Home- versus clinic-based treatment of vascular headache.

Contrasted the efficacy of a traditional clinic-based relaxation training and thermal biofeedback treatment to a comparable home-based program with minimal therapist contact in the treatment of 40 vascular-headache sufferers (mean age 37 yrs). The home-based condition was at least as efficacious as the clinic-based treatment in terms of reduction of headache intensity and frequency and medication usage, and was clearly more cost-effective. Findings suggest that a minimal-therapist-contact condition may be a viable, low-cost alternative to more expensive clinic-based programs in the treatment of vascular headache. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of behavioral and pharmacological treatment on smokeless tobacco users.

The purpose of this study was to examine the effects of 2 mg of nicotine polacrilex versus placebo gum and of group behavioral treatment versus minimal contact on cessation of smokeless tobacco use. Participants (N?=?210) were randomly assigned 1 of the 4 treatment conditions. Withdrawal symptoms were assessed throughout the treatment. Follow-up assessments were made at 1, 6, and 12 months posttreatment. Survival curve analysis showed that any of the 3 treatment groups involving group behavioral therapy or placebo gum were equally effective and superior to the minimal contact plus 2 mg of nicotine gum treatment in terms of abstinence. On the other hand, withdrawal symptoms were significantly reduced by nicotine gum, compared with placebo during the initial phases of cessation. The ineffectiveness of nicotine gum on treatment outcome may be attributed to its similarity with smokeless tobacco. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-hypnosis versus heterohypnosis: Experiential and behavioral comparisons.

In a study of experiential and behavioral differences between autohypnosis and heterohypnosis, standard group autohypnotic and heterohypnotic experiences were administered to 48 college students in counter-balanced order. Self-report measures of behavioral and subjective responses were obtained for each experience, and the total scores were compared. The experiential scores were also factor analyzed for each type of hypnosis. Behavioral total scores were comparable. Inexperienced Ss were as able to hypnotize themselves as to be hypnotized by another. Scores on "challenge" items were also comparable, whereas items suggesting positive actions showed greater variability. Factor analyses showed that the subjective experiences were generally similar. Heterohypnosis evoked more feelings of unawareness, passivity, and loss of control. Self-hypnosis elicited more feelings of time distortion, disorientation, active direction and trance variability. Conclusions are drawn that the procedures labeled self-hypnosis and heterohypnosis are indeed similar in most behavioral and phenomenological effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of cotherapists versus single therapists and immediate versus delayed treatment in behavioral marital therapy.

Evaluated the overall effectiveness of behavioral marital therapy (BMT) in aiding distressed couples, and explored the relative effectiveness of (a) cotherapists vs single therapists and (b) immediate treatment vs delayed treatment, which resulted from placing couples on a waiting list. 30 maritally distressed couples (aged 19–59 yrs) were randomly assigned to 1 of 6 treatment conditions, with 5 couples per condition: (a) immediate treatment by Therapist A; (b) immediate treatment by Therapist B; (c) immediate treatment by Therapists A and B as a cotherapy team; (d) delayed treatment by Therapist A; (e) delayed treatment by Therapist B; or (f) delayed treatment by Therapists A and B as a cotherapy team. Ss were administered a battery of tests that included the Marital Adjustment Test and Areas-of-Change Questionnaire. Results indicate that BMT was more effective than no treatment on both self-report measures and 1 of 2 behavioral measures, thus affirming the overall effectiveness of the treatment. A cotherapy team and single therapists were equally effective in producing treatment changes. In addition, overall there were no significant differences between couples receiving therapy immediately and couples treated after a 10-wk waiting period. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modeling the effects of combined behavioral and pharmacological treatment on cigarette smoking: behavioral-economic analyses

Effects of different response requirements, response-independent cigarette puffs, and an alternative nondrug reinforcer on cigarette smoking were assessed in 2 experiments. The response requirement to obtain 2 puffs on a cigarette was manipulated while various numbers of response-independent puffs were provided (0, 6, or 12 in Experiment 1; 0 or 12 in Experiment 2). In Experiment 2, effects of response-dependent money ($0.25) on smoking were assessed within subjects. Response-dependent puff consumption decreased as price increased and as the number of response-independent puffs increased. Concurrently available money also decreased response-dependent smoking. The largest decrease in smoking occurred when puffs were at the highest price and when response-independent puffs and response-dependent money were both concurrently available. Findings suggest that combined pharmacological and behavioral interventions produce the greatest reductions in smoking.     

A battle of wills: Self-verification versus behavioral confirmation.

Investigated whose viewpoint triumphs when a perceiver forms an expectancy about a target individual that is discrepant with that target's self-conception. Although research on behavioral confirmation argues that perceivers will "win" by causing targets to confirm the expectancy, research on self-verification argues that targets will win by bringing perceivers to treat them in a manner that confirms their self-conceptions. In the present study with 128 undergraduate women, perceivers first formed relatively certain or uncertain expectancies about targets that were inconsistent with targets' self-conceptions. They then interacted with targets, who possessed relatively certain or uncertain self-conceptions, in a series of 3 successive interview sessions. Analyses of the behavior of targets indicated that self-verification always occurred when targets were certain of their self-conceptions. Self-verification also tended to occur when both perceivers and targets were uncertain of their beliefs. Behavioral confirmation tended to occur only when perceivers were certain of their expectancies and targets were uncertain of their self-conceptions. At the end of the experiment, perceivers had generally abandoned their expectancies, but targets revealed no self-rating change. (67 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiological outcome of behavioral and pharmacological treatments of agoraphobia.

