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Pain Treatment and Research

Dr. Kenneth A. Holroyd

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Mission Statement

The Headache Treatment and Research program brings together an interdisciplinary team of research scientists and clinicians with two primary goals: (1) to understand the psychobiological mechanisms of chronic pain, and (2) to develop and evaluate new interventions to more effectively prevent and treat chronic pain problems. The program, funded by the National Institutes of Health for more than a decade, is based in the Department of Psychology at Ohio University with clinical research sites in Columbus, Westerville, and Athens, Ohio.

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Current Projects

Treatment of Severe Migraine (TSM) Trial

The TSM study is a joint project between Ohio University and the National Institutes of Health. The aim of the study is to identify the most effective combinations of medical and behavioral treatments for severe migraine headaches. When migraines occur frequently they often are best treated with a combination of therapies including medication to treat migraine attacks and to prevent migraines from occurring, and non-drug or behavioral therapies that teach methods of controlling migraine without the use of medication. This study will determine the best combination of these therapies for different individuals.

All participants receive free medical and neurological evaluations and treatment of their migraines for at least 18 months. Participants complete headache diaries and receive regular evaluations of their headache to determine the effectiveness of their treatment. If you would like more information about this study: call (740) 593-1060 in Athens or (614) 839-3254 in Columbus. The video below provides additional information.

Treatment of Severe Migraine Video (AVI)

See Pain Treatment and Research (Alternate Site) for more details.

Treatment of Migraine in Adolescents

Migraines may be most effectively treated early is life before headaches become chronic. The peak onset time for migraines is in adolescence. This pilot study examines the treatment of migraines in adolescents (age 12 to 17) with either an innovative home-based behavioral treatment program, or acute (“triptan”) medication. Additional information is in the video below, and in the recent publications section of this Web site.

Treatment of Migraine in Adolescents Video (AVI)

Cottrell, C., Drew, J., Gibson, J., Holroyd, K., O’Donnell, F. (2007). Feasibility Assessment of Telephone-Administered Behavioral Treatment for Adolescent Migraine. Headache.

Treatment of Chronic Tension-type (TCTH) Headache Trial

This trial compares the effectiveness of preventive (Amitriptyline HCL) medication and stress-management (cognitive-behavioral) therapy in managing chronic tension-type headaches. Chronic tension-type headaches occur at least 15 days per month and often occur almost every day. The most effective treatment may be the combination of medication and stress-management therapy. See below reference and others in references section below.

Holroyd, K. A., O'Donnell, F. J., Stensland, M., Lipchik, G. L., Cordingley, G. E., & Carlson, B. W. (2001). Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: A randomized controlled trial. JAMA: Journal of the American Medical Association, 285(17), 2208-2215.

Pain, Depression & Pain Modulation

In laboratory studies, we are examining changes in pain modulation and pain transmission that may index vulnerability to tension-type headaches. When individuals are depressed they are more vulnerable to experiencing tension-type headaches during and following laboratory stress. The same final common pathway (sensitization of the trigeminal nucleus) underlies the effect of depression on pain and other headache vulnerability factors. Additional information is in the references section of this Web site.

Janke, E. A., Holroyd, K. A., Romanek, K. (2004). Depression increases onset of tension-type headache following laboratory stress. Pain, 111, 230-238.

Schoenen, J. (2004). Depression in tension-type headache sufferers: bystander or villain? Pain, 111, 225. Editorial.

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Snapshots

Athens Site

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Columbus Site

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Personnel

Athens Site

Photo Name Position Email Telephone
         
Kenneth A. Holroyd Kenneth A. Holroyd, Ph.D. Clinic/Laboratory Director holroyd@ohio.edu (740) 593-1085
Bernadette Davantes Heckman Bernadette Davantes Heckman, Ph.D. Clinical Health Psychologist heckmanb@ohio.edu (740) 597-1449
Gary Cordingley Gary Cordingley, M.D., Ph.D. Research Neurologist N/A (740) 594-8147
Carol Nogrady Carol Nogrady Office Assistant nogrady@ohio.edu (740) 593-1060
Kathleen Romanek Kathleen Romanek Graduate Student kr227302@ohio.edu (740) 593-1060
Jamie Huckins Jamie Huckins Graduate Student jh177600@ohio.edu (740) 593-1061
Elizabeth Seng Elizabeth Seng Graduate Student es842306@ohio.edu (740) 593-1061

