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Dynamics of changes in self efficacy and locus of control expectancies in the behavioral and drug treatment of severe migraine
Seng EK, Holroyd KA
Annals of Behavioral Medicine 2010 Dec;40(3):235-247
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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-) x 2 (beta-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.

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