PRELIMINARY INVESTIGATION OF ASSOCIATIONS OF ILLNESS SCHEMATA AND TREATMENT-INDUCED REDUCTION IN HEADACHES

This study examined how illness schemata-ways people organize informat ion about illness-change over the course of cognitive-behavioral treat ment of chronic headache and the extent to which such changes predict reduction of headache. 73 subjects with chronic migraine, mixed migrai ne and tension, or tension headache were classified on the basis of ou tcome from imagery-based treatment as Treatment-responders (n=24), Tre atment-nonresponders (n=27), and Monitoring Controls (n=22). Self-repo rted illness schemata related to the seriousness and changeability of headache were assessed at pretreatment and S-wk. follow-up. While grou ps did not differ on pretreatment measures of illness schemata, at fol low-up the Treatment-responder group reported higher Changeability sco res than Treatment-nonresponders and Control subjects and lower Seriou sness scores than Control subjects. Headache reduction at follow-up wa s related to follow-up Changeability scores, in-session changes in sys tolic blood pressure and reported posttreatment expectations of headac he activity, but not pretreatment measures of illness schemata. Findin gs indicate that improvements in headache activity are nor influenced by the severity of headaches and may change prior to cognitive-behavio ral treatment. Rather, among individuals who show decreases in headach e activity, changes in beliefs about illness and headache reduction ma y have reciprocal relations both of which result from cognitive-behavi oral treatment.