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Autonomic Stress Recovery and Habituation in Migraine

Mandell, Darcy (2016) Autonomic Stress Recovery and Habituation in Migraine. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Migraine sufferers have been characterized as particularly “stress-sensitive,” and they tend to experience headaches following periods of increased psychological stress. The biological mechanisms responsible for this unusual stress response are poorly understood. In particular, it is unclear why migraineurs suffer from headaches in response to stress while others do not. Several theories have implicated autonomic dysfunction—and in particular, sympathetic hyper-reactivity to stress— as a way of explaining increased psychological stress reactivity found in migraineurs. Despite efforts to capture these patterns in laboratory stress settings, researchers have been largely unable to provide reliable evidence of autonomic hyper-reactivity to acute stress in this population. The present study pursued the alternative hypothesis that migraineurs have prolonged autonomic recovery following stress, along with decreased habituation to repeated stressors. We compared patterns of autonomic stress recovery and habituation in a sample of young adult migraineurs and healthy controls using a repeated intermittent stressor task and separate measures of sympathetic and parasympathetic function. In contrast to our predictions, which posited sustained sympathetic engagement and a possibly blunted parasympathetic rebound upon stressor cessation, we found that individuals with episodic migraine were largely indistinguishable from controls in their sustained stress responses. Unexpectedly, migraineurs demonstrated consistently stronger vagal withdrawal to repeated stressors than healthy controls. They also showed evidence of greater cognitive and emotional reactions than controls, primarily in the form of higher subjective stress and more negative appraisals of the stressor task itself. While this is not the first study to report altered parasympathetic function in migraineurs, it is one of only a handful to assess these patterns in the context of acute laboratory stress exposure, and the only known study to report exaggerated parasympathetic withdrawal alongside reports of increased subjective stress and negative stress appraisals.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Mandell, Darcydarcy.mandell@gmail.comDLM60
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee CoChairSiegle,
Committee CoChairMarsland, Anna
Committee MemberGianaros, Peter
Committee MemberPogue-Geile,
Committee MemberJones, Neil
Date: 30 September 2016
Date Type: Publication
Defense Date: 14 June 2016
Approval Date: 30 September 2016
Submission Date: 25 July 2016
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 137
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Stress, Migraine, Autonomic, Sympathetic, Parasympathetic
Date Deposited: 30 Sep 2016 19:58
Last Modified: 15 Nov 2016 14:34


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