Melissa A Day1, Beverly E Thorn, L Charles Ward, Nancy Rubin, Steven D Hickman, Forrest Scogin, Gary R Kilgo. 1. *Department of Psychology, University of Alabama †Psychology Service, V.A. Medical Center ‡Department of Psychiatry and Behavioral Medicine, The University of Alabama School of Medicine, Tuscaloosa ∥The Kilgo Headache Clinic, Northport, AL §UC San Diego Center for Mindfulness, San Diego, CA.
Abstract
OBJECTIVE: This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes. MATERIALS AND METHODS: RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24). RESULTS: Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24). DISCUSSION: This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.
RCT Entities:
OBJECTIVE: This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes. MATERIALS AND METHODS: RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24). RESULTS:Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24). DISCUSSION: This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.
Authors: Elizabeth K Seng; Alexandra B Singer; Christopher Metts; Amy S Grinberg; Zarine S Patel; Maya Marzouk; Lauren Rosenberg; Melissa Day; Mia T Minen; Richard B Lipton; Dawn C Buse Journal: Headache Date: 2019-09-26 Impact factor: 5.887
Authors: Rhonda M Williams; Dawn M Ehde; Melissa Day; Aaron P Turner; Shahin Hakimian; Kevin Gertz; Marcia Ciol; Alisha McCall; Carrie Kincaid; Mark W Pettet; David Patterson; Pradeep Suri; Mark P Jensen Journal: Contemp Clin Trials Date: 2020-01-09 Impact factor: 2.226
Authors: Rebecca Erwin Wells; Elizabeth K Seng; Robert R Edwards; David E Victorson; Charles R Pierce; Lauren Rosenberg; Vitaly Napadow; Zev Schuman-Olivier Journal: Expert Rev Neurother Date: 2020-02-12 Impact factor: 4.618
Authors: Marasha de Jong; Frenk Peeters; Tim Gard; Heidi Ashih; Jim Doorley; Rosemary Walker; Laurie Rhoades; Ronald J Kulich; Karsten D Kueppenbender; Jonathan E Alpert; Elizabeth A Hoge; Willoughby B Britton; Sara W Lazar; Maurizio Fava; David Mischoulon Journal: J Clin Psychiatry Date: 2018 Jan/Feb Impact factor: 4.384