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Relaxation Training and Written Emotional Disclosure for Tension or Migraine Headaches: A Randomized, Controlled Trial
Open accessAbstract
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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“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]
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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 [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]
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“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]
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“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]
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“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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Pain and emotion: a biopsychosocial review of recent research
Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., & Keefe, F. J. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20816 · Cited by 836
Self-citationDifferential Effectiveness of Placebo Treatments
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Metadata
- 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
- 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
- bronze
- doi.org
- 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 › Clinical Neurology › 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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