62 severe and chronic agoraphobics (aged 18–65 yrs) participated in a 2?×?2 factorial investigation of the relative and combined effectiveness of behavior therapy (prolonged in vivo exposure) and pharmacotherapy (imipramine). Treatment was conducted in 12 weekly sessions. Imipramine or placebo was administered in 25-mg tablets at bed time, with 25-mg increases every 2nd day until the maximum tolerable amount was achieved. Tripartite assessments were conducted at pretreatment and at 4 wks, 8 wks, 12 wks, and 1-mo posttreatment. Differential temporal response and treatment patterns were identified across the psychophysiological domains. Ss receiving medication showed equivocal patterns of positive and negative responses. Decreases in arousal were noted with Ss who received prolonged exposure. Synchrony/desynchrony phenomena yielded significant findings with regard to both process and clinical outcome status. Exploratory analyses were performed to identify potential mediating factors in physiological outcome, and a psychophysiological comparison was also undertaken contrasting agoraphobics prior to and following treatment with normative (nonphobic) cohorts. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new type of headache of ocular origin: ophthalmotonic headache. Diagnosis and treatment

INTRODUCTION: In some patients it was seen that chronic headaches disappeared after laser iridectomies had been done to prevent glaucoma, in persons with normal intra-ocular pressure (IOP). OBJECTIVE: To make a study of patients with headache, some of whom were treated with topical beta-blockers (carteolol) and others by Yag-laser iridectomies. The effect on headache and IOP was analyzed. MATERIAL AND METHODS: A survey, ophthalmological examination and headache provocation test were carried out in patients with headaches, and the changes in IOP determined by pharmacologically inducing miosis and mydriasis were recorded. Three treatment groups were formed and the results analyzed statistically. RESULTS: In the 12 patients treated pharmacologically, 62% improved and in 14% the headaches disappeared. In the 16 treated using laser 94% were cured and 6% improved. When both types of treatment were used on 9 patients, 22% improved and 78% were cured. The validity of the ocular pressure curve was checked in the diagnosis of blockage of the pupil. CONCLUSIONS: Some headaches of ocular origin (ophthalmotonic), not previously described, occur due to abrupt changes in intraocular pressure, and improve significantly when the IOP is reduced by beta-blockers or Yag-laser iridectomies are done. A valid provocation tests for diagnosis of this type of headache is described. We consider that blockage of the pupil and/or of the angle of the anterior chamber are possible etiopathogenic mechanisms.     

Direction of temperature control in the thermal biofeedback treatment of vascular headache

In order to test for the specific therapeutic effects of thermal biofeedback (TBF) for hand warming on vascular headache (HA), 70 patients with chronic vascular HA were randomly assigned to TBF for hand warming, TBF for hand cooling, TBF for stabilization of hand temperature, or biofeedback to suppress alpha in the EEG. Patients in each condition initially had high levels of expectation of therapeutic benefit and found the treatment rationales highly credible. Participants in each condition received 12 treatment sessions on a twice-per-week basis. Based on daily HA diary data gathered for 4 weeks prior to treatment and 4 weeks after treatment, HA Index was significantly (p = .003) reduced as was HA medication consumption. There were no differential reductions in HA Index or Medication Index among the four conditions. Global self-reports of improvement gathered at the end of the post-treatment monitoring period also did not differ among the four conditions. We were unable to demonstrate a specific effect of TBF for hand warming on vascular HA activity.     

Characterological versus behavioral self-blame: Inquiries into depression and rape.

Distinguishes 2 types of self-blame—behavioral and characterological. Behavioral self-blame is control related, involves attributions to a modifiable source (one's behavior), and is associated with a belief in the future avoidance of a negative outcome. Characterological self-blame is esteem related, involves attributions to a relatively nonmodifiable source (one's character), and is associated with a belief in personal deservingness for past negative outcomes. Two studies are reported that bear on this self-blame distinction. In the 1st study, with 120 female college students, it was found that depressed Ss engaged in more characterological self-blame than nondepressed Ss, whereas behavioral self-blame did not differ between groups; depressed Ss were also characterized by greater attributions to chance and decreased beliefs in personal control. Characterological self-blame is proposed as a possible solution to the "paradox in depression." In a 2nd study, 38 rape crisis centers were surveyed. Behavioral self-blame, and not characterological self-blame, emerged as the most common response of rape victims to their victimization, suggesting the victim's desire to maintain a belief in control, particularly the belief in the future avoidability of rape. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological treatment of benign headache disorders.

