Effects of Behavioral Psychophysiological Treatment on Schoolchildren with Migraine in a Nonclinical Setting: Predictors and Process Variables

Evaluated the outcome of a combined behavioral therapy, comprising relaxation training, temperature biofeedback, and cognitive training, administered in a school setting, at posttreatment, and 7-month follow-up, on a group of school children with migraine. Comparison between the experimental group (n = 32) and the waiting-list control group (n = 9) showed a treatment effect on headache frequency and duration but not on intensity. Using a 50% reduction in the headache activity as a criterion for clinical improvement, 45% of the children in the experimental group were clinically improved at the end of the treatment. The treated subjects were found to have maintained significant improvement at follow-up. Sex, headache history, age, and psychosomatic complaints before the training emerged as predictors of outcome. A decrease in state anxiety and an increase in the ability to relax during the sessions contributed to headache improvement. Finally, the acquired capacity to raise one's finger temperature during the biofeedback sessions was related to headache reduction after the training. © 1993 Plenum Publishing Corporation

A behavioral treatment of young migranious and nonmigranious headache patients: Prediction of treatment success

We evaluated the outcome of a behavioral treatment package in a clinical selling with a group of young (age: 12-22) headache patients, suffering from migrainous or nonmigrainous. Comparison between the experimental (n = 24) and the waiting-list control group(n = 15) showed a treatment effect on headache frequency and on the headache index. Using a 50% reduction in the headache activity as a criterion for clinical improvement, 52% of the participants in the experimental group had improved clinically at the end of the treatment. The treated participants were found to have maintained significant improvement at 1-year follow-up. The treatment effect was significantly higher for nonmigrainous headache patients than for migraineurs. The most important background predictor of outcome was duration of headache history: youngsters with a longer headache history profited less by the treatment than youngsters with a shorter headache history. Family predictors of pre-post improvement were maternal rewarding of illness behavior and mother-child relationship. Those youngsters who reported more rewarding and/or a more positive mother-child relationship profited less by the treatment than those who reported less rewarding and/or a less positive mother-child relationship. We conclude that therapists treating young headache patients should be alert to pain-rewarding patterns in the family