TY - JOUR
T1 - Behavioral management of the triggers of recurrent headache: a randomized controlled trial
AU - Martin, Paul Russell
AU - Reece, John E
AU - Callan, Moira Ruth
AU - MacLeod, Colin
AU - Kaur, Archana
AU - Gregg, Karen Jane
AU - Goadsby, Peter J
PY - 2014
Y1 - 2014
N2 - This study was designed to evaluate the traditional advice to headache sufferers to avoid all triggers ( Avoidance ), and a novel approach to trigger management (Learning to Cope with Triggers - LCT ) that included graduated exposure to selected triggers to promote desensitization. Individuals (84F, 43M) with migraine and/or tension-type headache were assigned randomly to one of four groups: Waiting-list (Waitlist); Avoidance; Avoidance combined with cognitive behavior therapy (Avoid+CBT); and LCT. Changes in headaches and medication consumption (in parentheses) from pre- to post-treatment were (a minus sign indicates improvement): Waitlist,+11.0 (+15.4 ); Avoidance,-13.2 (-9.0 ); Avoid+CBT,-30.0 (-19.4 ); and LCT,-35.9 (-27.9 ). Avoidance did not differ significantly from Waitlist on headaches or medication use, but LCT differed significantly from Waitlist on both measures. Avoid+CBT significantly differed from Waitlist on headaches but not medication consumption. In summary, the study failed to find support for the standard approach to trigger management of advising avoidance, but LCT emerged as a promising strategy. LCT resulted in greater improvement than the other three conditions on all measures of headaches and medication consumption, and was the only treatment condition that significantly differed from the waiting-list control condition in terms of treatment responder rate (50 or greater reduction in headaches) and medication consumption
AB - This study was designed to evaluate the traditional advice to headache sufferers to avoid all triggers ( Avoidance ), and a novel approach to trigger management (Learning to Cope with Triggers - LCT ) that included graduated exposure to selected triggers to promote desensitization. Individuals (84F, 43M) with migraine and/or tension-type headache were assigned randomly to one of four groups: Waiting-list (Waitlist); Avoidance; Avoidance combined with cognitive behavior therapy (Avoid+CBT); and LCT. Changes in headaches and medication consumption (in parentheses) from pre- to post-treatment were (a minus sign indicates improvement): Waitlist,+11.0 (+15.4 ); Avoidance,-13.2 (-9.0 ); Avoid+CBT,-30.0 (-19.4 ); and LCT,-35.9 (-27.9 ). Avoidance did not differ significantly from Waitlist on headaches or medication use, but LCT differed significantly from Waitlist on both measures. Avoid+CBT significantly differed from Waitlist on headaches but not medication consumption. In summary, the study failed to find support for the standard approach to trigger management of advising avoidance, but LCT emerged as a promising strategy. LCT resulted in greater improvement than the other three conditions on all measures of headaches and medication consumption, and was the only treatment condition that significantly differed from the waiting-list control condition in terms of treatment responder rate (50 or greater reduction in headaches) and medication consumption
UR - http://ac.els-cdn.com/S0005796714000990/1-s2.0-S0005796714000990-main.pdf?_tid=d4826190-ab39-11e4-a019-00000aab0f6b&acdnat=1422922739_e7c54e28792fd826
U2 - 10.1016/j.brat.2014.07.002
DO - 10.1016/j.brat.2014.07.002
M3 - Article
SN - 0005-7967
VL - 61
SP - 1
EP - 11
JO - Behaviour Research and Therapy
JF - Behaviour Research and Therapy
ER -