The effectiveness of a group-based acceptance and commitment additive therapy on rehabilitation of female outpatients with chronic headache: preliminary findings reducing 3 dimensions of headache impact
Headache: The Journal of Head and Face Pain, 06/21/2012
Mo'tamedi H et al. – The effectiveness of a brief acceptance and commitment additive therapy in the treatment of Iranian outpatient females with chronic headache represents a significant scientific finding and clinical progress, as it implies that this kind of treatment can be effectively delivered in a hospital setting.Methods
- This study used a randomized pretest–post–test control group design.
- The sample was selected from consecutive female outpatients with chronic headache, attending and/or referred to a headache clinic in a governmental hospital from April 2011 to June 2011.
- In total, 80 female outpatients were interviewed, and after implementing inclusion/exclusion criteria, thirty females were considered eligible to participate in the study.
- Half (n = 15) were randomly selected to participate in the treatment group.
- Four participants of this group failed to complete the treatment sessions (n = 11).
- The Acceptance and Commitment Therapy group received the medical treatment as usual and 8 sessions of Acceptance and Commitment Therapy.
- The other half (n = 15) served as the control group that received only medical treatment as usual.
- The short form of McGill pain questionnaire, the migraine disability assessment scale, and the trait subscale of the state–trait anxiety inventory were administered, which operationalized 3 dimensions of impact of chronic headache, sensory pain, disability, and emotional distress, respectively, to explore the impact of recurrent headache episodes.
- Pretest and post–test measures on these 3 dimensions of impact were the primary outcome measures of this study.
- Analyses of covariance with the pretreatment score used as a covariate were conducted on pain intensity, degree of disability, and level of affective distress before and after therapy to assess therapeutic intervention effectiveness.
- Chronic tension type of headache (63%) and chronic migraine without aura (37%) were the headache types reported by the participants.
- Data analyses indicated the significant reduction in disability (F[1,29] = 33.72, P < .0001) and affective distress (F[1,29] = 28.27, P < .0001), but not in reported sensory aspect of pain (F[1,29] = .81, P = .574), in the treatment group in comparison with the control group.