The role of home practice in thermal biofeedback.

The role of regular home practice of hand warming was examined in the thermal biofeedback (TBF) treatment of vascular (migraine and mixed migraine and tension) headache (HA) by giving 12 sessions (over 6 weeks) of TBF to two groups of vascular HA patients (n = 23 per group). One group was asked to practice regularly at home with a home trainer between clinic sessions, whereas no mention of practice was made to the other group. A third group merely monitored HAs. Treatment was superior to no treatment. There was no advantage for the group receiving home practice, either in headache reduction or in acquisition of the hand-warming response.

The role of regular home practice in the relaxation treatment of tension headache.

This study evaluated the contribution of regular home practice in the treatment of tension headache (HA) with progressive muscle relaxation (PMR) by giving 14 tension HA sufferers 10 sessions (over 8 weeks) of standard PMR with home practice and application instructions while 13 additional patients received the same PMR training (except for the omission of cue-controlled relaxation) with no home practice or application instruction. A third group of 6 patients merely monitored HA activity. Both treated groups showed significant reduction in HA activity, whereas the symptom monitoring group did not change. The 2 treated groups did not differ. On a measure of clinically significant reduction in HA activity (at least 50% reduction in HA activity), however, the group receiving home practice instruction (50%) showed a trend (p = .056) to improve more than did those receiving PMR without home practice (15%).

Psychological changes accompanying non-pharmacological treatment of chronic headache: the effects of outcome.

Several prior studies suggest that non-drug treatment for chronic headache is accompanied by concomitant reductions in patients' anxiety, depression and somatization. It is currently unclear, however, whether such beneficial side effects are a function of degree of headache relief or are due simply to receiving treatment. Most work to date in this area has treated outcome as a dichotomous variable. The present report employed a regression approach which treats outcome (degree of headache relief) as a continuous variable in the study of 149 chronic headache patients and their accompanying psychological changes. Anxiety and depression were significantly reduced for headache patients regardless of degree of headache relief. With somatization, however, degree of headache relief had a significant effect; the greater the reduction in headache, the fewer somatic concerns were expressed, especially for mixed headache.

Locus of control and self-esteem of adult children of alcoholics.

Many recent reports suggest that children of alcoholics express belief in a more external locus of control and have lower self-esteem than do children of nonalcoholics. Much of this work has been based on studies of children (under the age of 18). However, few studies have examined the impact of parental drinking on those people once they have reached adulthood. We administered the Rotter Internal/External Locus of Control scale, the self-esteem scale from the Jackson Personality Inventory and the Children of Alcoholics Screening Test to 497 college students. No significant relationships between parental alcoholism and locus of control or self-esteem were found. This finding conflicts with the previous research on children of alcoholics and suggests that caution is necessary before explaining specific personality factors on the basis of parental alcoholism alone.

A controlled evaluation of the addition of cognitive therapy to a home-based biofeedback and relaxation treatment of vascular headache.

Seventy-six patients with vascular (migraine or mixed migraine and tension) headache (HA) participated in a controlled evaluation of a minimal-therapist-contact, largely home-based, treatment program which combined relaxation (R) training with thermal biofeedback (TBF). One group received TBF + R administered in 3 office visit over 8 weeks, supplemented by audio tapes and manuals. A second group received the TBF + R plus instruction in cognitive stress coping techniques, all of which was administered in 5 office visits over 8 weeks. A third group monitored headache activity for 8 weeks. Evaluations, based on 4 weeks of HA diary at pre-treatment and after treatment, revealed significantly greater reductions in HA activity and medication consumption for both treated groups than the HA monitoring controls who did not change. Significantly more of the treated patients had clinically significant reductions in HA activity than the controls. The two treated groups did not differ on any measure.

Two studies of the occurrence of psychophysiological symptoms in chronic headache patients.

Two separate, but related, studies are described in which psychophysiological symptoms associated with chronic headache were examined. In the first study, the Psychosomatic Symptom Checklist (PSC) was administered to evaluate the presence of 15 different psychophysiological symptoms in 3 types of chronic headache patients (migraine, tension, and combined migraine and tension). Over 97% of these 438 patients reported at least one other symptom occurring at least monthly and 75% reported another intense symptom occurring at least once a week. The tension and combined headache groups reported significantly higher overall symptomatic distress than the migraine headache patients. The tension patients reported significantly higher scores on the backache and weakness items, while the migraine and combined headache patients reported significantly more nausea. The differences between the diagnostic groups is more a function of the intensity of the symptoms than the presence of the symptoms, since, for many individual symptoms, the percentage of patients reporting is nearly equal. In the second study, 150 patients from the original sample (50 from each diagnostic group) were reassessed using the PSC after psychological treatment of headache. There were significant decreases in total scores for all 3 groups with no significant differences between groups seen at post treatment. Different treatment effects were seen on the individual symptoms with 7 of the 15 showing significant reduction. Chronic headache does not occur in isolation and headache diagnostic groups do not differentiate well on other individual psychophysiological symptoms.