Mechanisms of change in posttraumatic headache–related disability: A mediation model

Objective To explore whether the association between change in headache management self‐efficacy and posttraumatic headache–related disability is partially mediated by a change in anxiety symptom severity. Background Many cognitive–behavioral therapy treatments for headache emphasize stress manageme...

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Bibliographic Details
Published in:Headache 2023-03, Vol.63 (3), p.410-417
Main Authors: Nabity, Paul S., Reed, David E., McGeary, Cindy A., Houle, Timothy T., Jaramillo, Carlos A., Resick, Patricia A., Eapen, Blessen C., Litz, Brett T., Mintz, Jim, Penzien, Donald B., Keane, Terence M., Young‐McCaughan, Stacey, Peterson, Alan L., McGeary, Donald D.
Format: Article
Language:English
Subjects:
Anxiety
Behavior modification
Cognitive ability
Cognitive Behavioral Therapy
disability
Effectiveness
Headache
Headache - etiology
Headache - psychology
Headache - therapy
Headaches
Humans
Impact tests
Information processing
Management
Post-Traumatic Headache
posttraumatic
Psychotherapy
Secondary analysis
self‐efficacy
Statistical analysis
Tension-Type Headache
Therapy
veteran
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Summary:Objective To explore whether the association between change in headache management self‐efficacy and posttraumatic headache–related disability is partially mediated by a change in anxiety symptom severity. Background Many cognitive–behavioral therapy treatments for headache emphasize stress management, which includes anxiety management strategies; however, little is currently known about mechanisms of change in posttraumatic headache–related disability. Increasing our understanding of mechanisms could lead to improvements in treatments for these debilitating headaches. Methods This study is a secondary analysis of veterans (N = 193) recruited to participate in a randomized clinical trial of cognitive–behavioral therapy, cognitive processing therapy, or treatment as usual for persistent posttraumatic headache. The direct relationship between headache management self‐efficacy and headache‐related disability, along with partial mediation through change in anxiety symptoms was tested. Results The mediated latent change direct, mediated, and total pathways were statistically significant. The path analysis supported a significant direct pathway between headache management self‐efficacy and headache‐related disability (b = −0.45, p 
ISSN:0017-8748
1526-4610
DOI:10.1111/head.14480