ABSTRACT
OBJECTIVE: To review the empirical research examining behavioral treatments for recurrent pediatric headache. METHODS: Thirty-one investigations published after 1980 were reviewed using predetermined criteria to evaluate the adequacy of research methodologies. A modification of criteria proposed for evaluating the efficacy of psychological interventions for adults (Task Force on Promotion and Dissemination of Psychological Procedures, 1995) was used to evaluate the adequacy of evidence available for individual intervention strategies. RESULTS: Sufficient evidence exists to conclude that relaxation/self-hypnosis is a well-established and efficacious treatment for recurrent headache. Furthermore, enough evidence exists to conclude that thermal biofeedback alone is a probably efficacious treatment. Other promising interventions have been tested that combine relaxation and biofeedback or integrate other cognitive-behavioral treatment approaches, but are limited by inadequate research methodologies. CONCLUSIONS: We discuss the importance of developmentally based conceptual models and the impact of diagnostic heterogeneity and offer specific recommendations for future intervention research in the area of recurrent pediatric headache.
Subject(s)
Evidence-Based Medicine/methods , Headache/therapy , Psychotherapy/standards , Child , Clinical Trials as Topic/standards , Humans , Psychotherapy/methods , Secondary PreventionABSTRACT
Assessment and intervention issues in recurrent pediatric headache are discussed. A broad overview of diagnostic and etiological issues is presented, with consideration of the application of functional models to recurrent headache patterns. Behavioral treatment outcome research is reviewed, and pharmacotherapy approaches are briefly addressed. Recommendations are made for clinical practice, and future research priorities in the area of recurrent pediatric headache are underscored.
