Assessing attack‐related fear in headache disorders—Structure and psychometric properties of the Fear of Attacks in Migraine Inventory. Issue 3 (18th February 2022)

• Record Type: Journal Article
• Authors: Klan, Timo; Bräscher, Anne‐Kathrin; Klein, Silja; Diezemann‐Prößdorf, Anke; Guth, Anna‐Lena; Gaul, Charly; Witthöft, Michael
• Is Part Of: Headache. Volume 62:Issue 3(2022)
• Page Start: 294
• Page End: 305
• Publication Date: 2022-02-18
• Subjects: anxiety -- attacks -- fear -- migraine -- questionnaire; Headache -- Periodicals; Headache -- Periodicals; 616.8491
• DOI: 10.1111/head.14272
• Languages: English
• ISSNs: 0017-8748

Abstract

Abstract: Objective: This study aimed to develop a self‐report questionnaire for the assessment of attack‐related fear in migraine, and to determine its factor structure as well as its psychometric properties by the primary analysis of a cross‐sectional survey's data. Background: High fear of attacks in migraine increases the burden of disease and is assumed to have a negative impact on the course of the disease. Little is known about the structure and dimensionality of attack‐related fear, and a valid instrument for the comprehensive assessment is lacking. Methods: Based on a literature search and interviews with persons with migraine as well as with experienced practitioners, a 46‐item self‐report questionnaire, the Fear of Attacks in Migraine Inventory (FAMI) was developed. A cross‐sectional online survey comprising an assessment of diagnostic criteria of migraine and a battery of questionnaires including the FAMI was conducted ( N = 387 persons with migraine, 364/387 [94.1%] women, M = 40.9 [SD = 13.1] years, migraine without aura: 153/387 [39.5%], migraine with aura: 85/387 [22.0%], and chronic migraine: 149/387 [38.5%]). Results: Item selection led to 29 items for the FAMI. Exploratory factor analysis resulted in three clearly interpretable factors (fear of negative consequences; attention and anticipation; fear‐avoidance); a confirmatory factor analysis yielded an acceptable to good model fit ( χ 2 (3) = 1328.84, p = 0.001, χ 2 / df = 3.55, RMSEA = 0.085, SRMR = 0.073, CFI = 0.98, and TLI = 0.97). Reliability was good (fear‐avoidance, ω = 0.85; attention and anticipation, ω = 0.88) to excellent (fear of negative consequences, ω = 0.91). Correlational analyses confirmed the convergent validity of the FAMI. Conclusions: The FAMI appears suitable and promising for the assessment of attack‐related fear in migraine research and clinical care.