Cogniphobia and Neuropsychological Functioning in Migraine

• Published in: Neuropsychology 2022-07, Vol.36 (5), p.433-442
• Main Authors: Klepper, Jaclyn E., Sebrow, Laura, Rosen, Noah L., Seng, Elizabeth K.
• Format: Article
• Language: English
• Subjects: Anxiety; Fear; Female; Human; Male; Migraine Headache; Neuropsychology; Phobias; Recall (Learning); Self-Report
• ISSN: 0894-4105; 1931-1559
• DOI: 10.1037/neu0000808

Objective: Cogniphobia refers to the fear and avoidance of cognitive exertion, believed to cause or exacerbate headache. The objective of the present study was to demonstrate associations between cogniphobia and key fear-avoidance constructs. Method: In this cross-sectional study, 72 adults with migraine were recruited from a tertiary headache center. Patients completed the Cogniphobia Scale for Headache Disorders (CS-HD) and a series of self-reported surveys and neuropsychological measures that assessed patient demographics, migraine diagnosis and headache characteristics, current pain severity, emotional state (i.e., anxiety, pain-related fear, and depression), cognitive exertion, and functioning (self-reported disability, self-reported cognitive symptoms, and neuropsychological measures). Results: The CS-HD was associated with greater anxiety (Patient-Reported Outcomes Measurement Information System; PROMIS Anxiety; r = 0.39, p = .001), pain-related fear (PASS-20; ρ = 0.37, p = .002), self-reported cognitive symptoms (ABS; ρ = 0.38, p = .001), self-reported headache disability (HDI; r = 0.28, p = .022), and depression (PROMIS Depression; r = 0.25, p = .039). The CS-HD was also associated with lower scores on neuropsychological measures of semantic fluency (Animal Naming; r = −0.29, p = .015), visual immediate recall memory (RCFT Immediate Recall; r = −0.27, p = .027), visual delayed recall memory (RCFT Delayed Recall; r = −0.36, p = .002), and visual recognition memory (RCFT Recognition; r = −0.42, p < .001), with comparable findings when adjusting for depression and anxiety. Conclusion: This study demonstrated associations between cogniphobia and key fear-avoidance constructs. Fear-avoidance constructs, such as cogniphobia, are important constructs to consider when evaluating migraine and neuropsychological functioning. Key Points Question: What are the relationships between cogniphobia and fear-avoidance constructs in patients with migraine? Findings: Cogniphobia was associated with fear-avoidance constructs (i.e., higher anxiety and pain-related fear, greater self-report of cognitive symptoms and lower neuropsychological functioning, and higher self-reported headache disability and depression in adults with migraine). Importance: Cogniphobia is an important construct to consider when evaluating migraine and neuropsychological functioning. Next Steps: Future research should evaluate if cogniphobia can be modified or if cogniphobia's impact on function