The effect of short duration heart rate variability (HRV) biofeedback on cognitive performance during laboratory induced cognitive stress

The aim of this study was to examine the effect of 10 minutes of heart rate variability (HRV) biofeedback on cognitive performance and affect scores during induced stress. Eighteen healthy male volunteers (aged 23–41 years) exposed to work‐related stress, were randomised into an HRV biofeedback intervention (BIO) and a comparative intervention group (COM). Subjects completed a modified Stroop task, which included having to mentally count 18 white squares randomly presented between colour words, before and after a 10‐minute intervention. Subjects also completed questionnaires to rate their anxiety. BIO subjects improved their reaction times and consistency of responses, and made fewer mistakes in counting squares during the modified Stroop task. They also felt more relaxed, less anxious and less sleepy than the COM subjects. In conclusion our results suggest that short duration HRV biofeedback is associated with improved cognitive performance while concurrently aiding relaxation. Copyright © 2010 John Wiley & Sons, Ltd.     

Development of physiological response patterns concomitant with the learning of voluntary heart rate control.

Thirty-six male undergraduate students were instructed to raise or lower heart rate in a multiple-session biofeedback experiment. Systolic and diastolic blood pressure, frontalis electromyographic activity, and skin conductance level were simultaneously recorded throughout biofeedback training. Principal axes factor analyses showed that physiological response patterning concomitant with the development of heart rate control was different early in training (Training Session 1) than it was late in training (Training Session 4) for both speeding and slowing conditions. These results indicate that different heart rate control strategies were used by the subjects early and late in training. The factor patterns also indicated a tendency for greater heart rate response specificity as training progressed for both speeding and slowing. Heart rate speeding sessions were also found to be associated with a significant increase in perceived state anxiety as measured by the State-Trait Anxiety Inventory. No significant change in perceived anxiety state, however, was associated with heart rate slowing.     

A longitudinal study of the development of anticipatory nausea and vomiting in cancer chemotherapy patients: the role of absorption and autonomic perception.

We interviewed 70 cancer patients receiving chemotherapy at home before their second treatment session to obtain baseline measures of absorption, autonomic perception, depression, state-trait anxiety, and basic demographic information. Patients were then interviewed before each of their next six treatment sessions, at which time measures of depression, state anxiety, severity and duration of postchemotherapy nausea and/or vomiting (PCNV), and experience of anticipatory nausea and/or vomiting (ANV) were obtained. Previous findings suggesting that motion sickness, trait anxiety, depression, sex of subject, and age are predictors of the development of ANV were not replicated. Patients with ANV did score significantly higher on measures of absorption and autonomic perception than patients who did not develop ANV. Those variables hypothesized to mediate conditioning (i.e., toxicity of treatment drugs, severity of PCNV, levels of state anxiety) accurately predicted which patients developed ANV. Absorption and autonomic perception added significantly to the prediction.     

The Impact of Biofeedback-Manipulated Physiological Change on Emotional State

In the present study, subjects were administered 16 biofeedback sessions, during which they were trained to significantly increase and decrease their heart rates. Before and immediately following each biofeedback training session, state anxiety was evaluated in subjects by use of the State-Trait Anxiety Inventory. Results indicated that heart-rate slowing performance was associated with a significant decrease in state anxiety; heart-rate speeding performance was associated with an increase in state anxiety. The implications of these findings for further investigation of theories of emotion, and the role played by physiological arousal, are discussed.     

预期焦虑对面孔表情加工的影响

预期焦虑是由于对未发生结果的负性投射造成的焦虑情绪。本文比较了被试在不同预期焦虑水平下观看愉快、中性及恐惧面孔时的行为和脑电数据。发现在高预期焦虑水平下,恐惧面孔诱发的N170波幅显著大于低预期焦虑水平,而愉快和中性面孔在两种水平下诱发的波幅差异不显著;且预期焦虑水平对恐惧面孔诱发的N170波幅的调节强度与个体的特质焦虑得分显著相关。这些结果表明,预期焦虑水平会影响面孔表情加工,且不同情绪面孔受到的影响不同。我们推测,预期焦虑水平会通过影响杏仁核等脑区的激活来调节颞上回对恐惧面孔的加工。     

Preparing Children for Court: Effects of a Model Court Education Program on Children's Anticipatory Anxiety

The current study examined whether a pretrial preparation program, consisting of legal knowledge education, stress inoculation training, and a mock trial, is associated with decreased anticipatory anxiety of child witnesses. One hundred and ninety-three 4- to 17-year-olds who were awaiting impending legal proceedings attended Kids’ Court School in Las Vegas, NV, one to two weeks before their court appearances. Participants completed a measure of anticipatory court-related anxiety before and after the intervention. As predicted, children's anticipatory anxiety decreased significantly from pretest to posttest. Results demonstrate the promise of a brief, unbiased, standardized program for reducing system-induced stress on child witnesses, while maintaining the integrity of the legal process. This study serves as a springboard to guide future research, practice, policy, and implementation on a larger scale. Copyright © 2015 John Wiley & Sons, Ltd.     

