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.

SYNOPSIS This study tested several clinical hypotheses about personality traits of migraine and tension headache patients in a controlled design. Achievement motivation was found to be elevated in both headache groups. The tension headache patients also exhibited greater rigidity in comparison to the migraine group and the controls. In migraine patients, both traits were positively correlated with duration of headache attacks. When the two patient groups were combined, the headache patients had, in addition to raised achievement motivation and rigidity, more fear of failure and less impulsiveness than the controls. No evidence was found for higher prevalence of neuroticism and obsessive‐compulsive behavior in the headache groups. Neither migraine nor tension headache patients revealed an abnormal pattern of defense mechanisms. Generally, those traits related to aspects of performance were found to be more prevalent in headache patients than in controls.

SYNOPSIS There are few findings of increased stress responses of the vascular system and the (head) muscles in migraine and tension headache patients. However, several studies ignored the headache state of the patients during the experiment and differences in sex, or used small experimental groups. In this controlled study, physiological parameters in migraine patients, tension headache patients and non‐headache controls were investigated during conditions of stress and rest. Each group was composed of at least 25 subjects. Sex was included as an independent variable, and separate analyses were carried out on patients with pain during the measurements. There were no differences in vascular responding nor in muscular responding to stress between migraine patients, tension headache patients and controls. Male migraine patients showed enhanced activity in some indicators of sympathetic activity. No evidence was found for a discrete border separating the two headache types.

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