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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2014

Open Access 01-12-2014 | Research article

Headstrong intervention for pediatric migraine headache: a randomized clinical trial

Authors: Michael A Rapoff, Mark Connelly, Jennifer L Bickel, Scott W Powers, Andrew D Hershey, Janelle R Allen, Cynthia W Karlson, Catrina C Litzenburg, John M Belmont

Published in: The Journal of Headache and Pain | Issue 1/2014

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Abstract

Background

The purpose of this study was to evaluate the efficacy of a self-guided CD-ROM program (“Headstrong”) containing cognitive-behavioral self-management strategies versus an educational CD-ROM program for treating headaches, headache-related disability, and quality of life.

Methods

Participants were 35 children ages 7–12 years with migraine recruited from one university medical center and two children’s hospital headache clinics. Participants were randomly assigned to complete the Headstrong or educational control CD-ROM program over a 4-week period. Data on headache frequency, duration, and severity, migraine-related disability, and quality of life (QOL) were obtained at baseline, post-intervention, and 3-months post-intervention.

Results

At post-intervention, Headstrong resulted in lower severity (on a 10-point scale) than the control group by child report (5.06 ± 1.50 SD vs. 6.25 ± 1.92 SD, p = 0.03, ES = 0.7). At 3-months post-intervention, parents reported less migraine-related disability (on the PedMIDAS) in the Headstrong group compared to the control group (1.36 ± 2.06 SD vs. 5.18 ± 6.40 SD; p = 0.04, ES = 0.8). There were no other group differences at post treatment or at 3-months post-intervention.

