The refractory headache patient--II. High medication consumption (analgesic rebound) headache

'Analgesic rebound headache' is identified by habituation of an individual to pain reducing medication, the exacerbation of headache pain a few hours after medication consumption and a marked increase in headache frequency and intensity for several weeks after medication is discontinued. We describe three studies undertaken to clarify the existence and characteristics of this proposed headache syndrome. In Study 1 we compared a group of headache sufferers who consume large amounts of analgesic medications to headache sufferers who did not consume excessive analgesics. It was found that the two groups did not differ on age, duration of headache problem or gender. However, the groups did differ on subjective headache pain (with the high medicators experiencing more headache pain than low medicators) and diagnosis (with high medicators being more likely to have a muscle contraction component to their headaches). In an analysis of drug use within the high medication group, it was found that 91% were taking some kind of analgesic and that a majority (84%) were taking more than one type of medication. In Study 2 we found that the group of high medicators were not as successful in reducing headache activity as a result of a self-regulatory behavioral treatment as the matched controls. Furthermore, there was a direct relationship between reduction and treatment success in the high medication consuming population. Lastly, in Study 3 we examined the current psychological functioning of the two groups; no differences were found between the two groups indicating the lack of 'addictive' personality characteristics as an explanation for the high medicating population. These findings all support the existence of a sub-population of headache sufferers who consume excessive amounts of analgesic medication and who are relatively refractory to behavioral treatment.     

Relationship between self-reported intensity of headache and magnitude of surface EMG

The study was designed to examine the relationship between self-reported intensity of headache and surface EMG. 98 patients, diagnosed by their neurologists with "muscle-contraction headaches" (tension-type headaches) were referred to evaluate their suitability for biofeedback therapy. At the time of examination, they were asked to rate their average headache intensity on a 10-point scale. Surface EMG data were collected to assess actual muscle contraction. Analysis indicated that among patients diagnosed with muscle contraction headache, there is a positive significant correlation between self-reported intensity of headache and actual muscle-contraction. The current data lend support to the hypothesis that the tension in the headaches currently described as "tension-type" may in fact refer to actual muscular tension or contraction.     

The effects of low and high intensity exercise on emotions,stress and effort

Objectives: To monitor the effects of exercise intensity on regular exercisers' emotions, stress and effort.Design: A two-period crossover design was used in each of two within-subjects field experiments.Methods: Participants were two different groups of regularly exercising male students. Each group exercised using their usual exercise mode in their usual exercise environment. Group 1 (n=38) ran 5.0 km at low and high intensities, Group 2 (n=36) ran 1.7 km at low and high intensities. The analysis of results also examined differences between fast and slow runners.Results: Doubly multivariate (DM) analysis was used in the statistical analysis which indicated that significant changes occurred in pleasant and unpleasant emotions pre- to post-running 5.0 km and 1.7 km. No significant results between high and low running intensities were obtained for the 5.0 km distance. For exercisers running 1.7 km, significant differences between high and low intensity running were found for bodily stress and effort. Several significant findings for pleasant emotions were also obtained between fast and slow runners pre- to post-exercise.Conclusions: The atheoretical nature of some previous studies was avoided by utilising reversal theory's broad range of pleasant and unpleasant emotions as the basis for measurement and analysis. The results show that, for regular exercisers, exercise can lead to improved positive affect and support findings obtained in other studies.     

The effect of daily stress, personality, and age on daily negative affect

The current study examined whether stress reactivity becomes stronger or weaker with age. Daily stress and daily negative affect were modeled using 1,012 subjects from the National Study of Daily Events (NSDE), an 8-day daily diary study. Age ranged from 25 to 74. Data were modeled using within-person HLM techniques. Daily stress and neuroticism interacted in their effect on daily negative affect. There was a stronger association between daily stress and negative affect for persons high in neuroticism as compared to those low on the trait. In addition, daily stress and age interacted in their effect on daily negative affect. There was a stronger association between daily stress and negative affect for older as compared to younger adults. Results suggest heightened reactivity to stressors in older adulthood, perhaps due to kindling effects. Changes in the aging brain may explain this effect. Our investigations illuminate the complexities that characterize the set of associations among negative affect, stress, personality, and age, and point to potential aging or cohort effects.     

The short-term influence of high and low intensity physical exercise on mood

Abstract

This study was designed to replicate and extend previous observations that the acute response to high intensity exercise is an increase in anxiety and other negative feelings. Forty female volunteers were allocated to two conditions—20 exercised at high level (100W) for 1.5 min, while 20 exercised at a low level (ZW). The purpose of the experiment was disguised. Mood was assessed before. during and immediately after exercise, and over a 1.5-min recovery period. Subjects were subsequently divided into highly and moderately fit groups on the basis of cardiac responses to a standard workload. It was found that tensiodanxiety increased immediately after high intensity exercise, declining over the recovery period. A similar pattern was found for mental fatigue. During exercise itself, anxiety diminished in the low but not the high intensity condition, No differences between fitness groups were observed in these patterns, although highly fit subjects reported greater mental vigour and exhilaration than moderately fit subjects following high intensity exercise. The mechanisms that may mediate these responses are discussed.     