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Columbus Site

Photo Name Position Email Telephone
         
Connie K. Cottrell Connie K. Cottrell, Ph.D., R.N. Project Manager cottrell@rrohio.com (614) 839-3254
Jana Drew Jana Drew, Ph.D. Clinical Health Psychologist drew@rrohio.com (614) 839-3254
Frank O'Donnell Frank O'Donnell, D.O. Research Neurologist N/A (614) 839-3254

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Publications

   
Cottrell, C., Drew, J., Gibson, J., Holroyd, K., O’Donnell, F. (2007). Feasibility Assessment of Telephone-Administered Behavioral Treatment for Adolescent Migraine. Headache.
   
Holroyd, K. A. (2007). Disentangling the Gordion Knot of Migraine Comorbidity. Headache, 876-877. Editorial Comment.
   
Holroyd, K. (2007). Psychological Therapy, Ch. 31 in Jensen, R., Diener, H. C., and Olesen, J. (Eds). Headache Clinics: Organization, patients and treatment, 15, 199-206, New York, Oxford Univeristy Press.
   
Janke, E. A. and Holroyd, K. A. (2007). Pericranial muscle tenderness is associated with widespread pain sensitivity, psychiatric comorbidity, and dysfunctional psychological responses to pain in healthy young adult females. Ch. 18 in Jensen, R., Diener, H. C., and Olesen, J. (Eds). Headache Clinics: Organization, patients and treatment, 15, 108-113, New York, Oxford Univeristy Press.
   
Romanek, K. M., Foster, K. E., Carson, K. and Holroyd, K. A. (2007). Frequent tension-type headache sufferers exhibit widespread pain sensitivity across pressure and thermal pain modalities. Ch. 27 in Jensen, R., Diener, H. C., and Olesen, J. (Eds). Headache Clinics: Organization, patients and treatment, 15, 167-171, New York, Oxford Univeristy Press.
   
Creer, T. L. & Holroyd, K. A. (2006). Self Management of Chronic Illness Conditions: The Legacy of Sir William Osler. Chronic Illness, 2, 7-14.
   
Holroyd, K. A., & Drew, J. B. (2006). Behavioral approaches to the treatment of migraine. Seminars in Neurology, 26(2), 199-207.
   
Penzien, D. B., Andrasik, F., Freidenberg, B. M., Houle, T. T., Lake, A. E., Lipchik, G. L., Holroyd, K. A., Lipton, R. B., McCrory, D. C., Nash, J. M., Nicholson, R. A., Powers, S. W., Rains, J. C., & Wittrock, D. A. (2005). Guidelines for trials of behavioral treatments for recurrent headache, first edition: American Headache Society behavioral clinical trials workgroup. Headache, 45(Suppl 2), S110-S132.
   
Holroyd, K. A., Powers, S. W., & Andrasik, F. (2005). Methodological Issues in Clinical Trials of Drug and Behavior Therapies. Headache, 45, 487-492.
   
Holroyd, K. A.(2004). Behavioral and psychologic aspects of the pathophysiology and management of tension-type headache. Current Pain and Headache Reports, 6, 401-407.
   
Holroyd, K. A. (2004). Recurrent headache disorders. In: R. H. Dworkin & W. S. Breitbart (eds.), Psychosocial Aspects of Pain: Handbook for Health Care Providers. Seattle: IASP Press, 379-403.
   
Janke, E. A., Holroyd, K. A., Romanek, K. (2004). Depression increases onset of tension-type headache following laboratory stress. Pain, 111, 230-238.
   
Holroyd, K. A. (2003). Management of migraine and tension-type headaches. In: J. A. Trafton & W. P. Gordon (eds.), Best Practices in the Behavioral Management of Chronic Disease. Los Altos: Institute for Disease Management, 1-43.
   
Holroyd, K. A., Labus, J. S., O’Donnell, F. J., & Cordingley, G. E. (2003). Treating Chronic Tension-type Headache Not Responding to Amytriptyline Hydrochloride With Paroxetine Hydrochloride: A Pilot Evaluation. Headache, 43, 999-1004.
   
