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15 Aug

The management of unwanted pre-sleep thoughts in insomnia: distraction with imagery versus general distraction.

Forty-one people with insomnia were assigned to one of three possible groups. One group received instructions on how to use imagery to distract themselves from the unwanted thoughts, worries and concerns that were keeping them awake. Another group got general instructions general instructions to distract themselves, and the third group got no instructions. The imagery group fell asleep faster and had less distressing pre-sleep thinking and worrying than the other two groups. The study investigators attribute the success of the "imagery distraction" intervention to its occupying sufficient "cognitive space" to keep the individual from re-engaging with thoughts, worries, and concerns during the pre-sleep period.

Citation: Harvey AG, Payne S., The management of unwanted pre-sleep thoughts in insomnia: distraction with imagery versus general distraction. Behavioral Research and Therapy 2002 Mar;40(3):267-77

15 Aug

A Norwegian research team from the University of Bergen randomly assigned 55 older insomniacs to 2 interventions (either sleep hygiene advice plus behavioral control training or sleep hygiene advice plus a relaxation tape.) in this controlled clinical trial. The subjects underwent no significant changes while on the wait list. But during the treatment periods, they improved on several sleep parameters and these gains were maintained at the 6-month follow-up. People did best on nocturnal treatment measures sleep onset and total sleep time and less well with daytime measures life satisfaction and daytime alertness. No differences were discovered between the two interventions.

Citation: Pallesen S, Nordhus IH, Kvale G, Nielsen GH, Havik OE, Johnsen BH, Skjotskift S. Behavioral treatment of insomnia in older adults: an open clinical trial comparing two interventions. Behavioral Research & Therapy 2003 Jan; 41 (1): pp. 31-48.

15 Aug

Strelow and Davidson tested the hypotheses that (a) introverts would produce more vivid imagery than would extraverts, and that (b) introverts would produce better imagery if the background auditory tempo were slow, and extraverts would produce better mental imagery of the background auditory tempo were fast. Participants (N=240) were classified as introverts or extraverts and were randomly assigned one of three tempo conditions: slow, fast, or none. They were instructed to form images while listening individually to one of two stories. Clicks (slow or fast) sounded in the background during the stories. All participants then completed detailed questionnaires about the vividness of their imagery. Analysis showed that introverts did indeed report significantly more vividness in their imagery than did extraverts. But no correlation between personality and tempo was found.

Citation: Strelow BR, Davidson WB. Introversion-extraversion, tempo, and guided imagery. Psychol Rep 2002 Apr;90(2):619-26

15 Aug

Researchers from the Department of Radiology, Brigham and Women''s Hospital/ Harvard Medical School, used MRI technology to see which neural pathways were involved when subjects imagined tactile stimulation on the dorsal side of their right hand. Results were then compared to the MRI findings from subjects who actually received tactile stimulation of the same area of the hand.

15 Aug

Segerstrom, Taylor, Kemeny, Reed and Visscher studied 86 HIV gay, seropositive men to test the relationship between decline of immune function (helper T-cells CD4) and negative beliefs about the self. There did appear to be an association between attributing negative events to aspects of the self and a faster CD4 decline over 18 months, controlling for things such as depression and health behavior. But there was no significant difference in the onset of AIDS.

Citation: Segerstrom SC, Taylor SE, Kemeny ME, Reed GM, Visscher BR. Casual attributions predict rate of immune decline in HIV-seropositive gay men. Health Psychology. 1996; 15: pp. 485-493.

15 Aug

Dr. Lisa K. Mannix MD of the Adelman Headache Center in Greensboro, NC reported at the American Association for the Study of Headache that she added guided imagery audiotapes to the course of treatment of half her headache patients in a 250-person study. The imagery group listened to the tape daily for one month. Mannix found that a significantly greater proportion of imagery patients (21.7% of 129, as opposed to 7.6% of 131 controls) reported an overall improvement in their headaches.

Citation: Mannix LK, Chandurkar RS, Rybicki LA, Tusek DL, Solomon GD. Effects of guided imagery on quality of life for patients with chronic tension-type headache. Headache. 1999 May;39(5):326-34.

15 Aug

A pilot study of one-session biofeedback training in pediatric headache.
15 Aug

Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial.

