Long‐Term Effects of Training in Relaxation and Stress‐Coping in Patients with Migraine: A 3‐Year Follow‐Up

Abstract

Research on the short-term effects of psychological interventions in migraine indicates improvement rates of 50 percent. Yet long-term follow-ups are scarce: the studies extending to three years provide evidence for the maintenance of effects, but these studies evaluate the benefits of rather complex psychological treatments and the samples include other types of headache. We compared the effects of single-method psychological interventions upon migraine. The study reports results obtained from 24 patients three years after completion of relaxation training, which is a psychophysiological regimen, and stress-coping training, which is a cognitive-behavioral regimen. Results for the complete sample, excluding data biased by confounding factors, provide clear evidence of the preservation of effects in migraine. Relaxation training (RT) and stress-coping training (SCT) were equally effective and both groups exhibited little medication consumption since completion of training. Among the secondary effects, SCT was found to improve assertiveness and active problem solving, and to decrease depressive reaction. The study yielded two predictor variables--little external stress for relaxation training, and high self motivation for stress-coping training--that accounted for more than 50 percent of the effect variance in the respective groups. Although more research is needed to substantiate our findings, the results suggest that, thus far, there is little reason to favor multimodal training or more complex psychological treatments over single-method psychological interventions in migraine. Also, our results do not support the assumed superiority of cognitive-behavioral treatment over psychophysiological treatment. Research on factors predicting long-term effects of psychological interventions in migraine may profit from considering separate variables on skill rehearsal and skill employment (instead of employing a global measure of home practice), and from a measure for post-training external stress.

Long-term follow-up of home-based behavioral management training provided by migraine patients

“…The strength of the present follow-up study is the length of the follow-up period. Research has shown that traditional vis-à-vis behavioral therapies are effective in the long term (35). To the best of our knowledge no study has examined the maintenance of effects of a behavioral management training provided by migraine patients at two to four years’ follow-up.…”

Long-term follow-up of home-based behavioral management training provided by migraine patients

“…The strength of the present follow-up study is the length of the follow-up period. Research has shown that traditional vis-à-vis behavioral therapies are effective in the long term (35). To the best of our knowledge no study has examined the maintenance of effects of a behavioral management training provided by migraine patients at two to four years’ follow-up.…”

Behavioural Medicine: The Application of Behaviour Therapy to Physical Health

“…Numerous studies have shown that relaxation training, similar to or even simpler than that used for hypertension, has marked and persistent effects on headache. In addition to the meta-analyses already mentioned, important individual studies have shown that relaxation is more effective than a medication placebo (Cox, Freundlich and Meyer, 1975) and self-relaxation (Haynes, Griffin, Mooney and Parise, 1975) and is as effective as more elaborate stress management (Sorbi, Tellegen and Du Long, 1989). The latter also found that the effects of both treatments held up well over a three year follow up.…”

The Canadian Migraine Forum

“…23 These data are consistent with an Italian study which showed a greater reduced of HRQoL in patients with chronic daily headache as compared to those with episodic migraine. 24 A 2005 Canadian population based study 4 confirmed that migraine causes significant disability in the general population. When 300 individuals with migraine were asked to estimate on how many days their migraines incapacitated them, including missed work days, difficulty doing housework and/or caring for children, the average number of days given equated to 21 days per year of total or partial incapacitation.…”

“…Its prevalence exceeds that of osteoarthritis, diabetes, and asthma, and is greater than the combined prevalence of epilepsy, multiple sclerosis, stroke, and Parkinson's disease. In Canada, the lifetime migraine prevalence in women was found to be 23 % in 1992, 2 24.9% in 1994, 3 and 26% in 2006. 4 In men, migraine lifetime prevalence was found to be 10% in 1992, 2 and 7.8% in 1994.…”

Long-term follow-up of home-based behavioral management training provided by migraine patients

“…The strength of the present follow-up study is the length of the follow-up period. Research has shown that traditional vis-à-vis behavioral therapies are effective in the long term (35). To the best of our knowledge no study has examined the maintenance of effects of a behavioral management training provided by migraine patients at two to four years’ follow-up.…”

Behavioural Medicine: The Application of Behaviour Therapy to Physical Health

“…Numerous studies have shown that relaxation training, similar to or even simpler than that used for hypertension, has marked and persistent effects on headache. In addition to the meta-analyses already mentioned, important individual studies have shown that relaxation is more effective than a medication placebo (Cox, Freundlich and Meyer, 1975) and self-relaxation (Haynes, Griffin, Mooney and Parise, 1975) and is as effective as more elaborate stress management (Sorbi, Tellegen and Du Long, 1989). The latter also found that the effects of both treatments held up well over a three year follow up.…”

The Canadian Migraine Forum

“…23 These data are consistent with an Italian study which showed a greater reduced of HRQoL in patients with chronic daily headache as compared to those with episodic migraine. 24 A 2005 Canadian population based study 4 confirmed that migraine causes significant disability in the general population. When 300 individuals with migraine were asked to estimate on how many days their migraines incapacitated them, including missed work days, difficulty doing housework and/or caring for children, the average number of days given equated to 21 days per year of total or partial incapacitation.…”

“…Its prevalence exceeds that of osteoarthritis, diabetes, and asthma, and is greater than the combined prevalence of epilepsy, multiple sclerosis, stroke, and Parkinson's disease. In Canada, the lifetime migraine prevalence in women was found to be 23 % in 1992, 2 24.9% in 1994, 3 and 26% in 2006. 4 In men, migraine lifetime prevalence was found to be 10% in 1992, 2 and 7.8% in 1994.…”

Long-term follow-up of home-based behavioral management training provided by migraine patients

“…The strength of the present follow-up study is the length of the follow-up period. Research has shown that traditional vis-à-vis behavioral therapies are effective in the long term (35). To the best of our knowledge no study has examined the maintenance of effects of a behavioral management training provided by migraine patients at two to four years’ follow-up.…”

Behavioural Medicine: The Application of Behaviour Therapy to Physical Health

“…Numerous studies have shown that relaxation training, similar to or even simpler than that used for hypertension, has marked and persistent effects on headache. In addition to the meta-analyses already mentioned, important individual studies have shown that relaxation is more effective than a medication placebo (Cox, Freundlich and Meyer, 1975) and self-relaxation (Haynes, Griffin, Mooney and Parise, 1975) and is as effective as more elaborate stress management (Sorbi, Tellegen and Du Long, 1989). The latter also found that the effects of both treatments held up well over a three year follow up.…”

The Canadian Migraine Forum

“…23 These data are consistent with an Italian study which showed a greater reduced of HRQoL in patients with chronic daily headache as compared to those with episodic migraine. 24 A 2005 Canadian population based study 4 confirmed that migraine causes significant disability in the general population. When 300 individuals with migraine were asked to estimate on how many days their migraines incapacitated them, including missed work days, difficulty doing housework and/or caring for children, the average number of days given equated to 21 days per year of total or partial incapacitation.…”

“…Its prevalence exceeds that of osteoarthritis, diabetes, and asthma, and is greater than the combined prevalence of epilepsy, multiple sclerosis, stroke, and Parkinson's disease. In Canada, the lifetime migraine prevalence in women was found to be 23 % in 1992, 2 24.9% in 1994, 3 and 26% in 2006. 4 In men, migraine lifetime prevalence was found to be 10% in 1992, 2 and 7.8% in 1994.…”