Headaches are a common problem, and psychological factors are widely acknowledged as playing a critical role in the development and maintenance of a high proportion of cases. This mini series consists of six contributions to the headache literature from researchers working in Australia. The papers focus on cycles in headache activity; behavioural patterns, copying styles and personality characteristics of headache sufferers; psychophysiological pain mechanisms; and potential adverse consequences of simplistic treatment approaches. The emphasis on non-treatment studies is unusual in this field but argued to be appropriate in view of the lack of knowledge concerning basic headache processes.

This article was written as a tribute to Robin Winkler, who died on 26 November 1986 after a long illness. The aim of the paper is to highlight Robin's major achievements in his research activity and to point out the themes that run through his work. These themes include his emphasis on the just and humane treatment of the disadvantaged, the recognition of the social context in which psychological treatment and research is conducted, and the interrelations between psychology and economics. The changes that took place in the direction of his work thoughout his career are discussed. Robin's impact on psychology in Australia will continue to find expression through the influence he has had on his many friends and colleagues.

Behaviour therapy is now beginning to assess the social validity, along with efficacy, of its treatments. Literature dealing with the social validity of parent-training programs is reviewed. The aim of this investigation was to obtain acceptability ratings of the “time out” procedure from the perspective of behaviour problem and non-problem children. The study looked at acceptability ratings of five maternal behaviours/disciplinary techniques (permissiveness, physical punishment, directed discussion, quiet time, time out) across four different situations (non-compliance with an initiating instruction, aggression toward others, non-compliance with a terminating instruction, non-compliance with known rule) by samples of clinical (problem behaviour) children and control children. Both groups were alike in rating permissiveness as less acceptable than any of the other behaviours across most situations and rating it as unacceptable in absolute terms. Time out was rated equally acceptable with physical punishment, directed discussion and quiet time. The results support previous findings that young children prefer interventionist to permissive parents, including the use of exclusionary time out. In a second study, ratings were taken from two clinical groups, treatment and waitlist, both at pre- and post-treatment. Despite large individual differences in the treatment group, no change in acceptability ratings was found at post-treatment. Thus, experiencing time out did not change the children's evaluation of this procedure. Possible reasons for these findings and their practical implications are discussed.

The acceptability of three treatments for the maladaptive, but not injurious, repetitive stereotyped behaviour of a mentally retarded child was evaluated. Evaluation was conducted by questionnaires to two groups of staff (nurses and teachers) at two New Zealand institutions for mentally retarded people. A differential reinforcement procedure was found to be most acceptable. A visual screening procedure was judged as being more than moderately acceptable by nurses but less than moderately acceptable by teachers. When visual screening and reinforcement were combined in a treatment package and a rationale for so doing was provided, acceptability was increased significantly for both groups of staff. Teachers rated visual screening, when explicitly prescribed with differential reinforcement, as more than moderately acceptable. The implications of the finding of differential rating of acceptability across and within occupational groups was discussed.

Individual case histories collected variously in Europe and in Australia, recorded over long unbroken sequences, on a daily self-report basis, are potentially analysable as time series. The assessment of spontaneous changes in the dynamics of headache generation and attenuation, and the consequences, if any, of superimposed therapeutic intervention, require that we treat the self-report ratings of headache intensity and duration as a multistate process which is highly autoregressive. Some strong insights into individual differences both in chronic headache patterns, and in response to treatment, are obtained. Of particular interest are individual differences in cyclical and quasi-periodic headaches and in the possible causality of such differences.

The effects of non-contingent rewards administered both directly and implicitly for a fine motor skills task were investigated under a time-series design. Data were collected from all members of a typical class, with the teacher acting as experimenter to enhance generalizability. Results indicated that non-contingent rewards possessed neutral consequential effects, thus challenging data from some previous studies which have methodological limitations. The ineffectiveness of non-contingent rewards as reinforcers is discussed, with several suggestions made for future research to investigate the issue of previous reward history and its effect upon the non-contingent reward condition.

This paper was delivered by Dr R. Winkler as an Invited Address at the Australian Behaviour Modification Association Annual Conference, Sydney, 13 May 1986. The article is published in tribute to Robin Winkler with the normal editorial requirements concerning references and stylistic issues being waived.

Tension (muscle contraction) headache is often associated with high task demands, and relaxation is frequently recommended during daily work activities in many treatment programs. The effect of relaxation on concurrent task performance is assumed to be beneficial, or at worst to have no effect, but this assumption is seldom made explicit. This paper presents results from two experiments which have examined the effects of muscle tension and relaxation on concurrent task performance, in headache-prone and non-headache groups. Results indicated that induced frontalis relaxation did not generally result in optimal task performance; the performance measure affected (accuracy or reaction time) was related to the type of task being performed. Differences between the headache and non-headache subjects were especially related to interactions between task difficulty level and “optimal” level of frontalis tension. Further research is needed to clarify the aspects of performance most affected by variations in frontalis tension and the appropriateness of attempting to relax the frontalis muscle in task situations.

Two case studies are described where behavioural strategies, including response prevention and controlled drinking, were used to successfully treat chronic compulsive polydipsia where traditional medical management had failed. The improvement during treatment and at the 3-month follow-up was reflected not only in reduced fluid intake but also in the reduction of associated thirst symptoms and psychological distress. The implications of these results for treatment of polydipsia and non-compliance with fluid restrictions, particularly among dialysis patients, are discussed.

