The Effectiveness of Metacognitive Therapy on Positive and Negative Affect and Brain/Behavior Systems of Patients with Migraine Headaches Referring to Clinics and Health Centers in Ahwaz, Iran


  • Masoumeh Ghanavati MSc, Department of Clinical Psychology, School of Humanities, Ahvaz Science and Research Branch, Islamic Azad University, Ahvaz, Iran
  • Reza Joharifard Assistant Professor, Department of Psychology, School of Humanities, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran



Metacognition, Affection, Brain, Systems, Migraine


Background: The present study investigated the effects of metacognitive therapy (MCT) on the positive and negative affect and brain/behavioral systems (BBSs) of patients with migraine headaches referred to clinics and medical centers in Ahwaz city, Iran.

Methods: The participants consisted of 30 men and women with migraine selected using convenience sampling method and based on the diagnosis of a neurologist and the initial interview. The Gray-Wilson Personality Questionnaire‎ (GWPQ) and Positive and Negative Affect Schedule (PANAS) ‎were used in the pretest for all patients. The participants were randomly divided into the experimental (n = 15) and control groups (n =15). Metacognitive intervention was performed during 8 weekly sessions in the experimental group. The questionnaires were again administered to both experimental and control groups in the posttest to determine the effect of the treatment intervention. In this study, multivariate analysis of covariance (MANCOVA) was used to analyze the data in SPSS software. The significance level to test the hypotheses was considered as 0.05.

Results: The individual analysis of the variables illustrated that MCT is effective on negative affect and components of escape war in BBSs and there is a significant correlation between them.

Conclusion: It can be concluded that MCT is effective on positive and negative affect and BBSs of patients with migraine headaches.


Balderson, B. H. K., Lin, E. H. B., & Von Korff, M. (2004). The management of pain-related fear in primary care. In G. Asmundson, J. Vlaeyen, & G. Crombez (Eds.), Understanding and Treating Fear of Pain (1st ed., pp. 267-292). Oxford, UK: Oxford University Press.

BashiriNejadian, A., Heidari, A., & Bakhtiarpoor, S. (2014). The comparison of brain-behavioral systems and positive and negative affect between patients with migraine and healthy individuals. Journal of Developmental Psychology (Iranian Psychologist), 11(42), 195-208.

Colder, C. R., Trucco, E. M., Lopez, H. I., Hawk, L. W., Jr., Read, J. P., Lengua, L. J. et al. (2011). Revised Reinforcement Sensitivity Theory and Laboratory Assessment of BIS and BAS in Children. J Res Pers., 45(2), 198-207. Retrieved from PM:21603055

Corr, P. J. (2004). Reinforcement sensitivity theory and personality. Neurosci Biobehav Rev, 28(3), 317-332.

Crombez, G., Eccleston, C., Van den Broeck, A., Van, H. B., & Goubert, L. (2002). The effects of catastrophic thinking about pain on attentional interference by pain: no mediation of negative affectivity in healthy volunteers and in patients with low back pain. Pain.Res Manag., 7(1), 31-39. doi:10.1155/2002/576792 [doi]. Retrieved from PM:16231065

Efklides, A. (2011). Interactions of Metacognition with Motivation and Affect in Self-Regulated Learning: The MASRL Model. Educ Psychol, 46(1), 6-25.

Efklides, A. (2006). Metacognition and affect: What can metacognitive experiences tell us about the learning process? Educ.Res.Rev., 1(1), 3-14.

Fredrickson, B. L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychol Sci, 13(2), 172-175. doi:10.1111/1467-9280.00431 [doi]. Retrieved from PM:11934003

Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull, 133(4), 581-624. doi:2007-09203-002 [pii];10.1037/0033-2909.133.4.581 [doi]. Retrieved from PM:17592957

Green, M. W. (2011). Headaches: Psychiatric Aspects. Neurol Clin., 29(1), 65-80.

Ivory, N. J., & Kambouropoulos, N. (2012). Coping mediates the relationship between revised reinforcement sensitivity and alcohol use. Pers Individ Dif., 52(7), 822-827.

Jensen, M. P., Turner, J. A., Romano, J. M., & Karoly, P. (1991). Coping with chronic pain: a critical review of the literature. Pain., 47(3), 249-283. Retrieved from PM:1784498

Johari-Fard, R., & Ghafourpour, R. (2015). The Effectiveness of Unified Treatment Approach on Quality of Life and Symptoms of Patients with Irritable Bowel Syndrome Referred to Gastrointestinal Clinics. Int J Body Mind Culture, 2(2), 85-94.