Information on the efficacy of psychological treatments of chronic benign headache (HA) disorders is selectively reviewed. Strong consistent evidence for efficacy is found, and the HA relief apparently persists for up to 5 yrs. Little information is available on cost-effectiveness, although largely homebased treatments with limited therapist contact have been shown to be efficacious. The limited number of comparisons of drug therapies to psychological therapies have yielded mixed results; more systematic research is needed. The side effects of psychological treatments are generally positive (reduction in negative affect). Research has begun to identify subpopulations of HA sufferers who are relatively refractory to psychological treatments, and in some instances newer treatment regimens have solved some of the problems of refractory groups (e.g., HA in the elderly). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological treatment of benign headache disorders.

Presents a selective summarization and critique of research on the psychological treatment of headache, with the primary focus on research appearing since 1980. Suggestions for future research directions and methodological improvements are included. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive versus behavioral–interpersonal approaches to the group treatment of depressed college students.

Treated matched groups of 38 depressed undergraduates by behavioral–interpersonal (B–I) and cognitive treatments, each under 2 conditions. Both kinds of treatment proved more effective than no treatment, with some evidence of superiority of the B–I approach. The group treated by the B–I method under intensive conditions made the greatest absolute gains on self-report measures of depression (e.g., Zung Self-Rating Depression Scale) and also became the most interpersonally skillful. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distinctiveness of behavioral versus insight-oriented marital therapy: An empirical analysis.

The present study determined whether behavioral and insight-oriented marital therapy could be rendered in a distinct and uncontaminated fashion in manual-guided outcome research in which therapists were crossed with treatment condition. Results indicated that therapist interventions could be reliably coded into techniques specific to the respective approaches and into additional interventions not specific to either treatment modality. When provided with explicit treatment manuals and ongoing case supervision, therapists were able to administer both treatment conditions faithfully without contamination from techniques that were inconsistent with that theoretical approach. Behavioral marital therapy (BMT) was shown to be highly structured, with 93% of therapist interventions reflecting techniques specific to that approach. In contrast, insight-oriented marital therapy (IOMT) comprised a large percentage of nonspecific interventions (62%) compatible with but not unique to a psychodynamic orientation. Implications for the two treatment approaches and for future marital therapy outcome research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative effectiveness of behavioral versus nonbehavioral child psychotherapy.

Some researchers have concluded that, for children and adolescents, behavioral interventions may be more effective than nonbehavioral interventions. Other researchers, however, have proposed artifactual hypotheses for the apparent superiority of behavioral treatments. In this study, one such hypothesis was evaluated: that the apparent superiority of behavioral interventions among children is due to differences in the methodological quality of studies of behavioral and nonbehavioral treatments. Meta-analytic results reported in this article found little support for this hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive–behavioral treatment for depression: Relapse prevention.

This study presents 2-year follow-up data of a comparison between complete cognitive–behavioral therapy for depression (CT) and its 2 major components: behavioral activation and behavioral activation with automatic thought modification. Data are reported on 137 participants who were randomly assigned to 1 of these 3 treatments for up to 20 sessions with experienced cognitive–behavioral therapists. Long-term effects of the therapy were evaluated through relapse rates, number of asymptomatic or minimally symptomatic weeks, and survival times at 6-, 12-, 18-, and 24-month follow-ups. CT was no more effective than its components in preventing relapse. Both clinical and theoretical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological versus pharmacological treatments of bulimia nervosa: Predictors and processes of change.

This article extends the acute outcome findings from a study comparing psychological and pharmacological interventions for bulimia nervosa (B. T. Walsh et al., 1997) by examining 3 additional domains: predictive factors, therapeutic alliance, and time course of change. One hundred twenty women were randomized to cognitive-behavioral therapy (CBT), supportive psychotherapy (SPT) plus antidepressant medication or a placebo, or a medication-alone condition. Results indicate that high baseline frequencies of binge eating and vomiting, as well as a positive history of substance abuse or dependence, are negative prognostic indicators. Although a greater overall therapeutic alliance may increase the likelihood of remission, symptom change over the course of treatment may have as much of an impact on patient ratings of alliance as the reverse. CBT was significantly more rapid than SPT in reducing binge eating and vomiting frequencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failure to complete treatment for headache: A multiple regression analysis.

Used a hierarchical multiple regression analysis to predict the number of sessions completed by 90 patients in a headache-treatment program. Demographic variables accounted for 18% of the variance (p?p?     

Outpatient behavioral treatment for cocaine dependence: One-year outcome.

This article describes outcomes observed during the year after treatment entry from two controlled trials in which cocaine-dependent outpatients were randomly assigned to either a multicomponent behavioral treatment or to one of two control treatments. The behavioral treatment integrated the community reinforcement approach (CRA) with an incentive program in which cocaine abstinence was reinforced with vouchers exchangeable for retail items. The two control treatments were drug abuse counseling and CRA without the incentive program. All treatment groups improved significantly compared to intake, and those changes were maintained through the follow-up period. When efficacy differences were observed during treatment and follow-up, they supported CRA with vouchers over control treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)