Annals of Behavioral Medicine

, Volume 40, Issue 3, pp 235–247 | Cite as

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

  • Elizabeth K. SengEmail author
  • Kenneth A. Holroyd
Original Article



Modification of expectancies (headache self-efficacy and headache locus of control) is thought to be central to the success of psychological treatments for migraine.


The purpose of this study is to examine expectancy changes with various combinations of Behavioral Migraine Management and migraine drug therapies.


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−) × 2 (β-blocker, placebo) treatment design.


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+.


The “deficiency” hypothesis best explained how patient characteristics influenced changes in of headache self-efficacy with Behavioral Migraine Management.


Migraine Behavioral treatment Drug treatment Self-efficacy Locus of control Socioeconomic status 



We would like to thank the following people for their assistance in carrying out the TSM trial: Constance Cottrell, Francis O’Donnell, Gary Cordingley, Carol Nogrady, Kimberly Hill, Victor Heh, Suzanne Smith, Bernadette Devantes Heckman, Brenda Pinkerman, Gregg Tkachuk, Sharon Waller, Donna Shiels, Kathleen Darchuk, Yi Chen, Timur Skeini, Manish Singla, Swati Dalmai, Lori Arnott, and Lina Himawan. Support for this trial was provided by grant NS-32374 (awarded to Dr. Holroyd) from the National Institutes of Health. Merck Pharmaceuticals, Inc and GlaxoSmithKline Pharmaceuticals donated triptans (5-HT1B/D-agonists) for acute migraine therapy, which was their only involvement.

Conflict of Interest Statement

Ms. Seng reports no conflicts of interest. Dr. Holroyd has received support from the National Institutes of Health (NINDS; NS32375), has consulted for ENDO Pharmaceuticals and Takeda Pharmaceuticals North America, and received an investigator initiated grant from ENDO Pharmaceuticals.


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Copyright information

© The Society of Behavioral Medicine 2010

Authors and Affiliations

  1. 1.Department of PsychologyOhio UniversityAthensUSA

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