Acceptance and Commitment Therapy for Primary Headache Sufferers: A Randomized Controlled Trial of Efficacy

Vasiliou, Vasilis; Karademas, Evangelos C.; Christou, Yiolanda; Papacostas, Savvas; Karekla, Maria

doi:10.1016/j.jpain.2020.06.006

Cited by 27 publications

(31 citation statements)

References 71 publications

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“…ACT was shown to reduce the sensory and emotional dimensions of clinical pain in these patients [ 109 ], but not the sensory dimension [ 109 ]. A reduction in pain severity has also been reported [ 99 ]. Migraine-related symptoms, such as depression and disability, were also found to be decreased by ACT [ 103 ].…”

Section: Resultsmentioning

confidence: 91%

“…While 5 studies were uncontrolled clinical trials [ 91 , 92 , 93 , 94 , 95 ], the remaining 16 did have one or more control group/s. Ten studies were performed in Europe (Sweden, United Kingdom, Spain, Denmark, Italy, Greece and Cyprus) [ 96 , 97 , 98 , 99 , 100 ], five in the USA [ 101 , 102 , 103 , 104 , 105 ], four in Iran [ 106 , 107 , 108 , 109 ], one in Canada [ 110 ], and one in Japan [ 111 ]. More details can be found in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The mean age of the subjects was 42.88 years, and there was no significant age difference between participants in the ACT group and those in the control group in any study, with the exceptions of Aghalar et al [ 106 ], in which the ACT group participants were significantly older than controls, and Kamalinejad et al [ 107 ], in which participant ages were not directly reported. Regarding sex, the samples of seven studies were composed entirely of women [ 93 , 95 , 96 , 97 , 100 , 105 , 109 ], while in ten studies there was a clear female predominance (≥80%) [ 10 , 91 , 92 , 98 , 99 , 100 , 103 , 104 , 108 , 111 ]. Finally, four studies did not report information about subject sex [ 94 , 102 , 106 , 107 ].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding emotional variables, ACT seems to reduce affective distress [ 109 ], as well as levels of anxiety and depression [ 99 , 103 , 104 ]. Antidepressant intake did not moderate the effects of the treatment on depression severity at the 3-month follow-up [ 103 ].…”

Section: Resultsmentioning

confidence: 99%

“…With respect to quality of life, ACT has been shown to increase quality of life [ 99 , 103 , 104 ], levels of functioning [ 103 ], psychological well-being and the quality of social relationships [ 104 ], as well as to reduce disability [ 99 , 101 , 103 , 104 ]. Moreover, ACT reduces pain fusion and pain avoidance, and increases adherence to values [ 99 ].…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review

Galvez-Sánchez

Montoro

Moreno-Padilla

et al. 2021

JCM

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Objectives: Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). Methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. Results: The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., “waiting list”) conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. Conclusions: There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review

Galvez-Sánchez

Montoro

Moreno-Padilla

et al. 2021

JCM

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Mechanisms of change in acceptance and commitment therapy for primary headaches

Vasiliou

Karademas

Papacostas

et al. 2021

European Journal of Pain

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Background: Despite the demonstrated effectiveness of behavioural headache interventions, it is not yet known which intervention processes account for treatment responses. Acceptance and commitment therapy (ACT), an emerging behavioural intervention for headaches, proposes psychological flexibility (PF) processes as the mechanisms via which intervention change occurs. This is the first study examining these processes of change variables on headache-related disability and quality of life (treatment outcome). Methods: Data originated from a Randomized Clinical Trial evaluating the efficacy of ACT for primary headaches. Ninety-four individuals with primary headaches (M = 43 y; 84% females; M headache frequency/month = 9.30) were randomized to either an ACT-based or a Wait-list control group (N = 47 in each). Participants completed questionnaires related to their headache experiences and PF processes at pre-(T1), post-treatment (T2), and 3-month follow-up (T3). Results: Following a bootstrapped cross product of coefficients approach, results demonstrated mediating effects of headache acceptance, cognitive defusion, avoidance of headache, and mindfulness in the ACT group compared to control on parameters of headache-related disability and quality of life at post and 3-month follow-ups. Conclusions: These findings demonstrate that changes in certain PF processes lower disability and improve quality of life in headache sufferers, supporting that ACT works via its proposed mechanisms of change. Interventions for headache management may be optimized if they target increases in headache acceptance, defusion from thoughts, and mindfulness. Significance: Psychological flexibility (PF) guides the ACT approach, an emerging behavioral headache intervention that focuses on optimizing head pain adjustment via flexible responses to pain. It targets at increasing daily functioning rather than preventing or controlling headache episodes. Pain acceptance, cognitive defusion, and mindfulness act as processes of functional change in ACT, lowering disability and increasing daily functioning and quality of life. These components can upgrade the established effectiveness of behavioral headache interventions with personalized, modularized therapeutic targets that can help headache sufferers re-establish optimal daily functioning even in fluctuating and persistent headache episodes. Trial registration: clinical trials.gov registry (NCT02734992).

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Psychedelics in the Treatment of Headache and Chronic Pain Disorders

Schindler

2022

Disruptive Psychopharmacology

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Acceptance and Commitment Therapy for Primary Headache Sufferers: A Randomized Controlled Trial of Efficacy

Cited by 27 publications

References 71 publications

Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review

Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review

Mechanisms of change in acceptance and commitment therapy for primary headaches

Psychedelics in the Treatment of Headache and Chronic Pain Disorders

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