Future treatment strategies may address the impact of stigma
In the not-so-distant-future, treatments for migraine may include much more than just the symptoms experienced. In order to minimize the impact of stigma, treatments may be tailored to suit each patient’s personality, too.
The results of a study presented at the June 2014 Annual Scientific Meeting for the American Headache Society show a connection between personality traits and the impact of stigma. 126 migraineurs (57 episodic and 59 chronic) took two assessments: the Stigma Scale for Chronic Illness and either the MMPI-2 or the MMPI-2-RF. Researchers then compared the results of both assessments to determine what (if any) relationship existed between the level of stigma experienced and each patient’s MMPI results. They did find surprising connections.
The study found that episodic migraineurs generally experienced less of an impact from stigma. However, introverted migraineurs who tend to prefer being alone even when pain-free were negatively impacted by stigma. This may be due to extroverts having a bigger social network or because our society tends to view introverts negatively with or without migraine.
For chronic migraineurs, the picture is more complicated. A number of personality factors influenced the results. Patients who are prone to mood swings, excitability, or have periods of excess energy were negatively impacted by stigma more than those patients with a tendency to be calm, cool, and collected.
I was surprised by the next result. I expected depressed migraineurs to experience the worst impact from stigma. Apparently that is not the case according to this study. The patients who experienced some of the worst impact from stigma tend to feel a lot of anxiety, worry a lot, be self-critical, have difficulty concentrating, and experience excessive guilt. These issues come up a lot for our readers, so maybe there is something to these results.
The study also found a relationship between stigma and migraineurs who tend to have a lot of vague physical complaints. Their stress manifests as physical symptoms instead of emotional or cognitive ones. This isn't to say that their symptoms are psychological in nature, but that stress tends to trigger physical symptoms first. My guess is that this explains why so many of us identify stress as a primary trigger.
What this means for you
Don't take all this to mean that your personality traits either doom or protect you from impact of stigma. This is the very first study of its kind. More research is needed before anyone can determine why stigma affects some patients worse than others.
What the study tells us is that personality traits and the impact of stigma are connected. Patients with certain tendencies or traits may be more negatively impacted by stigma. Maybe their personality traits make them a vulnerable target for stigmatizing behavior from others. Or perhaps their personality traits make them more likely to internalize stigma even when it is not obvious. More research is needed to learn how the two are connected.
The researchers suggest that doctors assess the effect stigma is having on a migraineur’s daily functioning. They assert that it’s not just the symptoms of the disease that make life so miserable for some patients. Hopefully the results of this study (and the many more to follow) will support the development of multidisciplinary programs that include mental health services, peer support services, and migraine education for caregivers, loved ones, and the community.
Concerns, questions, issues, problems
No study is perfect. All have their weaknesses. That’s what leads to more research, better results, and over time, a concensus. This is the first study of its kind to assess the relationship between stigma and personality traits. It also had a relatively small sample size. To extrapolate information about all 36 million migraineurs based on only 126 patients of a single headache clinic is not practical or reliable at this time.
As I thought about my own personality and experiences with stigma, some of the results started to make sense. I am an introvert who enjoys spending a lot of time alone. I also tend to be harder on myself and feel guilty that I can't do everything I used to do. According to this study, I should be affected by stigma more than an extrovert with a laid-back personality. That might have been true many years ago, but certainly not now. Lots of education and online connection with other migraineurs has made me more resilient. Sure, I tend to react to stigma like a mother bear defending her cubs. Yet it doesn't have the power to hold me back anymore. I'm no longer the helpless victim of stigma, but a warrior who fights against it.
What do you think? Do the results make sense based on your experiences? Take the study for what it’s worth – a snapshot of the impact of stigma on the migraine patients of one headache clinic. If it applies to you, use the information to improve your life with migraine. If not, then I have a circular file where you can dump the results.1-5
Can you tell when a migraine attack is coming?