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Biomedical subjects

P R Nathan

Publications and source records attributed to P R Nathan.

6 recordsLinked to original sources
PubMed1993

Towards a functional model of chronic headaches: investigation of antecedents and consequences.

The traditional approach to classifying headache based on symptoms and assumed mechanisms is criticized as having limited utility when applied to tension-type headache and migraine. The study reported here was designed to explore an alternative method of conceptualizing chronic headaches based on functional characteristics or controlling variables. One hundred and ninety nine chronic headache sufferers completed questionnaires which enquired about the antecedents and consequences of their headaches. An attempt to build a categorical model driven by functional characteristics using cluster analysis was unsuccessful but a subsequent attempt to construct a dimensional model using factor analysis proved more successful. This approach led to the emergence of five antecedent dimensions and six consequences dimensions (three pertaining to the responses of sufferers and three to the reactions of significant others) which were readily identifiable. The functional dimensions were significantly related to traditional diagnostic categories but at a low level. Three functional dimensions predicted response to psychological treatment.

Adult↗
PubMed1992

Psychophysiological mechanisms of chronic headaches: investigation using pain induction and pain reduction procedures.

Psychophysiological investigations of tension headaches and migraines have produced inconsistent and inconclusive findings. The study reported here aimed to further explore headache mechanisms by repeating earlier research with two main variations. The first pertained to recording and analytic procedures: a different approach was taken to measuring and interpreting cephalic vascular activity. The second was in the experimental conditions used: pain levels were manipulated so that the psychophysiology of headaches could be studied under conditions of pain increasing and decreasing. The findings provided no support for the role of muscle tension as a headache mechanism. Tentative support was obtained for vascular models of headaches. Headaches were associated with distension of the superficial temporal artery between pressure pulses. The data suggested that local vasomotor activity might play a role in dilating the temporal artery but that the effect seemed driven by elevated blood pressure and heart rate.

Adult↗
PubMed1989

Cognitive therapy vs. self-management training in the treatment of chronic headaches.

In view of the association between chronic headaches and depression, this study compared a cognitive therapy package designed for depression with a relatively standard behavioural treatment package designed for headaches (self-management training), in terms of their effects on headaches and depressive symptoms. Fifty-five subjects suffering from chronic headaches (tension, migraine and combined) were randomly assigned to the two treatment conditions. Cognitive therapy and self-management training were equally effective at decreasing headaches and depressive symptoms on most measures. Changes in headaches and depressive symptoms were not significantly correlated in either condition, however. Greater headache improvement was associated with high pre-treatment headache activity for both conditions but, whilst self-management training was more effective for subjects low on depression, cognitive therapy was more effective for subjects high on chronicity. This suggests that the latter approach, or some variation of it, may be the treatment of choice for more chronic headache sufferers with depressive symptoms.

Adult↗