Pain acceptance as a change mechanism for mindfulness-based cognitive therapy for migraine.

Migraine is one of the leading causes of disability worldwide. Third wave therapies, such as Mindfulness Based Cognitive Therapy for Migraine (MBCT-M), have proven efficacious in reducing headache-related disability. However, research is needed to better understand the change mechanisms involved in these third-wave therapies. Acceptance is a fundamental component of third wave therapies, and more research is warranted on the role of pain acceptance in MBCT-M. It is also valuable to understand the independent roles of the two components of pain acceptance-pain willingness (PW) and activity engagement (AE). The current study is a secondary analysis of a randomized control trial of MBCT-M. Sixty participants were included in the study (MBCT = 31; WL/TAU = 29). Baseline correlations between overall pain acceptance, PW, AE, and headache-related disability were run. Mixed models assessed change from baseline to one-month post-treatment and treatment-by-time interaction for overall pain acceptance, PW, and AE. Mixed models also assessed maintenance of changes at 6-month follow-up in the MBCT-M group. Longitudinal mediation models assessed whether change in pain acceptance, PW, and AE mediated the relationship between treatment and change in headache-related disability. Pain acceptance, PW, and AE were all negatively correlated with headache-related disability at baseline. Pain acceptance, PW, and AE all significantly increased over time in both the waitlist/ treatment-as-usual group (WL/TAU) and the MBCT-M group. Only AE increased more in the MBCT group than the WL/TAU group. Change in pain acceptance, PW, and AE all significantly mediated the relationship between MBCT and change in headache-related disability. The study supports the importance of pain acceptance, specifically the activity engagement component, in MBCT-M.

Older Adults Place Greater Importance Than Younger Adults on a Purposeful Retirement.

Objective: Regarding retirement, some but not all people decline in sense of purpose, and retirees may view maintaining a sense of purpose as nonessential. These findings suggest individual differences both in the importance placed on being purposeful during retirement in general and the discrepancy for purpose importance prior to and during retirement. Method: This study surveyed U.S. adults (n = 2009, Mage = 48.51) asking them about how they viewed having a purpose in two life stages: before and during retirement, as well as personality and demographic questions. Results: Findings suggest that, overall, people believe it is important to have a purpose and direction during retirement. This tendency was greater among older adults, and those higher on conscientiousness or lower on neuroticism. However, working status did not play a role in the perceived importance of purpose during the retirement period. Moreover, age differentiated who perceives during-retirement purpose as more important than prior-to-retirement purpose. Conclusion: The current findings add to our understanding of when individuals expect to be purposeful and counter the claims that older adults may place less importance on being purposeful. Instead, these findings point to the need for continuing work on how to help older adults maintain or find a purpose in life following retirement.

Cluster Headache: Clinical Characteristics and Opportunities to Enhance Quality of Life.

PURPOSE OF REVIEW: Cluster headache is a highly disabling primary headache disorder characterized by severe pain and autonomic features. We present the existing body of literature on psychological factors associated with cluster headache and recommendations to address gaps in current clinical care with regards to psychological treatments for cluster headache. RECENT FINDINGS: People with cluster headache often endorse depressive symptoms, are more likely than the general population to report suicidal ideation and behaviors, and experience significantly decreased quality of life. Psychological treatments such as Acceptance and Commitment Therapy may be particularly valuable for patients with cluster headache given that they are transdiagnostic in nature and can therefore simultaneously address the disease burden and common psychiatric comorbidities that present. Greater understanding of the debilitating nature of cluster headache and behavioral interventions that seek to reduce the burden of the disease and improve the quality of life of people with cluster headache is paramount.

Neuroticism predicts informant reported cognitive problems through health behaviors.

OBJECTIVE: Personality traits have been linked to cognitive impairment, though work is needed to understand the mechanisms involved. Research also needs to consider alternative markers of cognitive impairment, such as informant report measures. The aim of the current study was to examine the role of health behaviors and social engagement as mediators for the relationship between personality and informant reported cognitive problems. It was expected that neuroticism would predict cognitive problems through negative health behaviors, while conscientiousness might predict cognitive problems through positive health behaviors. METHODS: Using data from the St. Louis Personality and Aging Network study at three time points, spanning approximately 2.27 years (N = 829, M age = 65.95), correlations were computed between the Big Five personality traits and health behaviors at wave 1, social engagement at wave 2, and informant reported cognitive problems at wave 3. Mediation tests examined whether health behaviors and social engagement explained the relationships found between personality and informant reported cognitive problems. RESULTS: Findings showed that neuroticism at wave 1 significantly predicted informant reported cognitive problems at wave 3 and that health behaviors, specifically wellness maintenance, partially explained this relationship. No significant associations were found between informant reported cognitive problems and conscientiousness, agreeableness, extraversion, openness, or social engagement. CONCLUSION: This study supports claims that neuroticism predicts later cognitive problems and expands on previous literature by demonstrating this relationship using an informant report measure. Furthermore, we found that health behaviors, and specifically wellness maintenance, account for some of the relationship between neuroticism and informant reported cognitive problems.