To determine whether pain catastrophizing influenced migraine outcomes of disability and headache frequency in a clinically-recruited sample of youth 8-18 years old.

Migraine is a disabling condition affecting ~1 in 10 youth. Pain coping differs in youth with migraine compared to their peers, and pain catastrophizing, which involves maladaptive cognitive responses to pain such as rumination and magnification, occurs at a greater frequency. It was hypothesized that longitudinal changes in headache frequency and migraine-related disability would be influenced by baseline pain catastrophizing. 

Using a prospective cohort design powered a priori for a modest effect size, a sample (n=123) of youth 8-18 years old was recruited from a tertiary headache centre. Consenting participants diagnosed with migraine had clinical information systematically collected, and completed a battery of baseline instruments, including the Pain Catastrophizing Scale (PCS), the Pediatric Migraine Disability Scale, and headache questionnaires. Follow-up instruments were completed at the next scheduled visit. Multiple linear regression models were used to examine the association between baseline pain catastrophizing and the change in migraine outcomes between visits, adjusted for age, sex, baseline headache frequency, and preventive treatment use. Post-hoc one-tailed paired t-tests were run on a subsample of participants who reported PCS scores at both visits (N=65) to explore if scores decreased between visits.

Univariate and multiple linear regression models did not demonstrate a significant relationship between baseline PCS scores and the change in outcomes between visits. However, pain magnification sub-scale PCS scores were shown to decrease significantly between visits (t(64)=-1.98, p=0.03).