Conclusions

When compared to an educational control, Headstrong resulted in lower pain severity at post-treatment and less migraine-related disability at 3-months post-intervention, by child and parent report respectively. Headache frequency and quality of life did not change more for Headstrong versus control. Additional research is needed on the Headstrong Program to increase its efficacy and to test it with a larger sample recruited from multiple centers simultaneously.
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Literature
1.
Abu-Arafeh I, Razak S, Sivaraman B, Graham C: Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol 2010, 52: 1088–1097. 10.1111/j.1469-8749.2010.03793.xCrossRefPubMed
2.
Kernick D, Campbell J: Measuring the impact of headache in children: a critical review of the literature. Cephalalgia 2008, 29: 3–16.CrossRefPubMed
3.
Powers SW, Patton SR, Hommel KA, Hershey AD: Quality of life in paediatric migraine: characterization of age-related effects using PedsQL 4.0. Cephalalgia 2004, 24: 120–127. 10.1111/j.1468-2982.2004.00652.xCrossRefPubMed
4.
Charles JA, Peterlin BL, Rapoport AM, Linder SL, Kabbouche MA, Sheftell FD: Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification. J Headache Pain 2009, 10: 227–233. 10.1007/s10194-009-0133-3PubMedCentralCrossRefPubMed
5.
Kröner-Herwig B, Gassmann J: Headache disorders in children and adolescents: Their association with psychological, behavioral, and socio-environmental factors. Headache 2010, 52: 1387–1401.CrossRef
6.
Powers SW, Andrasik F: Biobehavioral treatment, disability, and psychological effects of pediatric headache. Pediatr Ann 2005, 34: 461–465.CrossRefPubMed
7.
Powers SW, Gilman DK, Hershey AD: Suggestions for biopsychosocial approach to treating children and adolescents who present with headache. Headache 2006, 46(Suppl 3):S149–150.CrossRefPubMed
8.
Holden EW, Deichmann MM, Levy JD: Empirically supported treatments in pediatric psychology: recurrent pediatric headache. J Pediatr Psychol 1999, 24: 91–109. 10.1093/jpepsy/24.2.91CrossRefPubMed
9.
Scharff L, Marcus DA, Masek BJ: A controlled study of a minimal-contact thermal biofeedback treatment in children with migraine. J Pediatr Psychol 2002, 27: 109–119. 10.1093/jpepsy/27.2.109CrossRefPubMed
10.
Eccleston C, Palermo TM, Williams AC, Lewandowski A, Morley S, Fisher E, Law E: Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev; 2012. Dec 12CrossRef
11.
Palermo TM, Eccleston C, Lewandowski AS, Williams AC, Morley S: Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: an updated meta-analytic review. Pain 2010, 148: 387–397. 10.1016/j.pain.2009.10.004PubMedCentralCrossRefPubMed
12.
Connelly M, Rapoff MA, Thompson N, Connelly W: ‘Headstrong’: A pilot study of a CD-ROM intervention for recurrent pediatric headache. J Pediatr Psychol 2006, 31: 737–747.CrossRefPubMed
13.
Hicks CL, von Baeyer CL, McGrath PJ: Online psychological treatment for pediatric recurrent pain: A randomized evaluation. J Pediatr Psychol 2006, 31: 724–736.CrossRefPubMed
14.
Trautmann E, Kröner-Herwig B: A randomized controlled trial of internet-based self-help training for recurrent headache in childhood and adolescence. Behav Res Ther 2010, 48: 28–37. 10.1016/j.brat.2009.09.004CrossRefPubMed
15.
Palermo TM, Wilson AC, Peters M, Lewandowski A, Somhegyi H: Randomized controlled trial of an internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain. Pain 2009, 146: 205–213. 10.1016/j.pain.2009.07.034PubMedCentralCrossRefPubMed
16.
Lelieveld OTHM, Armbrust W, Geertzen JHB, de Graaf I, van Leeuwen MA, Sauer PJJ, van Weert E, Bouma J: Promoting physical activity in children with juvenile idiopathic arthritis through an internet-based program: Results of a pilot randomized controlled trial. Arthrit Care Res 2010, 62: 697–703. 10.1002/acr.20085CrossRef
17.
Stinson JN, McGrath PJ, Hodnett ED, Feldman BM, Duffy CM, Huber AM, Tucker LB, Hetherington CR, Tse SML, Spiegel LR, Campillo S, Gill NK, White ME: An internet-based self-management program with telephone support for adolescents with arthritis: A pilot randomized controlled trial. J Rheumatol 2010, 37: 1944–1952. 10.3899/jrheum.091327CrossRefPubMed
18.
Penzien DB, Andrasik F, Freidenberg BM, Houle TT, Lake A, Lipchik GL, Holroyd KA, Lipton RB, McCrory DC, Nash JM, Nicholson RA, Powers SW, Rains JC, Wittrock DA: Guidelines for trials of behavioral treatments for recurrent headache, first edition: American Headache Society Behavioral Clinical Trials Workgroup. Headache 2005, 45(Suppl 2):S110-S132.CrossRefPubMed
19.
Andrasik F, Powers SW, McGrath PJ: Methodological considerations in research with special populations: Children and adolescents. Headache 2005, 45: 520–525. 10.1111/j.1526-4610.2005.05104.xCrossRefPubMed
20.
Headache Classification Subcommittee of the International Headache Society: The international classification of headache disorders, 2nd edition. Cephalalgia 2004, 24(Suppl 1):1–151.
21.
Achenbach TM: Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry; 1991.
22.
Kröner-Herwig B, Denecke H: Cognitive-behavioral therapy of pediatric headache: are there differences in efficacy between a therapist-administered group training and a self-help format? J Psychosom Res 2002, 53: 1107–1114. 10.1016/S0022-3999(02)00345-8CrossRef
23.
Hershey AD, Powers SW, Vockell AL, LeCates S, Kabbouche MA, Maynard MK: PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology 2001, 57: 2034–9. 10.1212/WNL.57.11.2034CrossRefPubMed
24.
Hershey AD, Powers SW, Kabbouche MA, Vockell ALB, LeCates S: Development of patient-oriented grading for PedMIDAS: increasing clinical utility. Headache 2002, 42: 442.CrossRef
25.
Hershey AD, Powers SW, Vockell AL, LeCates SI, Segers A, Kabbouche MA: Development of a patient-based grading scale for PedMIDAS. Cephalalgia 2004, 24: 844–89. 10.1111/j.1468-2982.2004.00757.xCrossRefPubMed
26.
Varni JW, Katz ER, Seid M, Quiggins DJL, Friedman-Bender A, Castro CM: The Pediatric Cancer Quality of Life Inventory (PCQL): I. Instrument development, descriptive statistics, and cross-informant variance. J Behav Med 1998, 21: 179–204. 10.1023/A:1018779908502CrossRefPubMed
27.
Varni JW, Seid M, Rode CA: The PedsQL: Measurement model for the Pediatric Quality of Life Inventory. Med Care 1999, 37: 126–139. 10.1097/00005650-199902000-00003CrossRefPubMed
28.
Varni JW, Seid M, Kurtin PS: The PedsQL™ 4.0: Reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001, 39: 800–812. 10.1097/00005650-200108000-00006CrossRefPubMed
29.
Varni JW, Seid M, Knight TS, Burwinkle TM, Brown J, Szer IS: The PedsQL in pediatric rheumatology: Reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory Generic Core Scales and Rheumatology Module. Arthritis Rheum 2002, 46: 714–725. 10.1002/art.10095CrossRefPubMed
30.
Varni JW, Seid M, Knight TS, Uzark K, Szer IS: The PedsQL 4.0 Generic Core Scales: Sensitivity, responsiveness, and impact on clinical decision-making. J Behav Med 2002, 25: 175–193. 10.1023/A:1014836921812CrossRefPubMed
31.
Connelly M, Rapoff MA: Assessing health-related quality of life in children recurrent headache: Reliability and validity of the PedsQL™ 4.0 in a pediatric headache sample. J Pediatr Psychol 2006, 31: 698–702.CrossRefPubMed
32.
Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.
33.
Karlson CW, Rapoff MA: Attrition in randomized controlled trials for pediatric chronic conditions. J Pediatr Psychol 2009, 34: 782–793. 10.1093/jpepsy/jsn122CrossRefPubMed
Metadata
Title
Headstrong intervention for pediatric migraine headache: a randomized clinical trial
Authors
Michael A Rapoff
Mark Connelly
Jennifer L Bickel
Scott W Powers
Andrew D Hershey
Janelle R Allen
Cynthia W Karlson
Catrina C Litzenburg
John M Belmont
Publication date
01-12-2014
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2014
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/1129-2377-15-12

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