The role of personality in the etiology of chronic headache.
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Biomedical subjects
Publications and source records attributed to F Andrasik.
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The effect of cigarette smoking on the pulse rate and carboxyhemoglobin concentration of the pregnant smoker was studied. The aim of this investigation was threefold: (1) to standardize cigarette consumption for studying short-term smoking effects in pregnant smokers, (2) to test for these effects by use of two noninvasive measures (concentration of carboxyhemoglobin in expired air and digital pulse rate), and (3) to compare the acute effects evidenced by pregnant smokers to those of a carefully matched group of nonpregnant control subjects. Increases in pulse rate and concentration of carboxyhemoglobin were found to be positively correlated with the level of intake of nicotine and concentration of inhaled mainstream smoke, respectively. The results, however, showed no evidence of significant differences between the pregnant and nonpregnant groups on either of the smoking measures. The methodologic implications of these findings are discussed.
The Psychosomatic Symptom Checklist (PSC), a questionnaire assessing psychosomatic symptoms, was administered to two separate samples of college students. For Sample 1 (N = 698), the questionnaire was readministered to three separate subsets at intervals of either 1 week (N = 143), 4 weeks (N = 74), or 8 weeks (N = 48). Each subset of subjects recompleted the PSC on only one of the three retest intervals. Based on the initial administration an analysis of the normative data revealed a mean total score of 23.7, suggesting a relatively low degree of psychosomatic symptoms in this group. Although total scores decreased slightly over time, test-retest correlations remained high (r greater than 0.80, P less than 0.0001). Individual item correlations was greater than r = 0.50 throughout. Sample 2 (N = 249) completed the PSC, Beck Depression Assertiveness Scale (RAS), and intercorrelations were computed between these measures. This analysis revealed little overlap between the psychosomatic complaints assessed by the PSC and other commonly used measures of psychological distress. Finally, a factor analysis revealed one major factor on which all but 2 of the 17 questionnaire items loaded significantly. These results suggest that the PSC is sensitive to psychosomatic distress and remains reliable over time.
Researchers administer thermal biofeedback in several different formats, although the most common are continuous administration and a series of brief trials separated by frequent rest breaks. The present study directly compared these two administration schedules with individuals suffering from migraine headache. Optimal training effects occurred for the continuous schedule of administration. Surprisingly, the interrupted schedule actually led to decreases in hand temperature over eight sessions. Possible reasons for this finding and its implications are discussed.
The present study examined the ability of three headache groups (migraine, mixed migraine/tension, and tension) to accurately discriminate subjective levels of muscle tension at the forearm flexor, frontalis, and trapezius muscle sites. Discrimination ability was assessed at pre- and posttreatment using a psychophysical method of magnitude production. Results show that the ability to discriminate muscle tension levels at pretreatment varied across the headache groups, with migraineurs being the most accurate (r = .854), followed by the mixed headache group (r = .785), and finally the tension headache group (r = .732). Discrimination ability significantly increased at the posttreatment assessment. A multiple regression analysis showed that pretreatment performance on the muscle discrimination task significantly predicted outcome (r = .75) from relaxation and biofeedback training for migraine patients but not for the mixed or tension headache groups.
In a controlled trial, thermal biofeedback (n = 20) and abbreviated progressive relaxation (n = 22) were compared in the treatment of mild to moderate hypertensive patients whose blood pressures (BP) were initially controlled on two medications. For the clinical end point of maintaining control of BP on a single drug after treatment, biofeedback was superior to relaxation training (at 3 months, 47% success for biofeedback versus 23% for relaxation). This same result tended to be true for patient-measured home BPs. BPs from laboratory psychophysiological testing showed no consistent advantage for one treatment over the other.
Three hypotheses regarding the possible etiological relationship between affect and headache activity were examined through the use of cross-lagged correlational analyses: (1) the relationship between headache activity and affect (anger, anxiety and depression) is isomorphic, that is, increased headache activity is associated with same day increases in emotionality; (2) increased affect precedes (and thus possibly causes) increased headache activity; and, (3) increased headache activity precedes (and thus possibly causes) increased affect. Only hypothesis one was supported in the present study, and the relationship was found to be weak and only to approach significance (r = 0.163, p less than 0.09). These findings cast serious doubt upon many psychological theories regarding the etiology of headache and on the relationship between affect and headache in general.
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A sample of 49 chronic headache patients (35 vascular and 14 tension) was separated according to capacity for absorption (as measured by Tellegen & Atkinson's 1974 scale) into groups high in absorption and groups low in absorption, with patients in the middle range being excluded. Absorption capacity was found to affect response to treatment in complex ways. Vascular headache patients high in absorption were significantly improved following relaxation training, but not after biofeedback training. Vascular headache patients low in absorption were significantly improved after biofeedback training. Tension headache patients low in absorption did not respond significantly to either form of treatment, while those high in absorption responded significantly to biofeedback training. Reasons for these differences in response to treatment were discussed.
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We studied the ability of headache history, a 4-week headache diary, standard psychological tests, and laboratory measures of psychophysiologic responses to stress to predict the outcome of relaxation therapy and biofeedback for three types of chronic headache. Using canonical discriminant function analyses, each potential predictor set was tested separately, and all four were tested together. Information from the headache history alone correctly classified 89 to 95% of patients as improved or unimproved. No other single predictor set was consistently better than headache history. When all four predictor sets were combined, prediction improved; 93 to 100% of patients were correctly classified.
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