Tension-type headache is common in children and adolescents and is generally treated with medication, but emerging literature suggests that various behavioral treatments may provide efficacious alternatives to medication. Juvenile tension-type headache sufferers were randomly assigned to biofeedback-assisted relaxation or relaxation placebo and followed for 1 year. Following treatment, both conditions led to sizeable headache reductions (approximately 50%). Over time, children receiving biofeedback-assisted relaxation continued to improve and were superior to the control condition at a 6- and 12-month follow-up (86% versus 50%). Biofeedback-assisted relaxation appears to be an efficacious and durable treatment for juvenile tension-type headache and merits further exploration.
AndrasikFBlakeDDMcCarranMSA biobehavioral analysis of pediatric headache. In:
KrasnegorNAArastehJDCataldoMF, editors.
Child health behavior: a behavioral pediatrics perspective.New York:
Wiley1986:
394434
2.
BilleBMigraine in school children.Acta Paediatr Scand1962;
51:
1–151
3.
DuckroPCantwell-SimmonsEA review of studies evaluating biofeedback and relaxation training in the management of pediatric headache.Headache1989;
29:
428–33
4.
BilleBMigraine in childhood and its prognosis.Cephalalgia1981;
1:
71–5
5.
BattistellaPARuffilliRCernettiRPettenazzoABaldinLBertoliSA placebo-controlled crossover trial using trazodone in pediatric migraine.Headache1992;
33:
36–9
6.
PothmannRCalcium-antagonist flunarizine vs low dose acetylsalicylic acid in childhood migraine: a double blind study.Cephalalgia1987;
7Suppl 6:
385–6
7.
SimonDPediatric migraine: a literature review of placebo controlled clinical trials.
Poster presented at the 3th Congress on Headache in Childhood and Adolescence, Budapest,
May 1995
8.
ThompsonJADiagnosis and treatment of headache in pediatric patients.Curr Probl Pediatr1980;
10:
1–52
9.
BrownJKMigraine and migraine equivalents in children.Dev Med Child Neurol1977;
19:
683–92
10.
FriedmanAPHarmsEHeadaches in children.Springfield, Illinois:
Charles and Thomas1967
11.
LarssonBDaleflodBHakanssonLMelinLTherapist-assisted versus self-help relaxation treatment of chronic headaches in adolescents: a school-based intervention.J Child Psychol Psychiatry1987;
28:
127–36
12.
LarssonBMelinLTreatment in a school setting with relaxation training as compared with information contact and self-registration.Pain1986;
25:
325–36
13.
LarssonBMelinLLamminenMUllstedtFA school-based treatment of chronic headaches in adolescents.J Pediatr Psychol1987;
12:
553–66
14.
LarssonBMelinLDoberlARecurrent tension headache in adolescents treated with self-help relaxation training and muscle relaxant drug.Headache1990;
30:
665–71
15.
AndrasikFBlanchardEBEdlundRSAttanasioVEMG biofeedback treatment of a child with muscle contraction headache.Am J Clin Biofeedback1983;
2:
96–102
16.
GrazziLLeoneMFredianiFBussoneGA therapeutic alternative for tension headache in children: treatment and one-year follow-up results.Biofeedback Self-Regul1990;
15:
1–6
17.
WerderDSSargentJDA study of childhood headache using biofeedback as a treatment alternative.Headache1984;
24:
122–6
18.
WomackWMSmithMSChenACNBehavioral management of childhood headache: a pilot study and case history report.Pain1988;
32:
279–83
19.
International Headache Society.Headache Classification Committee of International Headache Society.Cephalalgia1988;
8Suppl 7:
1–96
20.
SpielbergerCDEdwardsCDLusheneREMontouriDPlotzekDSTAIC Preliminary manual for the State Trait Anxiety Inventory for Children.Palo Alto CA:
Consult Psychol Press1973
21.
BernsteinDABorkovecTDProgressive relaxation training.Champagne, Illinois:
Res Press1973
22.
PritchardDEMG levels in children who suffer from severe headache.Headache1995;
35:
554–6
23.
AndrasikFHolroydKAA test of specific and nonspecific effects in the biofeedback treatment of tension headache.J Consult Clin Psychol1980;
48:
575–86
24.
AndrasikFHolroydKASpecific and nonspecific effects in the biofeedback treatment of tension headache: 3-year follow-up.J Consult Clin Psychol1983;
51:
634–6
25.
HolroydKAPenzienDBHurseyKGTobinDLRogersLHolmJEJ Change mechanisms in EMG biofeedback training: cognitive changes underlying improvements in tension headache.J Consult Clin Psychol1984;
52:
1039–53
26.
AndrasikFKabelaEQuinnSAttanasioVBlanchardEBRosenblumELPsychological functioning of children who have recurrent migraine.Pain1988;
34:
43–52
27.
CunninghamSJMcGrathPJFergusonHBHumphreysPD'AstousJLatterJPersonality and behavioral characteristics in pediatric migraine.Headache1987;
27:
16–20
28.
KowalAPritchardDPsychological characteristics of children who suffer from headache: a research note.J Clin Psychol1990;
31:
637–49
29.
MullerBSartoryGPothmannRFrankenbergSHeadache and depression and anxiety: results of an epidemiological study in German children and adolescents.
Poster presented at the International Headache Seminar, Copenhagen,
1993
30.
TamminenTMBredenbergPEscartinTKaukonenPRutanenMSuominenIPsychosomatic symptoms in preadolescent children.Psychother Psychosom1991;
56:
70–7
31.
AttanasioVAndrasikFBurkeEJBlakeDDKabelaEMcCarranMSClinical issues in utilizing biofeedback with children.Clin Bio Health1985;
8:
134–41
