Forty-three college students suffering from recurrent tension headache were randomly assigned to 1 of 4 elec-tromyographic (EMG) biofeedback training conditions. Although all subjects were led to believe they were learning to decrease frontal EMG activity, actual feedback was contingent on decreased EMG activity for half of the subjects and increased EMG activity for the other half. Within these 2 groups, subjects also viewed bogus video displays designed to convince them they were achieving large (high success) or small (moderate success) reductions in EMG activity. Regardless of actual changes in EMG activity, subjects receiving high-success feedback showed substantially greater improvement in headache activity (53%) than subjects receiving moderate success feedback (26%). Performance feedback was also related to changes in locus of control and self-efficacy. Changes in these 2 cog-nitive variables during biofeedback training were also correlated with reductions in headache activity following treatment, whereas changes in EMG activity exhibited during training were uncorrelated with outcome. These results suggest that the effectiveness of EMG biofeedback training with tension headache may be mediated by cog-nitive changes induced by performance feedback and not primarily by reductions in EMG activity. My favorite headache article remains the 1984 article by Holroyd, Penzien, and colleagues. This influential study was the first to demonstrate that the effectiveness of bio-feedback may be mediated by cognitive changes induced through biofeedback training rather than primarily by learned physiological control. In the 1970s and early 1980s, the rationale for biofeedback training as an intervention for recurrent headache was derived from the widely accepted notion that migraine was a vascular phenomenon and tension-type headache was a musculo-skeletal phenomenon. Accordingly, thermal and elec-tromyographic (EMG) biofeedback targeted the supposed physiological responses involved in migraine and tension-type headache, respectively. The 1984 study manipulated both the contingency of the feedback in EMG biofeedback training and patients' perceptions of their success with biofeedback, using a 2 (EMG increase vs EMG decrease) ¥ 2 (high vs moderate success) experimental design. Results demonstrated headache improvement with biofeedback regardless of whether patients had been trained to decrease or to increase EMG activity. Furthermore, superior headache improvement was achieved by the group who received the "high success" condition, regardless of biofeedback training. Headache improvements instead correlated with cognitive changes in self-efficacy and locus of control. The exemplary study challenged the popular beliefs of the day about mechanisms of biofeedback, and moreover raised questions for the prevailing notions concerning basic pathophysiology of so-called muscle contraction headache. Although previous studies had questioned the mechanisms of biofeedback with altered-contingency control conditions, this study surpa...

The purpose of the current study was to examine university undergraduate women's and men's attitudes and knowledge toward breastfeeding. Data were gathered for 111 women and 50 men. Data showed a significant relationship between positive attitudes toward breastfeeding and exposure to breastfeeding. Women and participants older than 20 years scored higher on measures of knowledge and attitudes. Results indicated that positive attitude toward breastfeeding was a significant predictor of intention to breastfeed among women and men. In conclusion, the results suggest that understanding attitudes among young adults is an important line of research. Further studies are needed to develop and evaluate interventions aimed at improving attitudes about breastfeeding and increasing initiation of breastfeeding among this population.

SYNOPSIS This study investigated the role of stress in recurrent tension headache. Although recurrent tension headache sufferers (N=117) and matched headache‐free controls (N=174) reported similar numbers and types of stressful life events, headache sufferers reported a greater number of chronic everyday stresses or daily hassles than did controls. Recurrent tension headache sufferers also appraised the stressful events they experienced more negatively than did controls, and employed less effective coping strategies in their efforts to manage stressful events. When the potential impact of a stressful event was ambiguous, recurrent headache sufferers appraised this event more negatively and themselves as having less control over the event than did headache‐free controls. In their coping efforts, recurrent tension headache sufferers also placed greater reliance on the relatively ineffective coping strategies of avoidance and self‐blame, and made less use of social support than did controls. These findings suggest that research on the role of stress in tensionheadaches should focus not on the occurrence of major stressful life events, but on the recurrent headache sufferer's cognitive appraisals of stressful events and efforts to cope with stress.

This study examined whether Antonovsky's (1987) stress-resistance construct, sense of coherence (SOC), affected individuals' psychological and/or physiological responses to a controlled stressful situation. Subjects were assessed for SOC level and then completed a battery of questionnaires before and after a stressful situation. Physiological responses were monitored during baseline, anticipation, and recovery periods. Analyses examined differences among low, middle, and high SOC groups and revealed group differences in psychological distress, cognitive appraisal, coping processes, and pulse rate. These results provide some support for the validity and utility of Antonovsky's SOC construct by indicating that low SOC subjects show more distress and appraise and cope with stressful situations in ways less likely to resolve or eliminate their distress.

Face-to-face interviews conducted by AI community members are an effective means of gathering health information about AIs living in rural, reservation communities. AIs living in these communities on the northern plains have a much higher prevalence of many health-risk behaviors and some medical conditions than are found in the general population. Improved health-care access, better preventive screenings, and culturally appropriate community-based health promotion programs and policies should be examined as possible ways to reduce health disparities.