The aim of the study was to determine if heart rate (HR) and skin conductance increase as a result of worrying and if the increase is greater in worriers than in non-worriers. Ten self-labelled worriers and 10 self-labelled non-worriers were individually interviewed, and a worrying event and a pleasant event were determined for each. The HR and skin resistance were then measured for all subjects when they were calm and quiet, when they imagined a worrying event, and when they imagined a pleasant event. There was no difference in the HR and skin conductance of worriers and non-worriers across the three conditions, namely, baseline, imagination of a worrying event and imagination of a pleasant event. Heart rate increased only as a result of worrying whereas the skin conductance increased both due to worrying and due to the imagination of the pleasant event. The results suggest that HR may be used as a measure of worrying.

Five groups of males and females (N = 65) were administered the Gambrill and Richey Assertion Inventory. These groups consisted of men and women who were not seeking professional counselling (Men-Control and Women-Control Groups), men and women who were visiting a Counselling Centre (Men-Counselling and Women-Counselling Groups) and women who were residents or ex-residents of a refuge in town (Women-Refuge Group). In general, women seeking counselling and women in the refuge group were less assertive than women who were not seeking counselling, and men who were either seeking counselling or not seeking counselling.

The view that dilatation of scalp arteries is a major source of pain in migraine was examined in a series of clinical and psychophysiological investigations. Examination of patients during unilateral migraine or tension-vascular headache demonstrated evidence of extracranial vasodilatation in only a minority of patients. Studies of psychophysiological reactivity indicated that the amplitude of superficial temporal artery pulsations increased more on the side habitually affected by headache than on the non-symptomatic side after light exercise, and increased more readily in migrainous subjects than in non-headache controls during psychological stress. In patients who had previously shown thermographic signs of an increase in blood flow at the site of headache, scalp arteries dilated readily to mental arithmetic stress and exercise. Although extracranial vasodilatation sometimes contributes to migraine, it does not appear to be the primary source of pain in the majority of patients. Regulation of scalp artery diameter may be most effective in the subgroup of patients whose scalp arteries contribute to pain.

Behaviour analysis and therapy is based on the investigation of functional relations between behaviour and its controlling variables. This article focuses on the description of the functional relation and methods used for its research. In particular it presents unpublished data to illustrate how the continuous measurement of independent variables aids the identification of functional relations, research into generalization (a major problem area in behaviour analysis and therapy) and the development of parametric analyses. The implications of comprehensive functional analyses are discussed.

It is argued that earlier models of obsessive-compulsive behaviour have failed to take adequate account of the role of cognitions. A new model is therefore presented, highlighting the major stages of an obsessive-compulsive episode and thereby allowing identification of the point at which cognitive interventions may be made. It is concluded that cognitive techniques may be most useful in assisting patients to “self-expose” and voluntarily instigate response prevention in the absence of the therapist. There is a need for further research in the area, particularly to clarify which cognitive interventions are being used and at which points in the episode.

The mother of a 7-year old boy with Down's syndrome was taught to use and to instruct others how to implement a behavioural management program to eliminate tantrum behaviour at home and in other social settings which was both frequent and persistent. The mother was the only person contacted throughout the program, which comprised three brief visits to the home and three telephone conversations. The program consisted of the extinction of tantrum behaviour using time-out from reinforcement coupled with differential reinforcement of appropriate behaviour. The behavioural objective of three consecutive days without tantrums was reached 18 days after the program was implemented and was maintained for a further 7 days, with only one minor relapse which occurred in a new setting. Six months later the improvement was being maintained. A brief discussion of factors affecting generalization and maintenance is included.

Institutional responses to high rates of youth unemployment in Western industrialized nations have been marked by costly labour market programs, career education services and systems of skill formation. The success of these responses has not been easy to demonstrate, and such programs ignore the fact that in imperfect labour markets the essential activity that does seem to be strongly related to successful job acquisition for any individual is that of structured job finding. Job-finding clubs (which use behavioural techniques to develop high levels of skill in obtaining jobs) have been demonstrated, both in the United States and in Australia, to be capable of significantly increasing the rates of employment among participating club members. The effectiveness and utility of this behavioural approach is outlined.

An alternating treatment design was used to measure the differing impact of visual screening and an auditory blocking procedure in the suppression of the screaming behaviour of a profoundly retarded girl. The auditory blocking procedure made use of white noise to mask any background or personal sounds. During separate sessions both screening procedures were applied for a duration of 1 minute following an occurrence of the screaming behaviour. Results showed that both techniques were successful in reducing the frequency of the behaviour. The visual screening procedure was the preferred treatment for maintaining and generalizing the suppression, because of ease of use and mobility.

This study is concerned with the coping strategies and personality characteristics of headache sufferers. Comparisons were made between headache patients, tinnitus patients and normal controls (N = 105) on the Neuroticism subscale of the Eysenck Personality Questionnaire (EPQ), Taylor Manifest Anxiety Scale (MAS), Beck Depression Inventory (BDI), Unpleasant Events Schedule (UES), a measure of emotional control and a measure of cognitive appraisal of stressors. Statistical analyses revealed that headache sufferers scored in the more pathological direction than the controls on the EPQ, MAS and the measure of cognitive appraisal of stressors. Tinnitus patients did not differ from normal controls on these measures. These results are compared with those of other studies of the personality characteristics and psychological features of headache sufferers. Implications for further research in this area, and for the treatment of headaches, are discussed.

Marital breakdown is common, and often associated with depression. A model is outlined in which such depression may be maintained by avoidance of depression eliciting stimuli. A 27-year-old recently-separated male with severe depression was treated with systematic exposures to depression eliciting stimuli, with cognitive coping self statements being used during exposures. The worst self ratings of depression reported by the client and scores on the Beck Depression Inventory improved greatly from baseline to treatment phases. Gains were maintained at 4 week, 3 and 6 month follow-ups. Further research is warranted to evaluate the efficacy of this potentially useful approach to treating marital breakdown, and possibly other adjustment disorders, which are associated with depressed mood.