Tkachuk, G. A., Cottrell, K. C., Gibson, J. S., O’Donnell, J. F., & Holroyd, K. A. (2003). Factors associated with migraine-related quality of life and disability in adolescents: A preliminary investigation. Headache, 43, 950-955.
   
Lipchik, G. L., Holroyd, K.A. & Nash, J.M. (2002) Cognitive-behavioral management of recurrent headache disorders: a minimal-therapist-contact approach. In Turk, D.C & Gatchel, R.J. (Eds.) Psychological approaches to pain management. (2ed Edition) New York: Guilford Pubs. Inc.
   
Cottrell, C. K., Drew, J. B., Waller, S., Holroyd, K. A., Brose, J. A., & O’Donell, F. J. (2002). Perceptions and needs of patients with migraine. Journal of Family Practice, 51(2), 142-147.
   
Holroyd, K.A. (2002). Assessment and Psychological Management of Recurrent Headache Disorders. Journal of Consulting and Clinical Psychology, 70(3), 656–677.
   
Holroyd, K. A., Stensland, M., & Carlson, B. (2001). Response Letter: Antidepressant medication for chronic tension headache. JAMA, 286(16), 1969.
   
Holroyd, K. A., O'Donnell, F. J., Stensland, M., Lipchik, G. L., Cordingley, G. E., & Carlson, B. W. (2001). Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: A randomized controlled trial. JAMA: Journal of the American Medical Association, 285(17), 2208-2215.
   
Holroyd, K. A. (2001). Learning from our treatment failures. Applied Psychophysiology & Biofeedback, 26 (4), 319-323.
   
Holroyd, K. A., & Lipchik, G. L. (2000). Sex Differences in Recurrent Headache Disorders: Overview & Significance. In: Fillingim, R. B. (Ed.), Sex, gender, and pain: From the benchtop to the clinic. Seattle: IASP, 251-279.
   
Holroyd, K. A., Stensland, M., Lipchik, G. L., Hill, K. R., O'Donnell, F. S., & Cordingley, Gary (2000). Psychosocial correlates and impact of chronic tension-type headaches. Headache, 40(1), 3-16.
   
Neufield, J. D. Holroyd, K. A., & Lipchik, G. L. (2000). Dynamic assessment of abnormalities in central pain transmission and modulation in tension-type headache sufferers. Headache, 40(2), 142-151.
   
Holroyd, K. A., Malinoski, P., Davis, K. M., & Lipchik, G. L. (1999). The three dimensions of headache impact: Pain, disability and affective distress. Pain, 83(3), 571-578.
   
Lipchik, G. L., Holroyd, K. A., Talbot, F., & Greer, M. (1997). Pericranial Muscle Tenderness and Exteroceptive Suppression of Temporalis Muscle Activity: A Blind Study of Chronic Tension-Type Headache. Headache, 37(6), 368-376.
   
Rokicki, L.A., Holroyd, K. A., France, C. R., Lipchik, G. L., France, J. L., & Kvaal, S. A. (1997). Change mechanisms associated with combined relaxation/EMG biofeedback training with chronic tension headache. Applied Psychophysiology and Biofeedback, 22(1), 21-41.
   
Holroyd, K. A. Talbot, F., Holm, J. E., Pingel, J. D., Lake, A. E. & Saper, J. R. (1996). Assessing the dimensions of pain: A multitrait-multimethod evaluation of seven measures. Pain, 76(2-3), 259-265.
   
Lipchik, G. L., Holroyd, K. A., France, C. R., Kvaal, S. A., Segal, D., Cordingley, G. E., Rokicki, L. A. & McCool, H. R. (1996). Central and peripheral mechanisms in chronic tension-type headache. Pain, 64(3), 467-475.
   
Holroyd, K. A., France, J. L., Cordingley, G. E., Rokicki, L. A., Kvaal, S. A., Lipchik, G. L., & McCool, H. R. (1995). Enhancing the effectiveness of relaxation-thermal biofeedback training with propanolol hydrochloride. Journal of Consulting and Clinical Psychology, 63(2), 327-330.
   
