PAIN
Volume 143, Issue 3 , Pages 213-222 , June 2009

Moderation and mediation in the psychological and drug treatment of chronic tension-type headache: The role of disorder severity and psychiatric comorbidity

  • Kenneth A. Holroyd

      Affiliations

    • Psychology Department, Ohio University, 200 Porter Hall, Athens, OH 45701-2979, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 740 593 1060; fax: +1 740 593 0116.
  • ,
  • Jenifer S. Labus

      Affiliations

    • Center for Neurobiology of Stress, Connectivity and Computational Statistics Division, University of California at Los Angeles, USA
  • ,
  • Bruce Carlson

      Affiliations

    • Psychology Department, Ohio University, 200 Porter Hall, Athens, OH 45701-2979, USA

Received 13 October 2008 ,Revised 20 February 2009 ,Accepted 20 February 2009.

References 

  1. Andrasik F, Lipchick G, McCrory D, Wittrock D. Outcome measurement in behavioral headache research: headache parameters and psychosocial outcomes. Headache. 2005;45:429–437
  2. Ashina A, Ashina M. Current and potential future drug therapies for tension-type headache. Curr Pain Head Rep. 2003;7:466–474
  3. Baskin S, Lipchik G, Smitherman T. Mood and anxiety disorders in chronic headache. Headache. 2006;46:S76–S87
  4. Beck AT. Cognitive approaches to stress. In:  Lehrer PM,  Woolfolk RL editor. Principles and practice of stress management. New York: The Guilford Press; 1993;p. 333–371
  5. Bendtsen L, Mathew N. Prophylactic pharmacotherapy of tension-type headache. In:  Olesen J,  Goadsby P,  Ramadan N,  Tfelt-Hansen P,  Welch K editor. The headaches. Philadelphia: Lippincott Williams & Wilkins; 2006;p. 735–741
  6. Bernstein D, Borkovec T, Hazlett-Stevens H. New directions in progressive relaxation training: a guidebook for helping professions. Westport, CT: Praeger Publishers; 2000;
  7. Blanchard E, Andrasik F. Management of chronic headaches: a psychological approach. Elmsford, NY: Pergamon Press; 1985;
  8. Blanchard E, Hillhouse J, Appelbaum K, Jaccard J. What is an adequate length of baseline in research and clinical practice with chronic headache. Appl Psychophysiol Biofeedback. 1987;12:323–329
  9. Blanchard EB. Psychological treatment of benign headache disorders. J Consult Clin Psychol. 1992;60:537–551
  10. Blanchard EB, Kim M, Hermann CU, Steffek BD. Preliminary results of the effects on headache relief of perception of success among tension headache patients receiving relaxation. Headache Q. 1993;4:249–253
  11. Blanchard EB, Applebaum KA, Radnitz CL, Michultka D, Morrill B, Kirsch C, et al. Placebo-controlled evaluation of abbreviated progressive muscle relaxation and of relaxation combined with cognitive therapy in the treatment of tension headache. J Consult Clin Psychol. 1990;58:210–215
  12. Borkum J. Chronic headaches: biology, psychology and behavioral treatment. Hillsdale, New Jersey: Laurence Erlbaum; 2007;
  13. Cerbo R, Barbanti P, Fabbrini G. Amitriptyline in tension-type headache prophylaxis. Headache. 1998;38:453–457
  14. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988;
  15. Couch J. Medical management of recurrent tension-type headache. In:  Tollison C,  Kunkel R editor. Headache diagnosis and treatment. Baltimore: Williams & Wilkins; 1993;p. 151–162
  16. D’Zurilla TJ. Problem-solving training for effective stress management and prevention. J Cogn Psychother. 1990;4:327–354
  17. D’Zurilla TJ, Nezu AM. Problem-solving therapy: a positive approach to clinical intervention. 3rd ed.. New York, NY: Springer Publishing Co.; 2006;
