This proposal will gather data relevant to the mechanisms by which widely used, non-drug treatments of headache (HA) have their benefits. While the long-term goal of this program of research is to compare three different models of the mechanisms by which non-drug treatments (thermal biofeedback [TBF] and progressive muscle relaxation [PMR] lead to the alleviation of chronic HA, the present proposal is designed to gather preliminary data to assist in the design of later, large scale, more definitive studies. The three models are the older psychophysiological model which posits that treatment leads to physiological change which in turn leads to HA relief. A new cognitive-attributional model posits that treatment leads to cognitive or attributional changes which lead re-interpretation of stressful, headache-causing events, which in turn leads to HA relief. A third interactional model posits that it is the interaction of the psychophysiological effects and cognitive- attributional effects which lead to HA relief. In Study 1 of this proposal, four different biofeedback conditions will be compared in the treatment of vascular HA: (1) TBF for hand warming, the most widely used non-drug treatment for vascular HA; (2) TBF for hand cooling, which some studies have shown is equally effective as (1); (3) TBF for hand temperature stabilization, which some claim is central to TBF's therapeutic effects; and (4) EEG alpha biofeedback for alpha suppression, to control for any vascular effects. We will also examine whether patients with pure migraine HA and those with mixed migraine and tension HA respond in the same way to the treatments. In Study 2 tension HA patients will receive PMR with computerized end of session feedback on degree of relaxation (to manipulate attributions of success) in order to have the equivalent of 2X2 design, two levels of cognitive-attributional change by varying degrees of physiological change. The results and models will be evaluated both with headache outcome measures (relative degree of headache relief) and with process measures evaluating psychophysiological change, cognitive and attributional change, and change in life stresses, mood and coping as they all relate to headache relief.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
2R01MH041341-09A3
Application #
3379955
Study Section
Health Behavior and Prevention Review Committee (HBPR)
Project Start
1992-09-30
Project End
1994-08-31
Budget Start
1992-09-30
Budget End
1993-08-31
Support Year
9
Fiscal Year
1992
Total Cost
Indirect Cost
Name
State University of New York at Albany
Department
Type
Schools of Arts and Sciences
DUNS #
City
Albany
State
NY
Country
United States
Zip Code
12222
Blanchard, E B; Peters, M L; Hermann, C et al. (1997) Direction of temperature control in the thermal biofeedback treatment of vascular headache. Appl Psychophysiol Biofeedback 22:227-45
Blanchard, E B; Appelbaum, K A; Radnitz, C L et al. (1990) A controlled evaluation of thermal biofeedback and thermal biofeedback combined with cognitive therapy in the treatment of vascular headache. J Consult Clin Psychol 58:216-24
Blanchard, E B; Appelbaum, K A; Nicholson, N L et al. (1990) A controlled evaluation of the addition of cognitive therapy to a home-based biofeedback and relaxation treatment of vascular headache. Headache 30:371-6
Guarnieri, P; Blanchard, E B (1990) Evaluation of home-based thermal biofeedback treatment of pediatric migraine headache. Biofeedback Self Regul 15:179-84
Blanchard, E B; Appelbaum, K A; Radnitz, C L et al. (1990) Placebo-controlled evaluation of abbreviated progressive muscle relaxation and of relaxation combined with cognitive therapy in the treatment of tension headache. J Consult Clin Psychol 58:210-5
Michultka, D M; Blanchard, E B; Appelbaum, K A et al. (1989) The refractory headache patient--II. High medication consumption (analgesic rebound) headache. Behav Res Ther 27:411-20
Morrill, B; Blanchard, E B (1989) Two studies of the potential mechanisms of action in the thermal biofeedback treatment of vascular headache. Headache 29:169-76
Blanchard, E B; Appelbaum, K A; Radnitz, C L et al. (1989) The refractory headache patient--I. Chronic, daily, high intensity headache. Behav Res Ther 27:403-10
Michultka, D M; Poppen, R L; Blanchard, E B (1988) Relaxation training as a treatment for chronic headaches in an individual having severe developmental disabilities. Biofeedback Self Regul 13:257-66
Blanchard, E B; Andrasik, F; Guarnieri, P et al. (1987) Two-, three, and four-year follow-up on the self-regulatory treatment of chronic headache. J Consult Clin Psychol 55:257-9

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