Emotional reactivity profiles and stress coping patterns in migraine: Implications for clinical management

Abstract

Background & Objective: Migraine is a prevalent and disabling neurological disorder, often accompanied by psychosocial factors such as emotional reactivity and stress-related coping patterns. While stress is a well-established trigger, limited evidence exists regarding how emotional reactivity dimensions and coping styles are related in individuals with migraine. This study examined the associations between emotional reactivity dimensions “sensitivity, arousal/intensity reactivity, and persistence” and stress coping strategies in patients diagnosed with migraine, using a structural equation modeling (SEM) framework.

Methods: A cross-sectional study was conducted with 382 patients meeting ICHD-III diagnostic criteria for migraine. Participants completed the Emotion Reactivity Scale and the Stress Coping Styles Inventory, along with a sociodemographic questionnaire. Data were analyzed using SPSS 26 and AMOS 24. Path analysis was performed to examine the relationships among emotional reactivity dimensions and coping strategies.

Results: Sensitivity was significantly associated with both adaptive coping strategies (self-confident: β = 0.219, p < .001; optimistic: β = 0.284, p < .001) and maladaptive coping (helpless: β = 0.148, p = .007). Arousal/intensity reactivity was negatively associated with optimism (β = −0.301, p < .001) and positively associated with helpless (β = 0.453, p < .001), submissive (β = 0.226, p = .003), and social support–seeking (β = 0.167, p = .031) coping strategies. Persistence was not significantly associated with coping styles. Sociodemographic factors including age, education, income, and marital status were also related to coping strategies.

Conclusion: Overall, higher levels of arousal/intensity reactivity were associated with greater reliance on avoidant and passive coping strategies, whereas sensitivity was related to both constructive and dysfunctional coping patterns. These findings highlight the complex role of emotional reactivity in migraine and underscore the importance of considering emotion regulation and stress management within psychosocial interventions for migraine care.