Validation of the Holtzman anxiety scale by vasomotor biofeedback

The Holtzman Inkblot Technique (HIT) and the State-Trait Anxiety Inventory were administered to 81 undergraduates who later received biofeedback training for increases in index finger skin temperature. The Holtzman anxiety measure correlated significantly with voluntary temperature increase and the High Anxiety Group, identified by the HIT, was able to achieve significant increases in digital temperature. No significant relationships were found between State-Trait Anxiety measures and either Holtzman anxiety scores or vasomotor control, nor were there significant increases in temperature among State-Trait anxiety groups. The results supported the validity of the HIT as a measure of anxiety, but failed to characterize this anxiety as either state or trait in nature.     

Comparing the effectiveness of behavioral treatment for chemotherapy-induced nausea and vomiting when administered by oncologists, oncology nurses, and clinical psychologists.

Adequate control of side effects during medical treatment of cancer increases patient compliance and quality of life. Antiemetic drugs are not an effective treatment for the one in three cancer patients on chemotherapy who experience anticipatory nausea and vomiting (ANV); the behavioral treatment of systematic desensitization has been found effective for ANV when delivered by clinical psychologists. This study examined the effectiveness of systematic desensitization when delivered by medical personnel versus clinical psychologists. Seventy-two consecutive cancer patients with ANV were randomly assigned to no-treatment control or to systematic desensitization from 5 behaviorally trained clinical psychologists, 6 clinical oncologists, or 10 oncology nurses. The treatment was found effective in reducing anticipatory nausea, anticipatory vomiting, posttreatment nausea, and posttreatment vomiting compared to control patients, with no significant differences in effectiveness found between clinical psychologists and oncology staff. Although medical personnel should not engage patients in psychotherapy or other interventions that cannot be completed successfully, they can treat patients effectively with systematic desensitization and should be encouraged to learn and use this and other behavioral intervention techniques to benefit total patient care.     

Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy.

Assessed the effectiveness of electromyographic (EMG) and skin-temperature (ST) biofeedback and relaxation training (RT) in reducing the aversiveness of cancer chemotherapy. Eighty-one cancer patients, equated on several individual-difference variables, were randomized to one of six groups formed by a 3 (EMG Biofeedback, ST Biofeedback, No Biofeedback) x 2 (RT, No RT) factorial design. Outcome was assessed with physiological, patient-reported, and nurse-reported indices taken over five consecutive chemotherapy treatments. RT patients showed decreases in nausea and anxiety during chemotherapy and physiological arousal after chemotherapy. EMG and ST biofeedback reduced some indices of physiological arousal but had no other effects on chemotherapy side effects. These findings suggest that RT can be effective in reducing the adverse consequences of chemotherapy and that the positive effects found for biofeedback in prior research were due to the RT that was given with the biofeedback, not to the biofeedback alone.     

Training mildly retarded individuals to control their anger through the use of cognitive-behavior therapy techniques

Four mildly retarded adults with chronic anger problems were treated with a cognitive-behavioral approach similar to stress-inoculation training. The treatment techniques included a simplified version of rational-emotive therapy (RET), coping self-statements, relaxation training, biofeedback, coping imagery, behavioral rehearsal, and assertiveness training. The treatment techniques varied in each case so as to meet the needs of the individual clients. The emphasis was on the development of self-control as opposed to control through external contingencies, such as rewards and punishments. There were decreases in the frequency of anger outbursts in all four clients. Violent behavior, such as hitting and kicking others, and destruction of property, was totally eliminated. In addition, the clients reported decreases in anxiety and stress-related symptoms. Although experimental research is needed in this area, these preliminary findings suggest that at least some mildly retarded individuals can be taught self-control through a cognitive-behavioral approach.     

Perfectionism and its relationship with anticipatory processing in social anxiety

Cognitive‐behavioural models suggest that perfectionistic beliefs and anticipatory processing are key maintaining factors of social anxiety. The present study examined the moderating and mediating role that anticipatory processing has on the relationship between perfectionism and social anxiety. The sample consisted of 245 individuals from the general community who completed an online questionnaire package comprising depression, perfectionism, and social anxiety measures. Participants also rated their levels of anticipatory processing in response to vignettes describing an upcoming social interaction and performance situation. Results showed that maladaptive perfectionism and maladaptive anticipatory processing were positively associated with social anxiety. Furthermore, maladaptive anticipatory processes (stagnant deliberation and outcome fantasy) remained significantly and positively associated with social anxiety even after controlling for depression and maladaptive perfectionism, whereas adaptive anticipatory processes (plan rehearsal and problem analysis) were not significantly associated with social anxiety. These findings support current classifications of anticipatory processing in social anxiety. Contrary to predictions, maladaptive anticipatory processing did not moderate the relationship between maladaptive perfectionism and social anxiety. An exploratory analysis indicated that maladaptive anticipatory processing mediated the relationship between maladaptive perfectionism and social anxiety. Implications for therapeutic intervention are discussed.     

