The moderating role of cognitive fusion in the relationship between trait and state anger in episodic migraine, chronic migraine and healthy controls

This study aimed to examine the combined moderating role of cognitive fusion and migraine in the relationship between trait and state anger. A total of 213 patients diagnosed with chronic migraine, 136 with episodic migraine and 131 healthy controls, participated in the study. Interactions between trait anger and cognitive fusion, and between trait anger and group (chronic migraine, episodic migraine, and controls) on state anger were examined using SPSS PROCESS. Participants with chronic or episodic migraines showed higher levels of trait anger and cognitive fusion than controls. Only chronic migraine patients reported higher levels of state anger than controls. At low levels of cognitive fusion, there was no association between trait anger and state anger; however, at moderate levels, the relationship was significant for people with chronic or episodic migraines. At higher levels of cognitive fusion, the relationship also was significant in healthy individuals. These findings suggest that frequent anger in migraine may be explained by higher trait anger and cognitive fusion, which may occur in the context of an inhibitory deficit related to effortful control. In migraineurs, inhibitory dysfunction may exacerbate cognitive fusion which may, in turn, reinforce negative interpretations and facilitate the transition from trait to situational anger, even at moderate levels of fusion. Consequently, repeated experiences of anger may strengthen an angry disposition. This study highlights the role of cognitive fusion in anger in migraine and its potential clinical relevance given its modifiable nature.