Mindfulness Practice and Perceived Stress: A Secondary Analysis of a Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Migraine

Abstract

Objective: To examine the relationship between mindfulness and perceived stress, at both group and individual levels.

Participants and Methods: 38 participants with a diagnosis of migraine were recruited through headache clinics and the community in an urban area as part of the Bronx Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) randomized controlled trial. Participants were randomized after baseline monitoring to either MBCT-M treatment group (N=18) or waitlist group (N=20). With Ecological Momentary Assessment. participants completed electronic diary entries daily including the perceived stress scale (4-item) and standard headache monitoring: those in the treatment group also recorded daily mindfulness practice.

Results: Linear Mixed Models compared changes in 30 daily perceived stress (PSS) scores nested within baseline and follow-up months between treatment and waitlist groups: the group by time interaction was significant F(1. 1677.57)= 6.72. p= .010. This demonstrated a significantly steeper slope for the treatment group's decrease in perceived stress over time compared to the waitlist group's change. For the treatment group, linear mixed models examined the relationship between the practice of mindfulness (y/n) and the participant's perceived stress on the same day as practice and on the day following mindfulness practice. Main effects of same day mindfulness practice F(1.1136.35)=2.97, p=.085 were not significant. However. when adjusted for yesterday's stress. main effects were significant for same day mindfulness practice F(1,725.24)=5.47. p=.020. This demonstrated that, when the previous day's perceived stress was accounted for, mindfulness practice was associated with lower perceived stress on the same day as practice.

Conclusions: Mindfulness training (participation in MBCT-M) may significantly reduce perceived stress within the migraine population. Additionally, practicing formal mindfulness is associated with lower perceived stress that day; however this is likely a bidirectional relationship. These findings have significant clinical implications and should be further explored.