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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2010

01-12-2010 | Original Article

Dynamics of Changes in Self-Efficacy and Locus of Control Expectancies in the Behavioral and Drug Treatment of Severe Migraine

Authors: Elizabeth K. Seng, M.S., Kenneth A. Holroyd, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 3/2010

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Abstract

Background

Modification of expectancies (headache self-efficacy and headache locus of control) is thought to be central to the success of psychological treatments for migraine.

Purpose

The purpose of this study is to examine expectancy changes with various combinations of Behavioral Migraine Management and migraine drug therapies.

Methods

Frequent migraine sufferers who failed to respond to 5 weeks of optimized acute migraine drug therapy were randomized to a 2 (Behavioral Migraine Management+, Behavioral Migraine Management−) × 2 (β-blocker, placebo) treatment design.

Results

Mixed models for repeated measures analyses (N = 176) revealed large increases in headache self-efficacy and internal headache locus of control and large decreases in chance headache locus of control with Behavioral Migraine Management+ that were maintained over a 12-month evaluation period. Chance headache locus of control and socioeconomic status moderated changes in headache self-efficacy with Behavioral Migraine Management+.

Conclusions

The “deficiency” hypothesis best explained how patient characteristics influenced changes in of headache self-efficacy with Behavioral Migraine Management.
Footnotes
1
Studies that experimentally manipulate “perceived success” and/or other treatment elements (physiological learning) may provide information about change mechanisms, but have experimentally altered clinical treatment, and thus fail to provide information about changes in expectancies that occur when treatment is administered in the clinical setting [56‐58].
 
2
All variables examined in the moderator analyses, other than ethnicity, are continuous variables. However, the terms “high” and “low” are used for readability.
 
3
The most recent clinical trials of preventative migraine medication tend to report dropout rates of 50% at 6 months. In contrast, the Treatment of Severe Migraine trial has a dropout rate of 35% at 10 months. Thus, crudely averaged over months, the dropout rate for the Treatment of Severe Migraine trial (≈3.5% per month) was less than half of the comparative dropout rate for other recent preventative medication trials (≈8% per month). Another way to compare dropouts across trials is to note that the dropout rate for the Treatment of Severe Migraine trial at 16 months is similar to the dropout rate for other recent trials at 6 months.
 
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Metadata
Title
Dynamics of Changes in Self-Efficacy and Locus of Control Expectancies in the Behavioral and Drug Treatment of Severe Migraine
Authors
Elizabeth K. Seng, M.S.
Kenneth A. Holroyd, Ph.D.
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 3/2010
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-010-9223-3

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