*Department of Psychology, University of Alabama †Psychology Service, V.A. Medical Center ‡Department of Psychiatry and Behavioral Medicine, The University of Alabama School of Medicine, Tuscaloosa ∥The Kilgo Headache Clinic, Northport, AL §UC San Diego Center for Mindfulness, San Diego, CA.
Clin J Pain. 2014 Feb;30(2):152-61. doi: 10.1097/AJP.0b013e318287a1dc.
This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes.
RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24).
Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24).
This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.
本研究报告了一项随机对照试验（RCT）的结果，该试验旨在调查正念认知疗法（MBCT）治疗头痛的可行性、耐受性、可接受性和初步疗效。与延迟治疗（DT）对照组相比，假设 MBCT 将是一种可行的治疗方法，与 DT 相比，将显著改善主要头痛相关结局和次要认知相关结局。
采用 RCT 方法，对意向治疗样本（N=36）和完成者样本（N=24）的每日头痛日记数据和预评估及后评估数据进行多元方差分析模型。
患者流量数据和标准化测量结果发现，MBCT 治疗头痛对参与者是可行的、可耐受的和可接受的。意向治疗分析表明，与 DT 相比，MBCT 患者的自我效能感（P=0.02，d=0.82）和疼痛接受度（P=0.02，d=0.82）显著提高。完成者分析的结果产生了类似的发现；此外，与 DT 相比，MBCT 完成者报告疼痛干扰（P<0.01，d=-1.29）和疼痛灾难化（P=0.03，d=-0.94）显著改善。组间每日头痛日记结局的变化无显著差异（P 值>0.05，d 值≤-0.24）。
本研究实证检验了 MBCT 治疗头痛。结果表明，MBCT 是一种可行、可耐受、可接受且可能有效的治疗方案，适用于头痛患者。本研究为未来将 MBCT 与注意力控制进行比较的 RCT 以及未来对 MBCT 和认知行为疗法的比较效果研究提供了研究基础。
