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Longitudinal Relationships Between Anxiety, Depression, Repetitive Negative Thinking and Headache Among Non-clinical Students After One Week and One Month

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This study examined the longitudinal relationship of anxiety, depression, and perseverative cognition with headache frequency, severity, and disability among non-clinical students in two waves. The interval between the two self-reported measurements was one month for Sample 1 (n = 426) and one week for Sample 2 (n = 92). The results showed that anxiety and repetitive negative thinking predicted the onset of migraine after one month. Depression was related to higher headache parameters after one month. Among probable migraine sufferers, repetitive negative thinking predicted higher headache impact after one month. Contrarily, metacognitions related to repetitive negative thinking indicated both positive and negative prospective relations to headache a month later, according to initial migraine status.

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The data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher.


  1. There is a rising debate on the use of change (difference) score of Time 2—Time 1 vs residualized Time 2 score controlling for Time 1, as the target of longitudinal data analyses (e.g., Kohler et al., 2021). Both approaches have strengths and caveats, which are dependent on many (including unobservable) assumptions. Therefore, deciding between two approaches involves a rather empirical question than a priori planning. Structural equation modeling of the change between two measurements was used to inform model choice (Coman et al., 2013; McArdle, 2009) (Supplement Figure S1). Therefore, whether the change score was dependent on Time 1 score was examined. In all four dependent variables, a path from Time 1 to the modeled latent factor of change, which is equal to difference between Time 2 and Time 1, was significant and adding it led to a better overall model fit (reduction in Akaike’s information criteria) in Sample 1. In Sample 2, except for the HIT, a path from Time 1 to change score was significant, associated with better model fit. This means that controlling for the Time 1 score is still necessary for change score. Therefore, regressions controlling for Time 1 score as a covariate were adopted.

  2. Inspection of paired profiles and distribution of residualized change between two measurements indicated that both the levels and degree of change varied according to individuals, which are to be modeled in regressions (Supplement Figure S2).

  3. Regressions for MIDAS and frequency were repeated without migraine status or interactions. No cognitive variable predicted MIDAS and headache frequency (R2s < .007, p > .24).


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This study was supported by a JSPS Grant-in-Aid for Scientific Research (C) to the author (No. 18K03095).

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This study has a single author, who contributed to the whole study process: conception, design, data collection, analysis, and drafting.

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Correspondence to Yoshinori Sugiura.

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Sugiura, Y. Longitudinal Relationships Between Anxiety, Depression, Repetitive Negative Thinking and Headache Among Non-clinical Students After One Week and One Month. J Cogn Ther 16, 237–265 (2023).

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