(PS5-B32) The Five Facets of Mindfulness: A Cross-sectional Analysis of Mindfulness and Its Association with Depression, Anxiety and Disability in Adults with Migraine

Objective: This study evaluated the five facets of mindfulness for associations with depression, anxiety, and disability in patients with migraine who presented for a mindfulness-based clinical trial.

Background: During COVID-19, mindfulness has been used to help people with migraine. Promising research is emerging that demonstrates how mindfulness-based interventions reduce disability in adults with migraine. While the relationships between mindfulness and depression, anxiety, and disability have been evaluated in chronic pain, little is known about the relationships between mindfulness facets and these factors in migraine.

Method: This is a cross-sectional secondary analysis of baseline participant data combined from two randomized clinical trials in adults with migraine evaluating mindfulness-interventions (either Mindfulness Based Cognitive Therapy (MBCT) or Mindfulness Based Stress Reduction (MBSR)). 210 participants (90% women; M age = 43, SD = 13) were administered the Five Facet Mindfulness Questionnaire (FFMQ), which contains five subscales: Observing, Describing, Acting with Awareness, Non-Judging of Inner Experience, and Non-Reactivity to Inner Experience, and the Migraine Disability Assessment. Z-scores were used to combine two different measures of the same construct from the two different studies for depression (PROMIS-D and PHQ-9), anxiety, (PROMIS-A and GAD-7), and disability (HDI and HIT-6). Linear regression (outcomes = Z-Depression, Z-Anxiety, Z-Disability) and logistic regression (outcome = Severe MIDAS Disability, Score >=21) evaluated the relationships between total FFMQ (Model 1) all five FFMQ subscales entered simultaneously (Model 1) and outcomes.

Results: In participants with migraine, higher total mindfulness was associated with lower Z-Depression (β = -.40, p < .001), Z-Anxiety (β = -.42, p < .001), and Z-Disability (β = -.18, p = .009). Of all the mindfulness facets, Non-Judging of Inner Experience accounted for the most unique variance in Z-Depression (β = -.35, p < .001), Z-Anxiety (β = -.45, p < .001), and Z-Disability (β = -.22, p = .012). The mindfulness facet of Describing accounted for the most unique variance in Severe MIDAS Disability (OR = 1.05, 95% CI = 0.99, 1.12).

Conclusion: In people with migraine, increased baseline levels of mindfulness is associated with lower depression, anxiety, and disability. Non-judgment of inner experiences may be driving this effect. Further research on the multidimensional construct of mindfulness in migraine may help elucidate these findings.