  18. Diamond S, Baltes BJ. Chronic tension headache treated with amitriptyline – a double blind study. Headache. 1971;11:110–116
  19. Ernst E. Towards a scientific understanding of placebo effects. In:  Peters D editors. Understanding the placebo effect in complementary medicine. London (UK): Harcourt; 2001;p. 17–30
  20. Frank E, Kupfer DJ. Does a placebo tablet affect psychotherapeutic outcome? Results from the Pittsburgh study of maintenance therapies in recurrent depression. Psychother Res. 1992;2:102–111
  21. French DJ, Holroyd KA, Pinnell C, Malinoski PT, ODonnell FJ, Hill KR. Perceived self-efficacy and headache-related disability. Headache. 2000;40:647–656
  22. Gadbury G, Coffey C, Allison D. Modern statistical methods for handling missing data. Obes Rev. 2003;4:175–184
  23. Hatcher R, Gillaspy J. Development and validation of a revised short version of the Working Alliance Inventory. Psychother Res. 2006;16:12–25
  24. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd ed. Cephalalgia 2004;24:9–160.
  25. Heckman B, Holroyd K. Tension-type headache and psychiatric comorbidity. Curr Pain Headache Rep. 2006;10:439–447
  26. Hollon SD, DeRubeis J. Placebo-psychotherapy combinations: inappropriate representations of psychotherapy in drug-psychotherapy comparative trials. Psychol Bull. 1981;90:467–477
  27. Holroyd K. Behavioral and psychologic aspects of the pathophysiology and management of tension-type headache. Curr Pain Headache Rep. 2002;6:401–407
  28. Holroyd K, Lipchik G, Penzien D. Psychological management of recurrent headache disorders: empirical basis for clinical practice. In:  Dobson K,  Craig K editor. Best practice: developing and promoting empirically supported interventions. Newbury Park, CA: Sage; 1998;p. 193–212
  29. Holroyd K, Martin P, Nash J. Psychological treatments of tension-type headaches. In:  Olesen J,  Goadsby P,  Ramadan N,  Tfelt-Hansen P,  Welch K editor. The headaches. Philadelphia: Lippincott Williams & Wilkins; 2006;p. 711–720
  30. Holroyd K, French D, Nash J, Tobin D, Echelberger-McCune R. Stress management for tension headaches: a treatment program for controlling headaches. Athens, OH: Ohio University Headache Project; 1995;
  31. Holroyd K, Drew J, Cottrell C, Romanek K, Heh V. Impaired functioning and quality of life in severe migraine: the role of catastrophizing and associated symptoms. Cephalalgia. 2007;27:1156–1165
  32. Holroyd K, Penzien D, Rains J, Lipchik G, Buse D. Behavioral management of headaches. In:  Silberstein S,  Lipton R,  Dodick D editor. Wolff’s headache and other head pain. New York, NY: Oxford University Press; 2008;p. 721–746
  33. Holroyd K, Stensland M, Lipchik G, Hill K, O’Donnell F, Cordingley G. Psychosocial correlates and impact of chronic tension-type headaches. Headache. 2000;40:3–16
  34. Holroyd KA. Assessment and psychological treatment of recurrent headache disorders. J Consult Clin Psychol. 2002;70:656–677
  35. Holroyd KA, Penzien D. EMG biofeedback and tension headache: therapeutic mechanisms. In:  Holroyd K,  Schlote B,  Zenz H editor. Perspectives in research on headache. Toronto: Hogrefe; 1983;p. 147–162
  36. Holroyd KA, Malinoski P, Davis MK, Lipchik GL. The three dimensions of headache impact: pain, disability and affective distress. Pain. 1999;83:571–578
  37. Holroyd KA, O’Donnell FJ, Stensland M, Lipchik GL, Cordingley GE, Carlson B. Management of chronic tension-type headache with tricyclic antidepressant medication, stress-management therapy, and their combination: a randomized controlled trial. JAMA. 2001;285:2208–2215