Anticipation of interoceptive threat in highly anxiety sensitive persons

Anticipatory anxiety plays a major role in the etiology of panic disorder. Although anticipatory anxiety elicited by expectation of interoceptive cues is specifically relevant for panic patients, it has rarely been studied. Using a population analogue in high fear of such interoceptive arousal sensations (highly anxiety sensitive persons) we evaluated a new experimental paradigm to assess anticipatory anxiety during anticipation of interoceptive (somatic sensations evoked by hyperventilation) and exteroceptive (electric shock) threat. Symptom reports, autonomic arousal, and defensive response mobilization (startle eyeblink response) were monitored during threat and matched safe conditions in 26 highly anxiety sensitive persons and 22 controls. The anticipation of exteroceptive threat led to a defensive and autonomic mobilization as indexed by a potentiation of the startle response and an increase in skin conductance level in both experimental groups. During interoceptive threat, however, only highly anxiety sensitive persons but not the controls exhibited a startle response potentiation as well as autonomic activation. The anticipation of a hyperventilation procedure thus seems a valid paradigm to investigate anticipatory anxiety elicited by interoceptive cues in the clinical context.     

Impact of anticipatory processing versus distraction on multiple indices of anxiety in socially anxious individuals

In models of social phobia, anticipatory processing before a social-evaluative event is a key maintaining factor for the disorder. This study investigated the impact of anticipatory processing versus distraction before a social-evaluative task on affective (self-reported anxiety), psychophysiological (skin conductance), cognitive (self-reported maladaptive self-beliefs) and behavioural (in-situation performance) responses of participants. High and low socially anxious undergraduates were randomly allocated to either an anticipatory processing or distraction condition, and then completed an impromptu speech task. Relative to distraction, anticipatory processing increased self-reported anxiety in all participants, and increased skin conductance and the strength of conditional and high standard beliefs in the high (but not low) socially anxious participants. Unconditional beliefs were not affected. For high socially anxious individuals, anticipatory processing was also indirectly associated with poorer speech performance by increasing self-reported anxiety. Anticipatory processing appears to have multiple adverse effects in socially anxious individuals.     

Biofeedback treatment of paradoxical vocal fold motion and respiratory distress in an adolescent girl

In this investigation, we evaluated the effectiveness of surface electromyography (EMG) biofeedback to treat paradoxical vocal fold motion in a 16-year-old girl. EMG biofeedback training occurred once per week over the course of 10 weeks. In a changing criterion design, muscle tension showed systematic changes that corresponded with changes in the criterion. Overall, baseline muscle tension levels were reduced over 60%, with corresponding reductions in episodes of respiratory distress and chest pain. Subjective reports by the patient and the patient's mother indicated improvements in school attendance and overall adaptive functioning.     

BIOFEEDBACK AND RATIONAL-EMOTIVE THERAPY IN THE MANAGEMENT OF MIGRAINE HEADACHE

Twenty-four migraine patients were randomly assigned to one of four conditions: (a) self-monitoring of headache activity (waiting list), (b) frontalis EMG biofeedback, (c) digit temperature biofeedback, and (d) digit temperature biofeedback plus Rational-Emotive Therapy (RET). Bidirectional control over the target physiological response was assessed through a reversal design in each session. Following at least a four-week baseline, the three biofeedback groups received 8 to 10, 30-minute sessions of bidirectional biofeedback training, scheduled twice a week. Subjects in the combined digit temperature biofeedback plus RET group received three 40-minute sessions of RET as an addition to the third, fifth, and seventh biofeedback sessions. Records of daily home practice were kept throughout treatment and three-month followup. Subjects on the waiting list monitored headaches for at least five months, corresponding to “baseline”, “treatment”, and three-month followup. Digit temperature biofeedback alone and in conjunction with RET did not prove to be more effective than the control conditions. All the EMG subjects reduced headache activity to two-thirds or less of the baseline level by the third month of followup. Bidirectional digit temperature performance did not improve with training, was demonstrated in only 33% of the biofeedback sessions, was not maintained over time, and was unrelated to improvement in headache activity. EMG subjects reported biofeedback performance to be an easier task and met the performance criterion on 85% of the sessions. The frequency of home practice contributed over 55% of the variance in retrospective estimates of headache improvement but was not related to changes in daily records of headache activity.     

