Exploring the relationship between pain catastrophizing and migraine in youth: A longitudinal clinical cohort study
Bibliographic record
Abstract
OBJECTIVE: This study explored the relationship between pain catastrophizing and migraine-related outcomes (i.e., migraine-related disability and headache frequency) between visits with a neurologist in a clinical population of children and adolescents with migraine. BACKGROUND: Evidence from adult populations suggests that pain catastrophizing, the tendency to magnify the threat value of, and ruminate and feel helpless about, pain may be associated with migraine-related outcomes, but the association in children and adolescents is less clear. METHODS: In this prospective longitudinal clinical cohort study, children and adolescents aged 8-18 years with migraine completed headache questionnaires and a validated measure of pain catastrophizing (Pain Catastrophizing Scale for Children) at baseline and initial follow-up visits with a neurologist. Recruitment spanned from May 2019 to July 2023. Headache frequency and migraine-related disability (Pediatric Migraine Disability Assessment) were assessed at both visits. Migraine outcomes at follow-up were examined in relation to baseline pain catastrophizing scores in models that controlled for sex, age, preventive treatment use, baseline headache frequency, and baseline disability. RESULTS: For this study, 121 consenting participants were included. In models adjusted for age, sex, baseline headache frequency, baseline disability, and preventive treatment use, baseline pain catastrophizing scores were significantly associated with disability scores at follow-up (β = 0.81, 95% confidence interval [CI] = 0.13-1.48, p = 0.020), but not with headache frequency at follow-up (β = 0.04, 95% CI = -0.10 to 0.19, p = 0.575). When examining the specific subscales of pain catastrophizing in an adjusted model, only baseline pain magnification (β = 6.73, 95% CI = 2.95-10.51, p = 0.001) had a significant association with disability at follow-up, while feelings of helplessness (β = 0.08, 95% CI = -2.11 to 2.27, p = 0.944) and rumination did not (β = -1.83, 95% CI = -4.22 to 0.56, p = 0.133). In a subset of participants with pain catastrophizing measured at both visits (n = 65), pain catastrophizing total and subscale scores did not significantly differ between visits. CONCLUSION: Baseline pain catastrophizing scores were associated with migraine-related disability, but not headache frequency, at follow-up in a clinical population of children and adolescents with migraine. Pain magnification specifically appeared to drive this association. Future studies should aim to replicate our results and to investigate if interventions aimed specifically at reducing pain magnification may help to mitigate migraine-related disability in children and adolescents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".