A behavioral treatment of young migrainous and nonmigrainous headache patients: prediction of treatment success.

We evaluated the outcome of a behavioral treatment package in a clinical setting 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 high 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.

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 schoolchildren 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.

The optimal length of headache recording in juvenile migraine patients.

The representativeness of headache recording periods of one, two, three, four and five weeks for juvenile migraine was examined in 41 juvenile patients (suffering from migraine attacks at least twice a month). At pre-treatment and at follow-up, on average a three-week recording period was found to be adequate. On the basis of these findings a longer data-collection period is recommended for juvenile migraineurs than for adult migraine patients at follow-up.

Relaxation training in school classes does not reduce headache complaints.

The effect of teacher-presented Progressive Relaxation Training (PRT) on headaches, fear of failure and school problems was studied in school students. During ten physical education lessons, students received either PRT (n = 110) or placebo training (n = 92). The effect of the training was investigated in students who indicated the presence of headaches in a pre-training diary. No significant differences were found between both training groups regarding headache frequency, duration and intensity and the psychological variables. On the basis of these and previous findings, it is recommended to present PRT to fairly small groups of self-selected subjects instead of complete classes.