[Thought protocols before and after a psychological headache--treatment with imagery].

Cognitive changes accompanying a headache treatment with imagery strategies were investigated. 15 female and 6 male headache sufferers with migraine (6), tension-type headache (7) or both (8) wrote down their thoughts during 1-5 headache episodes, kept a headache diary and filled in several pain questionnaires before and after treatment. After treatment there were significantly more positive and less negative thoughts. Pain frequency, duration, medication intake intensity, catastrophizing and helplessness were reduced, self-efficacy was enhanced. Changes of thought protocol variables were correlated with treatment effects. The role of cognitive changes in the psychological treatment of chronic headache is discussed.