  38. Holroyd KA, Penzien DB, Hursey K, Tobin D, Rogers L, Holm J, et al. Change mechanisms in EMG biofeedback training: cognitive changes underlying improvements in tension headache. J Consult Clin Psychol. 1984;52:1039–1053
  39. Hro’bjartsson A. What are the main methodological problems in the estimation of placebo effects?. J Clin Epidemiol. 2002;55:
  40. Hro’bjartsson A, Gotzsche P. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. N Engl J Med. 2001;344:1594–1601
  41. Hro’bjartsson A, Gotzsche P. Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment. J Int Med. 2004;256:91–100
  42. Jacobson GP, Ramadan NM, Aggarwal SK, Newman CW. The Henry Ford Hospital Headache Disability Inventory (HDI). Neurology. 1994;44:837–842
  43. Jacobson GP, Ramadan NM, Norris L, Newman CW. Headache Disability Inventory (HDI): short-term test-retest reliability and spouse perceptions. Headache. 1995;35:534–539
  44. Jensen MP, Turner JA, Romano JM. Changes in beliefs, catastrophizing and coping are associated with improvement in multidisciplinary pain treatment. J Consult Clin Psychol. 2001;69:655–662
  45. Jensen R, Sandrini G. Symptomatology of chronic tension-type headache. In:  Olesen J,  Tfelt-Hansen P,  Welch K editor. The headaches. Philadelphia: Lippincott Williams & Wilkins; 2000;p. 627–634
  46. Jensen R, Symon D. Epidemiology of tension-type headaches. In:  Olesen J,  Goadsby P,  Ramadan N,  Tfelt-Hansen P,  Welch K editor. The headaches. Philadelphia: Lippincott WIlliams & Wilkins; 2006;p. 621–624
  47. Kaptchuk T, Kelley J, Deykin A, Wayne P, Lasagna L, Epstein I, et al. Do placebo responders exist?. Contemp Clin Trials. 2008;29:587–595
  48. Kenny D, Calsyn R, Morse G, Klinkenberg W, Winter J, Trusty M. Evaluation of treatment programs for persons with severe mental illness: moderator and mediator effects. Eval Rev. 2004;28:294–324
  49. Kraemer H, Wilson G, Fairburn C, Agras W. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002;59:877–883
  50. Kunkel RS. Diagnosis and treatment of muscle contraction (tension-type) headaches. Med Clin North Am. 1991;75:595–603
  51. Lake A, Rains J, Penzien D, Lipchik G. Headache and psychiatric comorbidity: historical context, clinical implications, and research relevance. Headache. 2005;45:493–506
  52. Lenaerts M, Newman L. Tension-type headache. Wolff’s headache and other head pain. New York, NY: Oxford University Press; 2008;p. 293–314
  53. Linde K, Witt C, Streng A, Weidenhammer W, Wagenpfeil S, Brinkhaus B, et al. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain. 2007;128:264–271
  54. Lipchik G, Holroyd K, Nash J. Cognitive-behavioral management of recurrent headache disorders: a minimal-therapist contact approach. In:  Turk DC,  Gatchel RS editor. Psychological approaches to pain management. New York, NY: Guilford Press; 2002;p. 356–389
  55. Lipchik GL, Smitherman TA, Penzien DB, Holroyd KA. Basic principles and techniques of cognitive-behavioral therapies for comorbid psychiatric symptoms among headache patients. Headache. 2006;46:S119–S132
  56. MacKinnon D, Lockwood C, Hoffman J. A comparison of methods to test mediation and other intervening variable effects. Psychol Methods. 2002;7:83–104
  57. MacKinnon D, Fairchild A, Fritz M. Mediation analysis. Annu Rev Psychol. 2007;58:593–614
  58. MacKinnon D, Fairchild A, Fritz M. Introduction to statistical mediation analysis. Mahwah, NJ: Erlbaum; 2008;
