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Cited by 109Migraine and Headache StudiesMental Health via WritingPsychosomatic Disorders and Their Treatments

Relaxation training and written emotional disclosure for tension or migraine headaches: a randomized, controlled trial

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D’Souza, Pamela J., Lumley, Mark A., Kraft, Christina A., Dooley, John A.·2008·Annals of Behavioral Medicine
DOI 10.1007/s12160-008-9046-7PMC PMC2931412
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Abstract

BACKGROUND AND PURPOSE: Behavioral medicine interventions that directly reduce arousal and negative emotions, such as relaxation training (RT), are conceptually different from interventions that temporarily increase negative emotions, such as written emotional disclosure (WED), but no studies have directly compared their efficacy. We compared the effects of RT and WED on people with tension or migraine headaches. METHODS: College students with either tension (n = 51) or migraine (n = 90) headaches were randomized to one of three groups: RT, WED, or a neutral writing control condition; four sessions were held over 2 weeks. Mood was measured before and after each session, and outcomes (headache frequency, severity, disability, and general physical symptoms) were assessed at baseline and at 1-month and 3-month follow-ups. RESULTS: As expected, RT led to an immediate increase in calmness, whereas WED led to an immediate increase in negative mood, for both headache samples. Intent-to-treat analyses showed that, for the tension headache sample, RT led to improved headache frequency and disability compared to both WED and the control group, but WED had no effect. For migraine headaches, RT improved pain severity relative to the control group, but WED again had no effect. CONCLUSIONS: A brief RT protocol was effective for tension headaches, but WED had no effect on health status for either tension or migraine headaches. Modifications to WED, such as targeting people with unresolved stress, providing guidance to enhance the potency of the writing, or including additional at-home writing and exposure exercises, may improve its efficacy for people with headaches and other health problems.

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  • Of 61 RCTs in recent reviews of psychological pain management, only 2 reported participants with a mean age between 18 and 30.

    “In fact, of the 61 RCTs in these reviews, only 2 reported participants with a mean age between 18 and 30.19,20”

    From Internet-Delivered Psychological Pain-Management for Young Adults With Chronic Pain: An Investigation of Clinical Trial Data (2024) · cites this paper as [19]

    The Methods > Participants passage describes a randomized trial of undergraduate students with tension or migraine headaches, so this paper can serve as an example of a trial involving young adults. It does not report the tally of 61 RCTs or establish that only two had a mean participant age between 18 and 30; the passages retrieved also do not give this trial’s mean age. (LLM, conf=0.83)

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  • The efficacy of stress-oriented psychotherapeutic interventions, such as acceptance and commitment therapy and mindfulness, has been shown to be poor.

    “the efficacy of stress-oriented psychotherapeutic interventions, such as acceptance and commitment therapy and mindfulness, has been shown to be poor [8–18]”

    From Protocol and methods for testing the efficacy of well-being therapy in chronic migraine patients: a randomized controlled trial. (2018) · cites this paper as [9]

    The Discussion reports no efficacy for written emotional disclosure in people with tension or migraine headaches, which supports a narrow claim about that intervention. It also reports benefits from relaxation training for tension headaches and suggests that mindfulness meditation may have broader applicability; it does not test acceptance and commitment therapy or mindfulness. The finding about disclosure therefore cannot establish poor efficacy for stress-oriented interventions generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Current evidence on the efficacy of psychological interventions remains limited and unsatisfactory.

    “Current evidence on the efficacy of psychological interventions remains limited and unsatisfactory [8–18]”

    From Protocol and methods for testing the efficacy of well-being therapy in chronic migraine patients: a randomized controlled trial. (2018) · cites this paper as [9]

    The Discussion (Lack of Effects of Written Emotional Disclosure; page unavailable) describes limited or null effects for written emotional disclosure in clinical populations, supporting concern about that intervention. But the Discussion (Effects of Relaxation Training; page unavailable) reports benefits of relaxation training for tension headaches and cites prior supportive research. The paper therefore does not support the broader claim that evidence for psychological interventions generally is limited and unsatisfactory. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Measures selected in this study mirror those commonly used in treatment outcome trials for chronic migraine and are consistent with the international expert consensus guidelines for determining treatment response.

    “Measures selected in this study mirror those commonly used in treatment outcome trials for chronic migraine [9, 13, 15, 16] and are consistent with the international expert consensus guidelines for determining treatment response [35, 36]”

    From Protocol and methods for testing the efficacy of well-being therapy in chronic migraine patients: a randomized controlled trial. (2018) · cites this paper as [9]

    The Methods > Measures section identifies headache frequency, severity, and disability as primary outcomes, so this paper is an example of a migraine treatment trial using those measures. But Methods > Participants describes students with migraines at least monthly, not a chronic-migraine trial; it therefore does not establish the chronic-migraine specificity of the claim. The separate consensus-guidelines clause is attributed to other citations, not this paper. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The post- and follow-up treatment effects expand on findings of psychological pain-management for young adults by showing significant effects of a cognitive and behavioural approach in young adults with heterogeneous pain conditions, recruited from around the country.

    “The post-and follow-up treatment effects expand on findings of psychological painmanagement for young adults, 19 by showing significant effects of a cognitive and behavioural approach in young adults with heterogeneous pain conditions, recruited from around the country.”

    From Internet-Delivered Psychological Pain-Management for Young Adults With Chronic Pain: An Investigation of Clinical Trial Data (2024) · cites this paper as [19]

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Authors
D’Souza, P. J., Lumley, M. A., Kraft, C. A., & Dooley, J. A.
Affiliations
Wayne State University (US)
Corresponding author
Lumley, Mark A.
ORCID
Lumley, Mark A.
Venue
Annals of Behavioral Medicine
Publisher
Oxford University Press (OUP)
Published
2008-08
Volume
36
Issue
1
Pages
21-32
ISSN
  • 0742-5554 (ISSN-L)
  • 0883-6612
  • 1532-4796
DOI
10.1007/s12160-008-9046-7
PMC
PMC2931412
OpenAlex
W1972528209
Cited by
109
References
57
Citations by year
2026: 1 · 2025: 6 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 1 · 2020: 41 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 8 · 2014: 3 · 2013: 4 · 2012: 10
FWCI
2.57
Type
journal article
Language
en
Open access
Locations
  • Annals of Behavioral Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Arthritis Foundation
  • National Institutes of Health
  • National Institute on Aging (AG009203, R01AG009203)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR049059, AR049059)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
  • Social Sciences › Psychology › Social Psychology › Mental Health via Writing
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
relaxation training, written emotional disclosure, tension-type headache, migraine, negative emotions, negative mood, headache frequency, headache-related disability, pain intensity, stress, university students
MeSH terms
Adolescent, Emotions, Female, Follow-Up Studies, Humans, Male, Migraine Disorders, Relaxation Therapy, Self-Assessment, Self Disclosure, Severity of Illness Index, Stress, Psychological, Writing, Treatment Outcome, Tension-Type Headache, Students, Public Health, Young Adult

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