Dynamics of Changes in Self-Efficacy and Locus of Control Expectancies in the Behavioral and Drug Treatment of Severe Migraine

Background Modification of expectancies (headache self-efficacy and headache locus of control) is thought to be central to the success of psychological treatments for migraine. Purpose The purpose of this study is to examine expectancy changes with various combinations of Behavioral Migraine Management and migraine drug therapies. Methods Frequent migraine sufferers who failed to respond to 5 weeks of optimized acute migraine drug therapy were randomized to a 2 (Behavioral Migraine Management+, Behavioral Migraine Management-) x 2 (beta-blocker, placebo) treatment design. Results Mixed models for repeated measures analyses (N= 176) revealed large increases in headache self-efficacy and internal headache locus of control and large decreases in chance headache locus of control with Behavioral Migraine Management+ that were maintained over a 12-month evaluation period. Chance headache locus of control and socioeconomic status moderated changes in headache self-efficacy with Behavioral Migraine Management+. Conclusions The "deficiency" hypothesis best explained how patient characteristics influenced changes in of headache self-efficacy with Behavioral Migraine Management.