Khodayarifard, M., Sadeghi, K., & Abedini, Y. (2007). Cognitive-behavioral family therapy combined with chiropractic in treatment of psychosomatic disorders. Research in Psychological Health, 1(1), 5-15.

Lackner, J. M., & Quigley, B. M. (2005). Pain catastrophizing mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome. Behav.Res Ther, 43(7), 943-957. doi:S0005-7967(04)00177-9 [pii];10.1016/j.brat.2004.06.018 [doi]. Retrieved from PM:15896288

Papageorgiou, C., & Wells, A. (2009). A prospective test of the clinical metacognitive model of rumination and depression. Int J Cogn Ther, 2(2), 123-131.

Pompili, M., Di, Cosimo D., Innamorati, M., Lester, D., Tatarelli, R., & Martelletti, P. (2009). Psychiatric comorbidity in patients with chronic daily headache and migraine: A selective overview including personality traits and suicide risk. J Headache.Pain., 10(4), 283-290. doi:10.1007/s10194-009-0134-2 [doi]. Retrieved from PM:19554418

Price, D. D., Harkins, S. W., & Baker, C. (1987). Sensory-affective relationships among different types of clinical and experimental pain. Pain., 28(3), 297-307. doi:0304-3959(87)90065-0 [pii]. Retrieved from PM:2952934

Sadock, B. J., & Sadock, V. A. (2007). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry, 10th ed. Philadelphia, PA: Lippincott Williams and Wilkins.

Sullivan, M. J. L., Tripp, D. A., & Santor, D. (2000). Gender Differences in Pain and Pain Behavior: The Role of Catastrophizing. Cognit Ther Res, 24(1), 121-134.

Sun-Edelstein, C., & Mauskop, A. (2009). Foods and supplements in the management of migraine headaches. Clin.J Pain., 25(5), 446-452. doi:10.1097/AJP.0b013e31819a6f65 [doi];00002508-200906000-00015 [pii]. Retrieved from PM:19454881

Tota-Faucette, M. E., Gil, K. M., Williams, D. A., Keefe, F. J., & Goli, V. (1993). Predictors of response to pain management treatment. The role of family environment and changes in cognitive processes. Clin.J Pain., 9(2), 115-123. Retrieved from PM:8358134

Turner, J. A., Jensen, M. P., & Romano, J. M. (2000). Do beliefs, coping, and catastrophizing independently predict functioning in patients with chronic pain? Pain., 85(1-2), 115-125. doi:S0304-3959(99)00259-6 [pii]. Retrieved from PM:10692610

Vervoort, T., Eccleston, C., Goubert, L., Buysse, A., & Crombez, G. (2010). Children's catastrophic thinking about their pain predicts pain and disability 6 months later. Eur.J Pain., 14(1), 90-96. doi:S1090-3801(09)00052-4 [pii];10.1016/j.ejpain.2009.03.001 [doi]. Retrieved from PM:19359203

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers.Soc Psychol, 54(6), 1063-1070. Retrieved from PM:3397865

Watson, D., & Tellegen, A. (1985). Toward a consensual structure of mood. Psychol Bull., 98(2), 219-235.

Weeks, R., Baskin, S., Rapoport, A., Sheftell, F., & Arrowsmith, F. (1983). A comparison of MMPI personality data and frontalis electromyographic readings in migraine and combination headache patients. Headache., 23(2), 75-82. Retrieved from PM:6853156

Wilson, G. D., Gray, J. A., & Barrett, P. T. (1990). A factor analysis of the Gray-Wilson Personality Questionnaire. Pers Individ Dif., 11(10), 1037-1045.

Zautra, A., Smith, B., Affleck, G., & Tennen, H. (2001). Examinations of chronic pain and affect relationships: applications of a dynamic model of affect. J Consult.Clin.Psychol, 69(5), 786-795. Retrieved from PM:11680555




How to Cite

Ghanavati, M., & Joharifard, R. (2019). The Effectiveness of Metacognitive Therapy on Positive and Negative Affect and Brain/Behavior Systems of Patients with Migraine Headaches Referring to Clinics and Health Centers in Ahwaz, Iran. International Journal of Body, Mind and Culture, 6(2), 87-96.



Quantitative Study(ies)