The cortisol awakening response: Associations with trait anxiety and stress reactivity

This study investigated the extent to which trait anxiety and state anxiety in response to stress are associated with the cortisol awakening response (CAR).Fifty-one healthy participants were recruited. State anxiety measures were taken in anticipation of and during a laboratory stressor. Salivary cortisol levels were measured immediately upon awakening (at 0, 15, 30, and 45 min) on two consecutive mornings. Cortisol awakening response was assessed by the area under the curve with respect to zero (AUC_G).The magnitude of the CAR was found to be negatively associated with both trait anxiety and anticipatory anxiety. Moreover, regression analysis showed that the effects of trait anxiety on the AUC_G were mediated by anticipatory anxiety.These results suggest that the CAR is influenced by trait anxiety. Moreover, the effect of trait anxiety on the CAR seems to operate by impacting on psychological stress reactivity (i.e., anticipatory anxiety).     

Coping with dental treatment correlates of dispositional and domain specific monitoring and blunting

Abstract

Relations between coping style and several variables on an intermediary level were studied in a group of dentally anxious patients (N = 68) awaiting dental treatment. Monitoring was found to be positively related to the need of information: General dispositional monitoring was the best predictor of the need of information in case of more distant threat, whereas domain specific monitoring was the best predictor in case of imminent threat. Furthermore. dental trait anxiety was strongly related to early anticipatory tension, degree of anticipatory tension at several moments in time, and tension during treatment as perceived by the dentist, thereby overshadowing the weaker effects of coping style. Domain specific blunting was negatively related to desires for informational adaptations in the waiting room, and to question proneness as perceived by the dentist during treatment. It is concluded that, in order to study further effects of coping style, a sample homogeneous with respect to domain specific anxiety is needed.     

Two controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome.

We report two controlled comparisons of a previously validated multicomponent (relaxation, thermal biofeedback, and cognitive therapy) treatment for irritable bowel syndrome (IBS) to an ostensible attention-placebo control (pseudo-meditation and EEG alpha suppression biofeedback) and to a symptom-monitoring control. In Study 1 (n = 10 per condition) there were nonsignificant trends for the multicomponent treatment to be superior to the attention-placebo condition. In Study 2 (n = 30 per condition), we found no advantage for the multicomponent treatment over the attention-placebo condition. Subjects in both treatment conditions showed significant reductions in GI symptoms, as measured by daily symptom diaries, and significant reductions in trait anxiety and depression. The GI symptom reductions held up over a 6 month follow-up. Possible explanations for the results are explored.     

生物反馈疗法对大学生考试焦虑的治疗作用

探讨生物反馈疗法对大学生考试焦虑的治疗作用。在某大学随机抽取学生1500名,采用考试焦虑量表进行筛查,选取焦虑组和对照组各30名。利用生物反馈疗法进行干预,采用脑电α波相对功率、肌电和皮电导联进行检测,每周2次,持续4周。结果表明：1.经过4周的干预,焦虑组干预前后各生理指标存在差异;2.生物反馈疗法干预考试焦虑在疗效上存在性别差异。结论：生物反馈疗法能有效降低大学生考试焦虑水平,对其治疗取得良好的效果。     

Rumination in Children with Social Anxiety Disorder: Effects of Cognitive Distraction and Relation to Social Stress Processing

According to cognitive models of social anxiety disorder (SAD), both anticipatory processing and post-event processing are core mechanisms in disorder maintenance leading to dysfunctional coping with social situations through negative self-evaluation and increased anxiety. To date, little is known about these processes during late childhood, a critical period for disorder development. Further, it remains unclear if dysfunctional rumination in children can be altered through psychotherapeutic interventions such as cognitive distraction. In the current study, children aged 9 to 13 years with SAD and age- and gender-matched healthy controls (HCs, each: n?=?30) participated in an experimental laboratory social stress task while anticipatory processing, post-event processing, subjective anxiety, self-evaluations, and autonomic arousal (skin conductance level) were assessed. Further, the impact of a brief cognitive distraction intervention on post-event processing was assessed. Children with SAD reported more negative anticipatory and post-event processing compared to HC children. Further, negative anticipatory processing was associated with higher subjective anxiety and reduced subjective performance ratings during the social stress task. In the aftermath of the stressor, distraction led to reduced subjective anxiety in the group with SAD and lower autonomic arousal in all children but did not alter post-event processing. The current study suggests that both anticipatory and post-event processing already play a key role in the maintenance of SAD in childhood. While distraction may be beneficial in reducing prolonged subjective anxiety and autonomic arousal after social situations, more research on interventions targeting ruminative processes is needed.