PSYCHOLOGICAL TREATMENT OF HEADACHE

这项提议将收集与下列机制有关的数据： 广泛使用的非药物治疗头痛(HA)有其好处。 虽然这项研究计划的长期目标是比较三个 非药物治疗(热疗)机制的不同模型 生物反馈和渐进性肌肉放松[PMR]导致 缓解慢性医管局，目前的建议旨在收集 初步数据有助于以后的设计，更大规模、更多 权威的研究。这三个模型都是较老的心理生理学模型 假设治疗会导致生理变化的模型 转弯通向HA救济。一种新的认知-归因模型假设 这种治疗导致认知或归因的改变，从而导致 对有压力的、令人头痛的事件的重新解释，这反过来 导致了医管局的救济。第三个交互模型假定它是 心理生理效应和认知- 导致HA救济的归因效应。 在这项提议的研究1中，四种不同的生物反馈条件将 比较其在治疗血管性透明质酸中的作用：(1)温手热敷， 最广泛使用的非药物治疗血管性HA；(2)TBF治疗 一些研究表明，手工降温与(1)同样有效； (3)用于手部温度稳定的TBF，一些人声称这是核心 和(4)脑电阿尔法生物反馈 抑制，以控制任何血管效应。我们还将检查 单纯偏头痛HA患者和混合型偏头痛患者 张力HA对治疗的反应也是一样的。 在研究2中，张力HA患者将接受具有计算机化结束的PMR 关于放松程度的会话反馈(以操纵 Success)为了拥有2X2设计的等价物，两个级别的 不同程度生理因素对认知-归因的影响 变化。 结果和模型都将根据头痛的结果进行评估 措施(头痛缓解的相对程度)和过程措施 评估心理生理变化、认知和归因 变化，以及生活压力、情绪和应对方式的变化，因为它们都相关 为了缓解头痛。

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.