The combined use of rational-emotive therapy and biofeedback in the treatment of childhood migraine

The available literature on the psychological treatment of childhood migraine was reviewed and evaluated. The current treatment modalities have relled essentially upon biofeedback techniques and neglected the potential cognitive factors that might lead to successful results. A case example is provided that demonstrates the combined treatment of childhood migraine using both biofeedback and rational emotive therapy (RET). Continued relief was reported during a follow-up interview conducted a year and a half after the treatment concluded. While both the biofeedback and RET elements for treatment were considered important for alleviation of the migraine condition, the subject reported that it was the RET training that proved most effective in dealing with stressors related to the onset of migraine attacks.     

Clinical effects of biofeedback treatment in migraine: The relation to achieved self-control and pretreatment predictors

Abstract

Factors contributing to the headache reduction six months after treatment of sixty-three migraine subjects were examined in three different studies. Subjects had originally been treated with either peripheral skin temperature biofeedback, biofeedback for blood-volume-pulse amplitude of the temporal artery, or applied relaxation. In Study 1 it was found that biofeedback subjects who had achieved self-control of the trained physiological parameter had significantly greater headache reductions than “nonlearners”. In Studies 2 and 3, potential predicting factors of clinical effects were studied. Age and whether subjects had achieved self-control emerged as (weak) predictors in different analyses using discriminant analysis. Using “PLS” (partial least squares projections to latent structures) a model emerged which gave a more complex picture, and which might indicate for example that there are different sets of factors which predict success and predict nonsuccess in treatment.     

Some methodological considerations in thermal biofeedback training

This article attempts to provide guidelines for acceptable practice in thermal biofeedback training. Criteria are set forth in three major areas: the nature of the interaction between the experimenter/therapist and subject/patient, training procedures, and the physical characteristics of the temperature sensing and feedback system.     

Evaluation of thermal biofeedback treatment of hypertension using 24-hr ambulatory blood pressure monitoring.

Ten male hypertensives, whose BPs were controlled on a combination of sympatholytic and diuretic medications, were given 16 sessions of thermal biofeedback prior to attempting withdrawal from the sympatholytic drug. Results were evaluated using 24-hr ambulatory BP monitoring (ABPM) as well as clinic and home BPs, both in multi-baseline-across-subject designs and as a single group. Results showed significant treatment effects on 24-hr ABPM data, both at the individual level (SBPs only) and in the aggregate analyses (SBP and DBP). BPs assessed in the clinic by random zero sphygmomanometer and patient-assessed home BPs were also reduced.     

Self-efficacy as a predictor of ability to learn control of heart rate increase with and without biofeedback

Abstract

The usefulness of self-efficacy as a predictor of success in controlling heart rate increase with and without biofeedback was investigated in an experimental study on 60 adult subjects. The first part of the study measured heart rate increase control without biofeedback training, the second part measured heart rate increase control with biofeedback training and a posttest measured subsequent heart rate increase control without biofeedback. The results revealed that higher levels of self-efficacy were predictive of success in controlling heart rate increase without biofeedback, but not with biofeedback.     

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: II. Effects on cardiovascular reactivity

In the course of conducting a controlled comparison of progressive muscle relaxation and thermal biofeedback as possible substitutes for second-stage (sympatholytic) antihypertensive medications, we measured reactivity (heart rate, systolic blood pressure, and diastolic blood pressure) to three different stressors (mental arithmetic, cold pressor, and negative mental imagery) before and after treatment and drug withdrawal. Neither treatment was consistently effective in reducing reactivity across a variety of stressors. Relaxation led to more reductions in some aspect of reactivity than did biofeedback. The modest level of reductions in reactivity were seen more for mental arithmetic and systolic blood pressure.     

Self-efficacy and disability beliefs in behavioral treatment of pain

Recent interest in self-efficacy theory and pain has produced a variety of reports on the relationship between self-efficacy expectancies and pain perception and its management. In studies of behavioral treatment approaches, self-efficacy expectancies were found to be related to experimental and acute clinical pain tolerance. Efficacy beliefs were also found to be associated with the level of functioning of chronic pain patients and their response to treatment. These preliminary observations are promising and suggest that self-efficacy theory may contribute to the understanding and behavioral management of clinical pain.     

A controlled evaluation of paraspinal EMG biofeedback in the treatment of chronic low back pain

Sixty-six chronic low back pain sufferers were randomly divided into three groups. Following individual assessments consisting of psychological questionnaires, pain monitoring, and measurement of paraspinal electromyogram (EMG), one group received paraspinal EMG biofeedback and another a placebo treatment. The third group received no intervention. Two further assessments were carried out on all groups immediately after treatment and at a 3-month follow-up. All groups showed significant reduction in pain, anxiety, depression, and paraspinal EMG following treatment and at follow-up, but there were no differences between groups. A regression analysis failed to identify subjects' characteristics that predicted positive outcome in the biofeedback group. However, high scores on the Evaluative scale of the McGill Pain Questionnaire and high hypnotizability were significant predictors of positive outcome for the placebo group. It is concluded that paraspinal EMG biofeedback is not a specific treatment for chronic low back pain in a nonhospitalized population.     

Electrical safety in the use of biofeedback instruments

Electrical hazards associated with the use of medical apparatus are described with emphasis on biofeedback instruments. Safety standards specify safe current levels for instruments in normal operation; however, the user can take steps to provide back-up protection against hazards caused by component malfunction or breakdown. Measures for protection of patient and operator are outlined, including instrument design considerations and guidelines for the user to follow in order to provide a margin of safety.