  59. Mallinckrodt C, Watkin J, Molenberghs G, Carroll R. Choice of the primary analysis in longitudinal clinical trials. Pharm Statist. 2004;3:161–169
  60. Martin NJ, Holroyd KA, Penzien DB. The headache-specific locus of control scale: adaptation to recurrent headaches. Headache. 1990;30:729–734
  61. Mathew N, Bendtsen L. Prophylactic pharmacotherapy of tension-type headache. In:  Olesen J,  Tfelt-Hansen P,  Welch K editor. The headaches. Philadelphia: Lippincott Williams & Wilkins; 2000;p. 667–674
  62. Mitsikostas D, Thomas A. Comorbidity of headache and depressive disorders. Cephalalgia. 1999;19:211–217
  63. Molenberghs G, Thijs H, Jansen I, Beunckens C. Analyzing incomplete longitudinal clinical trial data. Biostatistics. 2004;5:445–464
  64. Nicholson RA, Hursey RG, Nash JM. Moderators and mediators of behavioral treatment for headache. Headache. 2005;45:513–519
  65. Penzien D, Rains J, Andrasik F. Behavioral management of recurrent headache: three decades of experience and empiricism. Appl Psychophysiol Biofeedback. 2002;27:163–181
  66. Peveler R, George C, Kinmonth A, Cambell M, Thompson C. Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial. Brit Med J. 1999;319:612–615
  67. Powers M, Smits J, Whitley D, Bystritsky A, Telch M. The effect of attributional processes concerning medication taking on return of fear. J Consult Clin Psychol. 2008;76:478–490
  68. Rains J, Penzien D, Lipchik G. Behavioral facilitation of medical treatment of headache: implications of non-compliance and strategies for improving adherence. Headache. 2006;46:S142–S143
  69. Rifkin W, Ward L. Letter: antidepressant medication for chronic tension type headache. JAMA. 2001;286:1969
  70. Rokicki LA, Holroyd KA, France CR, Lipchik GL, France JL, Kvaal SA. Change mechanisms associated with combined relaxation/EMG biofeedback training for chronic tension headache. Appl Psychophysiol Biofeedback. 1997;22:21–41
  71. Schoenen J, Wang W. Tension-type headache. In:  Goadsby P,  Silberstein S editor. Headache. Boston: Butterworth-Heinemann; 1997;p. 177–200
  72. Shapiro A, Shapiro E. The powerful placebo effect. Baltimore, MA: Johns Hopkins University Press; 1997;
  73. Shrout P, Bolger N. Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods. 2002;7:422–445
  74. Silberstein S, Rosenberg J. Multispecialty consensus on diagnosis and treatment of headache. Neurology. 2000;54:1553–1554
  75. Silberstein S, Lipton R, Goadsby P. Headache in clinical practice. London, England: Martin Dunitz; 2002;
  76. Spitzer AL, Williams JBW, Gibbon M, First MB. Structured clinical interview for DSM-111-R. Washington, D.C.: American Psychiatric Press; 1990;
  77. Spitzer R, Williams J, Kroenke K, Linzer M, deGruy F, Hahn S, et al. Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME MD 1000 study. JAMA. 1994;272:1749–1756
  78. Tein J, Sandler I, MacKinnon D, Wolchik S. How did it work? Who did it work for? Mediation in the context of a moderated prevention effect for children of divorce. J Consult Clin Psychol. 2004;72:617–624
  79. Tobin DL, Holroyd KA, Baker A, Reynolds RVC, Holm JE. Development and clinical trial of a minimal contact, cognitive-behavioral treatment for tension headache. Cogn Ther Res. 1988;12:325–339
  80. Turner J, Deyo R, Loeser D, Von Korff M, Fordyce W. The importance of placebo effect in pain treatment and research. JAMA. 1994;271:1609–1614
  81. Wothke W, Arbuckle J. Full-information missing data analysis with Amos (SPSS White Paper). 1996.

PII: S0304-3959(09)00136-5

doi: 10.1016/j.pain.2009.02.019

PAIN
Volume 143, Issue 3 , Pages 213-222 , June 2009