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Anesth Pain Med. 2018 Nov 19;8(6):e82470. doi: 10.5812/aapm.82470. eCollection 2018 Dec.

Cognitive Processing Styles and Mindfulness on Pain Intensity Prediction in People with Primary Headache.

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Department of Health Psychology, Islamic Azad University of Alborz, Karaj, Iran.
Islamic Azad University of Alborz, Karaj, Iran.
Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.



Primary headaches are the most common cause of absence from work and school and one of the most common reasons for referring to the neurologists.


The present study was designed to investigate the relationship of cognitive processing style and mindfulness with pain intensity and the ultimate aim was to provide the role of pain-related cognitive processes and mindfulness in the prediction of headache intensity.


The study was conducted descriptively by using the correlation method. The statistical population of this study was composed of 85 patients (56 females and 29 males) with one type of primary headache, which were selected through purposive sampling after the diagnosis of a headache by a neurologist at Imam Hossein Hospital in Tehran province. To measure the variables of the study, the numeric pain rating scale (NRS) and the pain-related cognitive processes questionnaire (PCPQ) were used. All data were analyzed using descriptive statistics (frequency and percentages). Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used.


The results showed that there was a significant and negative association between pain intensity (NRS) and mindfulness (P < 0.01) and all pain-related cognitive processes, except pain focus (P < 0.01). The results of stepwise linear regression indicated that mindfulness only explains 39% of total score changes in pain intensity (P < 0.05 and ΔF (1 and 83) = 53.63, ΔR = 0.385). Adding cognitive processing styles to the model led to an 18% increase of the explained variance (R2 change = 0.179). In total, the present research model justifies 54% of the severity of headache variance (P < 0.01, ΔR = 0.54).


The results suggest that pain-related cognitive processes and mindfulness are effective on pain intensity prediction. In other words, this result can explain the role of mindfulness and adaptive cognitive processing in primary headache pain management.


Headache Pain; Mindfulness; Pain-Related Cognitive Processing

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