Individual differences,mood, and coping with Chronic pain in Rheumatoid Arthritis: a daily process analysis

This study examines individual differences in coping and associated health outcomes as they unfold across time. Twice daily for one week, 71 individuals with Rheumatoid Arthritis reported their pain, coping efforts, and negative mood via structured daily records. The five factor model of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) and disease status were also assessed. Multi-level statistical models examining within and between person variability indicated significant temporal associations from coping to pain and bi-directional associations between mood and pain within days. Furthermore, findings suggest that coping use and coping effectiveness were moderated by personality. Implications for models of coping with chronic pain, as well as clinical applications, are discussed.     

Intraindividual relations between the intensity and disclosure of daily emotional events: The moderating role of depressive symptoms

Individuals with high levels of depressive symptoms tend to engage in lower levels of emotional disclosure than individuals who are lower in depressive symptoms. However, little is known about how depressive symptoms relate to the intraindividual relation between daily disclosure and the intensity of the daily events. The authors addressed these relations using a daily diary methodology. College students (N = 239) completed a measure of depression symptoms. They then completed measures of the intensity of the day's most unpleasant event and their disclosure of that event each day for 7 days. Results indicated that depression moderated the intensity-disclosure relation such that depression symptoms were associated with diminished emotional disclosure for high-intensity events but not for low-intensity events. Individuals with relatively higher levels of depressive symptoms also experienced unpleasant daily events at a higher intensity level than did individuals with relatively fewer symptoms. Sex differences emerged such that men were less likely than women to disclose high-intensity negative events. These findings extend the use of the diary methodology to the study of emotional disclosure and also suggest possible interventions for counseling psychology practitioners.     

Chronic absence,eighth-grade achievement,and high school attainment in the Chicago Longitudinal Study

Although not as commonly reported as average daily attendance, chronic absence data may be of significant importance for understanding student success. Using data from 1148 participants in the Chicago Longitudinal Study, we assessed the associations of chronic absence in the early middle grades, grades fourth through sixth, with eighth-grade achievement and three measures of high school attainment including four-year graduation by diploma, graduation by diploma by age 21, and any high school completion by age 21. The rate of chronic absenteeism, defined here as students missing approximately 14 days of school or more in a year, was 15%. Using Ordinary Least Squares, probit regression, and inverse-probability-weighting regression-adjustment methods (IPWRA), results indicated that chronic absence in the early middle grades was negatively associated (d = − 0.17) with eighth-grade math achievement and reduced the probability of four-year graduation by diploma by 18 percentage points, graduation by diploma by age 21 by 17 percentage points, and any high school completion by age 21 by 11 percentage points. IPWRA yielded similar estimates. Coefficients varied by subgroup with males and children of mothers who completed high school experiencing more detrimental effects. Associations of chronic absence with outcomes are important to understand because school interventions and practices which begin early can be effective in reducing the prevalence of absenteeism.     

The impact of variation and autonomy on psychological responses to high intensity interval training exercise

IntroductionHigh-intensity interval training (HIIT) provides notable physiological benefits and is generally well-tolerated across modalities and populations. This study investigated how exercise autonomy support impacts psychological responses to exercise.MethodsTwenty-nine participants completed three HIIT trials: Conventional-HIIT with 60-sec work segments, Varied-HIIT with a mix of 30, 60, 90, & 120-sec segments, and Autonomous-HIIT with self-selected 30, 60, 90, & 120-sec segments. Affective valence, enjoyment, and intention were measured.ResultsAffective valence during exercise was not different between trials (p > 0.05) but enjoyment during exercise was higher for Autonomous-HIIT (p < 0.05). Enjoyment and intention measured post-exercise were greater for Autonomous-HIIT than Varied-HIIT (p < 0.05).ConclusionAutonomous HIIT produced more desirable responses than varied and traditional HIIT sessions. These data suggest that HIIT sessions utilizing self-selected interval durations can produce more positive responses, which provides the basis for recommending autonomy within HIIT exercise.     

The role of perfectionism in daily self-esteem, attachment, and negative affect

This study of university students (64 men, 99 women) examined the role of self-critical (SC) and personal standards (PS) higher order dimensions of perfectionism in daily self-esteem, attachment, and negative affect. Participants completed questionnaires at the end of the day for 7 consecutive days. Trait and situational influences were found in the daily reports of self-esteem, attachment, and affect. In contrast to PS perfectionism, SC perfectionism was strongly related to aggregated daily reports of low self-esteem, attachment fears (fear of closeness, fear of dependency, fear of loss), and negative affect as well as instability indexes of daily self-esteem, attachment, and negative affect. Multilevel modeling indicated that both SC and PS perfectionists were emotionally reactive to decreases in self-esteem, whereas only SC perfectionists were emotionally reactive to increases in fear of closeness with others. These results demonstrate the dispositional and moderating influences of perfectionism dimensions on daily self-esteem, attachment, and negative affect.     

A daily process approach to coping. Linking theory, research, and practice

For decades, coping researchers have used between-person designs to address inherently within-person questions derived from theory and clinical practice. The authors describe recent developments in the use of within-person, process-oriented methods that examine individuals intensively over time. Ongoing studies of stress and alcohol consumption, the effects of depression on adaptational processes, and the temporal dynamics of coping with chronic pain demonstrate that by tracking rapidly fluctuating processes such as mood and coping close to their real-time occurrence, daily process designs offer unique insights into conceptually and clinically challenging questions. Such designs also provide new opportunities to examine the purported mechanisms of therapeutic interventions. Despite its demands on participants and investigators, daily process research offers fresh opportunities to link psychological theory, research, and practice.