Ohio University psychologists Holroyd, O’Donnell, Stensland, Lipchik, Cordingley and Carlson compared the effectiveness of behavioral and pharmacological therapies, singly and combined, for chronic tension headaches. Their randomized, placebo-controlled trial studied 203 adult subjects, who were randomly assigned to receive either a tricyclic antidepressant (Elavil or Pamelor); stress management therapy (relaxation and coping skills) or both together. Placebo groups were used as well.

15 Aug

Behavioral management of recurrent headache: three decades of experience and empiricism.

This fresh review and meta-analysis of the research literature on behavioral interventions for headache (chiefly relaxation, biofeedback, and stress-management) out of the University of Mississippi Medical Center’s Head Pain Center show clinically significant reductions in recurrent headache. In fact, across studies, behavioral interventions have yielded approximately 35-50% reduction in migraine and tension-type headache activity. In addition, the available evidence suggests that the level of headache improvement with behavioral interventions may rival those obtained with widely used pharmacologic therapies in representative patient samples. The article also mentions that in recent years, some attempts have been made to increase the availability and cost effectiveness of behavioral interventions through alternative delivery formats and mass communications, and suggests further integration of behavioral treatments into primary care settings, the place where the great majority of headache sufferers receive treatment.

Citation: Penzien DB, Rains JC, Andrasik F. Behavioral management of recurrent headache: three decades of experience and empiricism. Applied Psychophysiology and Biofeedback. 2002 Jun; 27 (2): pp 163-81.

15 Aug

Cognitive-behavioral therapy of pediatric headache: are there differences in efficacy between a therapist-administered group training and a self-help format?

Researchers from the University of Goettingen in Germany compared the efficacy of cognitive-behavioral training in a therapist-administered, group format, to a self-help format (no therapist) with 77 children, ages 10-14, suffering from recurrent headache. The children were randomly assigned to either the therapist CBT group (n=29), the self-help group (n=27) or a wait list condition (n=19). In both formats, the topics covered were identical (e.g., self-monitoring of headache, trigger analysis, relaxation, etc.). Sessions were 90 minutes with groups of 5 children assigned to each. The self-help groups were given a written manual in which instructions were given and homework tasks assigned. The main outcome variables were related to changes in headache intensity, duration and frequency, as assessed in a diary prior to and following training, as well as at 6-month follow-up. The children reported an equally high degree of satisfaction with the training, with no significant differences between the two conditions. In both, headaches decreased markedly from posttraining to follow-up, with 68-76% of the children reporting clinically significant improvement. There were also significant changes in self-concept and ability to cope with stress after both types of intervention. In addition, the investigators found no differences by age, gender or headache diagnosis. The study concludes that the efficacy of the two training formats is nearly identical.

Citation: Kroener-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? Journal of Psychosomatic Research 2002 Dec;53 (6):pp. 1107-14. email: This email address is being protected from spambots. You need JavaScript enabled to view it.

15 Aug

When 45 Australian children with histories of ten or more upper respiratory tract infections were taught stress management and guided imagery, their episodes of illness were shorter and symptoms milder at the one-year follow-up than for the kids who were wait-listed. In addition, their psychological state remained improved as well. These findings were confirmed in a subsequent replication study, suggesting that psychological treatment interrupts a chronic illness cycle in children with symptoms of recurrent URTI.

Citation: Hewson-Bower B and Drummond PD, Psychological treatment for recurrent symptoms of colds and flu in children. Journal of Psychosomatic Research 2001 Jul;51(1):369-77.
15 Aug

Betsy Singh, Brian Berman, Victoria Hadhazy & Paul Creamer of the Complementary Medicine Program at the U of Maryland School of Medicine showed in a pilot study of 28 patients with fibromyalgia that a combination of patient education, meditation and qigong movement therapy significantly reduced pain, fatigue and sleeplessness. The eight weekly, 2.5 hr sessions also improved mood state, function and general health. (Alternative Therapies, March 1998, Vol 4, no. 2, pp. 67-70.)

Citation: Singh BB, Berman BM, Hadhazy VA, Creamer P. A pilot of cognitive behavioral therapy in fibromyalgia. Alternative Therapies Health Med. 1998 Mar; 4(2): 67-70.