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Biomedical subjects

K A Holroyd

Publications and source records attributed to K A Holroyd.

At least 37 records · Page 2Linked to original sources
PubMed1989

Long-term maintenance of improvements achieved with (abortive) pharmacological and nonpharmacological treatments for migraine: preliminary findings.

This report presents the first prospective comparison of the long-term maintenance of reductions in recurrent migraine headaches achieved with (abortive) pharmacological and nonpharmacological (combined relaxation training and thermal biofeedback training) treatments. Nineteen of 21 (90%) successfully treated patients (50% or greater reduction in headache activity) were contacted for follow-up evaluation 3 years later. Migraine sufferers who had been treated with ergotamine were less likely to still be relying on the treatment they had received and more likely to have additional medical treatment for their headaches and to be using prophylactic or narcotic medication than were migraine sufferers who had been treated with relaxation/biofeedback training. However, daily headache recordings revealed that patients in both treatment groups continued to show lower headache activity at 3-year follow-up than prior to treatment. Although preliminary, these findings raise the possibility that improvements achieved with nonpharmacological treatment are more likely to be maintained without additional treatment than are similar improvements achieved with abortive pharmacological treatment.

Adult↗
PubMed1989

Enhancing the effectiveness of abortive therapy: a controlled evaluation of self-management training.

Research suggests that approximately one half of recurrent headache sufferers fail to adhere properly to drug treatment regimens with as many as two thirds of patients failing to make optimal use of abortive medications such as ergotamine. In spite of these findings there are no controlled studies that have attempted to evaluate methods for improving adherence to drug regimens for the treatment of chronic headache disorders. In an initial effort to address this adherence problem thirty-four recurrent migraine sufferers were randomized to abortive therapy with ergotamine tartrate plus caffeine (standard abortive therapy) or to standard abortive therapy accompanied by a brief educational intervention designed to facilitate the migraine sufferer's effective use of ergotamine. Patients who received the adjunctive educational intervention attempted to abort a greater percentage of their migraine attacks (70% vs 40%) and showed larger reduction in headache activity (e.g., 40% vs 26% reduction in month two of treatment). However, patients in both treatment groups used similar amounts of abortive medication when attempting to abort a migraine attack and showed similar reductions in analgesic medication use with abortive therapy. There results suggest that brief educational interventions designed to address the problem of patient adherence may yield significant improvements in standard therapies. We argue that such educational interventions deserve more attention in the headache treatment literature than they have received to date.

Adult↗
PubMed1987

Personality and health in the 1980s: psychosomatic medicine revisited?

This special issue is a sign of a resurgence of interest in the role of personality in health not seen since the 1940s and early 1950s when the promises of the psychosomatic approach to health and illness appeared to be the greatest. This new look at personality and health represented by contributions to this special issue attempts to address the limitations of earlier work in psychosomatic medicine by making more explicit efforts to define personality variables precisely, to distinguish these variables from conceptually related psychological constructs, and to embed them in a body of theory and empirical research. This new work also attempts to remedy methodological limitations of earlier work by placing greater emphasis on prospective research and highlighting distinctions between symptom reports, illness behavior, and actual illness. However, the new work and earlier work in psychosomatic medicine share certain working assumptions, for example, a primary emphasis on the relatively direct impact of personality on disease onset, an assumption that personality variables operate in interaction with stressful events, and a frequent emphasis on general susceptibility to disease. Moreover, this new work frequently risks the same methodological pitfalls that limited scientific progress in psychosomatic medicine. We argue that the rapid rise and decline of psychosomatic medicine is most likely to be repeated in research on personality and health in the 1980s if reasonable criteria for considering personality variables a risk factor for disease are not precisely defined, disease endpoints (the dependent variable) are not assessed precisely, personality variables of interest (the independent variable) are not empirically distinguished from other related psychological variables, and complex relationships among risk factors are not taken into account. It is emphasized that models drawn from personality research cannot be transferred unchanged to the health arena without risking false inferences about the role of personality in health.

Arousal↗
PubMed1987

The "Asthma Self-Efficacy Scale".

According to Bandura, a person's expectations that a favorable outcome will follow a particular behavior are not sufficient to promote the occurrence of the behavior; the person must also believe that he or she will be effective at performing the behavior. The latter is referred to as self-efficacy. It has become a major focus in assessing patient performance of skills required to manage their illness. The present paper describes the development, testing, and applicability of an instrument for assessing self-efficacy in asthmatic patients. It notes that the Asthma Self-Efficacy Scale is not only a reliable paper-and-pencil instrument, but that it has a wide potential applicability throughout health care settings in measuring self-efficacy in asthmatic patients. The Asthma Self-Efficacy Scale is included.

Adolescent↗
PubMed1986

Client variables and the behavioral treatment of recurrent tension headache: a meta-analytic review.

Meta-analysis revealed that in studies evaluating behavioral treatments for tension headaches, the treatment outcome has varied with the client samples (e.g., age, gender, referral source) that have been used but not with the treatment procedures (e.g., type of behavioral intervention, length of treatment, whether or not efforts were made to facilitate transfer of training) or the research designs (e.g., internal validity, explicitness of diagnostic criteria) that have been used. Mean client age proved the best predictor of treatment outcome, accounting for 30% of the outcome variance following behavior therapy. Significantly poorer outcomes have also been reported in recent studies than were reported in early studies. These findings suggest that outcomes obtained with behavioral interventions have been less dependent upon the treatment variables that have been the primary focus of research attention than upon characteristics of client samples and behavioral interventions may be less effective in reducing headache activity than has previously been assumed.

Adult↗
PubMed1983

Young adults at risk for hypertension: effects of family history and anger management in determining responses to interpersonal conflict.

An experiment was conducted with young adults to study the effects of two hypothesized risk factors for essential hypertension, namely, having (1) a positive family history of essential hypertension, and (2) anger inhibition. Subjects were tested in a dyadic role play task designed to simulate mundane and conflictual social interactions. Heart rate and blood pressure were recorded, reports of emotion were obtained, and role play behavior was coded for assertiveness. Although family history of essential hypertension and anger inhibition were not associated with one another, both variables were related to cardiovascular activity. These results provide new information about the relationship between these two hypothesized risk factors and extend previously observed differences between at-risk and low-risk subjects for hypertension to a more naturalistic, interpersonal stressor.

Adolescent↗
PubMed1980

A comparison of EMG biofeedback and a credible pseudotherapy in treating tension headache.

Thirty-one tension headache sufferers were assigned to frontalis electromyographic (EMG) biofeedback training, to a highly credible pseudotherapy providing no opportunity to learn control of EMG activity, or to a symptom-monitoring control group. Participants receiving biofeedback showed significant reductions in frontalis EMG within and across treatment sessions and exhibited reduced EMG activity following treatment. Participants receiving pseudotherapy showed no changes in EMG activity. Although biofeedback and pseudotherapy were rated as equally credible treatments, only the headache activity of the biofeedback group was significantly improved following treatment. These results suggest that outcomes obtained with biofeedback do not result merely from exposure to a credible treatment procedure. Evidence suggesting that headache improvements may be mediated by cognitive and behavioral changes and not the learned control of physiological activity is discussed.

Adolescent↗