associations between stigma and disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a web\u2010based cross\u2010sectional survey study of 103 American adults with active migraine conducted during 2024 to 2025. Relationships among perceived migraine\u2010related stigma, perceived stress, anxiety and depression symptoms, pain catastrophizing, ictal disability, and interictal disability were assessed. Information was collected using a battery of questionnaires including the Migraine\u2010Related Stigma questionnaire, MIDAS, Migraine Interictal Burden Scale\u20104, Pain Catastrophizing Scale (headache version), Generalized Anxiety Disorder\u20107 questionnaire, Patient Health Questionnaire\u20109, and Perceived Stress Scale\u20104. Associational variable analysis, an alternative framework for nonexperimental cross\u2010sectional mediation studies, was used to examine associational patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Perceived stress was shown to partially account for variance between perceived migraine stigma and ictal disability (effect\u2009=\u20090.10, 95% confidence interval [CI] [0.01, 0.24]), whereas pain catastrophizing was found to partially account for the association between stigma and interictal disability (effect\u2009=\u20090.04, 95% CI [0.01, 0.09]). Transposing stigma and disability to examine reverse associations, perceived stress was found to partially account for the ictal disability\u2010stigma association (effect\u2009=\u20090.03, 95% CI [0.0002, 0.07]), whereas depressive symptoms (effect\u2009=\u20090.25, 95% CI [0.04, 0.54]) and pain catastrophizing (effect\u2009=\u20090.44, 95% CI [0.11, 0.91]) were shown to partially account for associations between interictal disability and stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among psychological variables examined, perceived stress and pain catastrophizing carried significant portions of stigma's relationship with ictal and interictal disability, respectively. Moreover, perceived stress (ictally) and depression symptoms\/pain catastrophizing (interictally) accounted for portions of disability's relationship with stigma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.70183","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:04:13Z","timestamp":1788426253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How are migraine\u2010related stigma, psychological factors, and disability related? A cross\u2010sectional investigation of associational patterns"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6728-6750","authenticated-orcid":false,"given":"Felicitas A.","family":"Huber","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth K.","family":"Seng","sequence":"additional","affiliation":[{"name":"Ferkauf Graduate School of Psychology Yeshiva University  Bronx New York USA"},{"name":"Saul R. Korey Department of Neurology Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Willroth","sequence":"additional","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences Washington University in St. Louis  Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parker A.","family":"Kell","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel S.","family":"Darken","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadas","family":"Nahman\u2010Averbuch","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences, Robert Larner, MD, College of Medicine University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata N.","family":"Vasquez","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Houston Methodist Research Institute  Houston Texas USA"},{"name":"Department of Psychiatry Weill Cornell Medical College  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Vanderbilt Center for Musculoskeletal Research Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Psychiatry and Human Behavior University of Mississippi Medical Center  Jackson Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burel R.","family":"Goodin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32160-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000252808.97649.21"},{"key":"e_1_2_11_4_1","volume-title":"GBD Compare Data Visualization. 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