Anxiety Sensitivity Associated With Migraine Severity in Women

Anxiety sensitivity is associated with migraine severity and psychological distress in women, according to a study published in Headache.

For this exploratory study to assess the relationship between anxiety sensitivity and emotional disorders, migraine characteristics, and migraine-related fear and avoidance behaviors, investigators selected adult women with probable migraine as determined by the IDMigraine Screener (N=100). Anxiety sensitivity was measured using the Anxiety Sensitivity Index-3 (ASI-3), an 18-item questionnaire about symptoms rated on a 5-point scale. The Patient Health Questionnaire-4 was used to assess the severity of anxiety and depressive symptoms. A migraine history questionnaire was used to assess migraine characteristics.

ASI-3 and all subscale scores correlated significantly with severity of anxiety symptoms. When compared with women without anxiety sensitivity (50/100, 50%), women with a probable anxiety disorder (50/100, 50%) had significantly higher ASI-3 total scores (30.0±14.3 vs 17.9±13.8; t[98]=-4.32; P <.001), ASI-3 physical concerns (8.9±5.8 vs 6.0±5.8; t[98]=-2.51; P =.014), ASI-3 cognitive concerns (8.4±6.5 vs 4.6±5.3; t[98]=-3.15; P =.002), and ASI-3 social concerns (12.8±5.7 vs 7.3±5.8; t[98]=-3.75; P <.001).

Women with a probable depressive disorder (58/100, 58.0%) relative to those without (42/100, 42.0%) had significantly higher ASI-3 total scores (29.7±15.0 vs 19.8±14.1; t[98]=-3.39; P =.001), ASI-3 cognitive concerns (8.8±6.7 vs 4.8±5.2; t[98]=-3.25; P =.002), and ASI-3 social concerns (12.4±6.4 vs 8.4±5.7; t[98]=-3.28, P =.001.)

Results indicated that ASI-3 cognitive concerns were positively correlated with average duration of migraine attacks (r=.22; P =.029). ASI-3 total and cognitive concerns were significantly, positively associated with greater tendency to avoid movement in the presence of head pain. (ASI-3 Total: r=.20; P =.046 and ASI-3 cognitive: r=.20; P =.050).

This study was limited by its cross-sectional design, in which investigators relied exclusively on self-report measures, including retrospective recall of migraine experiences. The presence of probable migraine, anxiety, and depressive disorders was based on self-reported screening tools, which may introduce measurement bias. This study was not sufficiently powered to detect statistically significant small-sized partial correlation effect. The sample was also relatively homogeneous with respect to racial diversity.

The researchers suggested that the findings are the novel, highly specified evidence for anxiety sensitivity as a cognitive vulnerability factor that is related to psychiatric symptoms and migraine in women, which makes anxiety sensitivity a promising target for therapeutic intervention. This could have a dual benefit in management of emotional distress and migraine if reduced via cognitive-behavioral intervention.

Several researchers acknowledge conflicts of interest. Please see reference for the full list of disclosures.

Reference

Farris SG, Burr EK, Abrantes AM, et al. Anxiety sensitivity as a risk indicator for anxiety, depression, and headache severity in women with migraine [published online June 5, 2019]. Headache. doi: 10.1111/head.13568