SYNOPSIS This study was designed to measure the validity of two variations of a self‐report pain intensity scale. Sixteen children aged 9‐17, suffering from migraine headaches and one parent of each child recorded headache intensity daily at fixed intervals for four weeks in headache diaries. Half of the children used a pain intensity scale with behavioral descriptors of pain severity accompanied by numbers zero to five; the remainder used a scale that was identical except for the addition of subjective pain descriptors. Validity was determined by assessing the degree of inter‐rater concordance between the child's rating of intensity of head pain and the parent's independent rating of the same phenomenon. Concordance values, determined by weighted kappa, ranged from slight to almost perfect and all but one were significant, r<.05, providing evidence for the validity of this scale. Percentage agreement and weighted percentage agreement were also calculated and indicated high levels of concordance. Inclusion of subjective descriptors did not significantly affect ratings.

The efficacy of a clinic-based cognitive-behavioral program for the treatment of common migraine was compared to the same approach using a minimal-therapist-contact format by means of a randomized controlled trial. Forty-eight subjects between 18 and 50 years of age completed the program. Following four weeks of recording headache activity, subjects were randomly assigned to a waiting list control condition or to one of the two treatment conditions. Treatment was followed by four weeks of recording of headache activity immediately posttreatment and again six months later. Multivariate analysis of variance indicated that there was a significant reduction in headache frequency, duration and peak intensity following treatment for both treated groups. These reductions were maintained at six months follow-up. Treatment for the minimal-contact group was significantly more cost-effective than for the clinic group.

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