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Mediators and moderators of stress m...
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Mediators and moderators of stress management and antidepressant treatment for chronic tension-type headache.
紀錄類型:
書目-電子資源 : Monograph/item
正題名/作者:
Mediators and moderators of stress management and antidepressant treatment for chronic tension-type headache./
作者:
Malinoski, Peter T.
面頁冊數:
241 p.
附註:
Director: Kenneth A. Holroyd.
Contained By:
Dissertation Abstracts International62-03B.
標題:
Health Sciences, Pharmacology. -
電子資源:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3007466
ISBN:
9780493170473
Mediators and moderators of stress management and antidepressant treatment for chronic tension-type headache.
Malinoski, Peter T.
Mediators and moderators of stress management and antidepressant treatment for chronic tension-type headache.
- 241 p.
Director: Kenneth A. Holroyd.
Thesis (Ph.D.)--Ohio University, 2001.
In summary, initial headache impact and anxiety diagnoses were robust moderators of treatment outcome. HSE change mediated SM differential treatment response.
ISBN: 9780493170473Subjects--Topical Terms:
1017717
Health Sciences, Pharmacology.
Mediators and moderators of stress management and antidepressant treatment for chronic tension-type headache.
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Source: Dissertation Abstracts International, Volume: 62-03, Section: B, page: 1587.
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In summary, initial headache impact and anxiety diagnoses were robust moderators of treatment outcome. HSE change mediated SM differential treatment response.
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This study examines moderators and mediators of CBT and tricyclic antidepressants compared to placebo for chronic tension-type headache in a six-month clinical trial.
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The 169 participants were randomized into four treatment groups: stress management + placebo (SM), antidepressants (AD), combined SM and AD (SM+AD), or placebo. Patients took either dose-adjusted amitriptyline HCl or matched placebo throughout the study; SM participants received CBT stress management sessions at weeks 1, 4, and 8. Final reassessment was at six months. The outcome measures were average weekly Headache Index (HI) from daily headache diaries and Headache Disability Inventory (HDI) change.
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Moderator analyses used longitudinal hierarchical models on HI and correlational models on HDI change. Pretreatment HI, HDI, mood and anxiety diagnoses, age, sex, headache self-efficacy (HSE) and headache specific locus of control (HSLC) were tested. Pretreatment HI and HDI moderated the effect of both AD and SM treatments vs. placebo on HI and HDI change, respectively; greater initial headache impact predicted better active treatment response vs. placebo. Both AD and SM treatments were particularly effective vs. placebo for anxious participants on HDI; differential treatment effects were smaller for nonanxious participants. Higher initial HSE predicted greater HI improvement for placebo; no correlation emerged for SM.
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Change in HSE, HSLC-Internal, and HSLC-Chance were tested as mediators of treatment outcome using correlational models. On HDI, changes in HSE mediated the differential treatment effect of SM vs. placebo; changes in HSLC-Internal and HSLC-Chance partially mediated the treatment effect. On HI, increases in HSLC-Internal and HSE partially mediated the differential SM vs. placebo treatment effect. For the AD+SM vs. SM contrast, increases in HSE and decreases in HSLC-Chance mediated the marginal differential treatment advantage ( p = .06) of AD+SM vs. AD on HDI. Participants' credibility ratings of SM correlated with HI improvement in SM. Medication adherence and blood level correlated with HI improvement in AD.
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