Relationship between different outcome and personality variables in psychophysiological headache therapy

152 patients with chronic headache were submitted to two intervention strategies. 43 Ss were trained by different relaxation techniques, 79 sS were treated by various biofeedback procedures. It was hypothesized that patients with headache perceive their somatic and psychic 'self' as more negative and have more difficulty in coping with stressors than headache-free controls. Furthermore it was expected that a therapy-induced reduction of headache activity would correlate with a normalization of self-evaluation and an improvement of coping processes. We suggested that the intervention (i.e. relaxation therapy), which best instigated cognitive reappraisal in the patient should be most successful. Compared to a headache-free control group headache patients showed a more negative self-image before therapy as measured by different personality tests. The groups treated by relaxation techniques were more successful in reducing their headache intensity than either the biofeedback groups or of controls (waiting control and placebo control). The symptom reduction coincided with a more pronounced psychological change. We concluded that a headache therapy, in order to be maximally effective, should not only focus on physiological modification but should comprise systematic efforts to help patients in restructuring their cognitive attitudes towards themselves and their symptoms.