Holroyd, K. A. & French, D. J. (1995). Recent developments in the psychological assessment and management of recurrent headache disorders. In: A. J. Goreczney (ed.), Handbook of Health and Rehabilitation Psychology. New York: Plenum Press, 3-30.
   
Holm, Jeffrey E., Penzien, Donald P., Holroyd, Kenneth A., Brown, & Timothy A. (1994). Headache and depression: Confounding effects of transdiagnostic symptoms. Headache, 34, 418-423.
   
Holroyd, K. A. (1993). Integrating pharmacological and non-pharmacological treatments. In: C. D. Tollison & R. S. Kunkel (eds.), Headache: Diagnosis and Treatment. Baltimore: Williams & Wilkins, 309-319.
   
Holm, J. E. & Holroyd, K. A. (1992). Daily Hassles Scale (Revised): Does it measure stress or symptoms? Behavioral Assessment, 14, 465-482.
   
Holroyd, K. A., Nash, J. M., Pingel, J. D., Cordingley, G. E., & Jerome, A. (1991). A comparison of pharmacological (Amytriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches. Journal of Consulting and Clinical Psychology, 59(3), 387-393.
   
Holroyd, K. A. & Penzien, D. B. (1990). Pharmacological versus non-pharmacological prophylaxis of recurrent migraine headache: A meta-analytic review of clinical trials. Pain, 42, 1-13.
   
Martin, N. J., Holroyd, K. A., & Penzien, D. B. (1990). The headache-specific locus of control scale: Adaptation to recurrent headaches. Headache, 30, 729-734.
   
   
  Measures (articles)
   
   
French, D. J., Holroyd, K. A., Pinell, C., Malinoski, P. T., O'Donnell, F., & Hill, K. R. (2000). Perceived self-efficacy and headache-related disability. Headache, 40(8), 647-656.
   
Holm, Jeffrey E., Penzien, Donald P., Holroyd, Kenneth A., Brown, & Timothy A. (1994). Headache and depression: Confounding effects of transdiagnostic symptoms. Headache, 34, 418-423.
   
Holm, J. E. & Holroyd, K. A. (1992). Daily Hassles Scale (Revised): Does it measure stress or symptoms? Behavioral Assessment, 14, 465-482.
   
Martin, N. J., Holroyd, K. A., & Penzien, D. B. (1990). The headache-specific locus of control scale: Adaptation to recurrent headaches. Headache, 30, 729-734.
   
Tobin, D. L., Holroyd, K. A., Reynolds, R. V. and Wigal, J. K. (1989). The Hierarchical Factor Structure of the Coping Strategies Inventory. Cognitive Therapy and Research, 13(4), 343-361.

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Presentations

  Talks
   
   
Holroyd et al. Treatment of Severe Migraine (TSM). Trial American Pain Society, 2007.
   
Romanek, K. Psychophysiological and Psychological Correlates of Allodynia and Affective Distress. Ohio University, 2007.
   
Behavioral Migraine Management, OAH, 2005
   
   
  Posters
   
   
Holroyd, K. A., & Labus, J. “Response to antidepressant medication, cognitive behavior therapy and placebo in chronic tension-type headache varies with psychiatric comorbidity & headache severity.” American Headache Society, 2006.
   
Romanek, K. M., Holroyd, K. A., Cottrell, C., & Drew, J. "Differences in Patterns of Impairment, Psychiatric Comorbidity and Headache Beliefs in Migraine and Chronic Tension-type Headache." presented at the annual meeting for the American Pain Society, 2006.
   

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Measures (copies of scales)

  To access the scales and instructions please email Carol Nogrady at nogrady@ohio.edu.
   
  Coping Strategies Inventory – Short Form 32
 

User Manual for the Coping Strategies Inventory
   
  Hassles Scale (Revised) – Short form (with instructions & scoring)
   
  Headache Locus of Control Scale (with instructions & scoring)
   
  Headache Self-Efficacy Scale (with instructions & scoring)
   
  Interview of Coping Efforts – Migraine
 

ICE-M Manual
 

ICE-M Categorization Exercise
 

ICE-M Categorization Test Key

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Related Links

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Updated: November 1, 2007