The refractory headache patient--I. Chronic, daily, high intensity headache

Two studies on patients with Chronic, Daily, High Intensity Headache (CDHIHA) are presented. In the first, their response to various self-regulatory (biofeedback, relaxation) treatments was compared to that of case controls matched for age, duration and Ad Hoc Committee diagnoses who had 1-2 headache-free days per week (Group II) and 3-5 headache-free days per week (Group III). The CDHIHA patients had a significantly poorer response to treatment (12.7 vs 49.8% improvement for Groups II and III combined). In the second study, the psychological profiles of an enlarged sample of CDHIHA patients were compared to matched case controls from Group II and Group III. The CDHIHA patients tended to be more anxious, more hysterical and to have more non-headache somatic complaints than Groups II and III combined.     

Construct Validity of the Relationship Profile Test: Links With Measures of Psychopathology and Adult Attachment

This study assessed the construct validity of the Relationship Profile Test (RPT; Bornstein &; Languirand, 2003 Bornstein, R. F., &; Languirand, M. A. (2003). Healthy dependency. New York, NY: Newmarket. [Google Scholar]) with a substance abuse sample. One hundred-eight substance abuse patients completed the RPT, Experiences in Close Relationships Scale–Short Form (Wei, Russell, Mallinckrodt, &; Vogel, 2007 Wei, M., Russell, D. W., Mallinckrodt, B., &; Vogel, D. L. (2007). The Experience in Close Relationships Scale (ECR)–Short Form: Reliability, validity and factor structure. Journal of Personality Assessment, 88, 187–204.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]), Personality Assessment Inventory (Morey, 1991 Morey, L. C. (1991). Personality Assessment Inventory professional manual. Odessa, FL: Psychological Assessment Resources. [Google Scholar]), and Symptom Checklist–90–Revised (Derogatis, 1983 Derogatis, L. R. (1983). SCL–90–R administration, scoring, and procedures manual II. Towson, MD: Clinical Psychometric Research. [Google Scholar]). Results suggest that the RPT has good construct validity when compared against theoretically related broadband measures of personality, psychopathology, and adult attachment. Overall, health dependency was negatively related to measures of psychopathology and insecure attachment, and overdependence was positively related to measures of psychopathology and attachment anxiety. Many of the predictions regarding RPT detachment and the criterion measures were not supported. Implications of these findings are discussed.     

Biofeedback and reinforcement to increase heterosexual arousal in homosexuals

Relatively few procedures exist for developing heterosexual arousal in the treatment of sexual deviation (Barlow, 1973) although several recent studies suggest this is a necessary component of treatment (Feldman and MacCulloch, 1971; Bancroft, 1970; Barlow, 1974).In recent years, biofeedback techniques have been applied to many types of disorders (Blanchard and Young, 1974). Basic to biofeedback technology is the notion that providing a person with feedback (or immediate information) of a bioelectric response enables him to learn (gain) self-control of that response. These responses traditionally have been considered involuntary and include heart rate (Scott et al., 1973a). blood pressure (Benson et al., 1971), stomach acid pH (Welgan. 1972), and electroencephalographic activity (Sterman, 1972), In the present experiments, biofeedback and its attendant technology was applied to the problem of generating heterosexual arousal in homosexual males.Frequently, in biofeedback research, reinforcement has been used in addition to feedback in attempting to teach self-control of a response. In fact, an alternate way of conceptualizing and describing the biofeedback research is in terms of operant conditioning (e.g., Weiss and Engel, 1971: Scott et al., 1973b). In one sense, however, feedback and reinforcement are inextricably confounded: the delivery or non-delivery of a reinforcer provides the S with information about the rightness or wrongness of his response and hence, binary feedback about it. Likewise, if feedback or knowledge of whether the response has reached a criterion level or not is effective in leading to a change in the response, then feedback functions as a reinforcer. Reinforcement, however, may be viewed as providing both information about the response (feedback) plus an incentive to change it in the desired direction in addition to any incentive provided by successful performance of a task. Thus, if one provides Ss with a separate, functionally defined reinforcer in such a way that no additional information about the response is conveyed, it becomes possible to detect additive effects of reinforcement over feedback effects. Such was the second purpose of this study.Several recent analogue experiments with volunteers have reported success in modifying erections through feedback and/or reinforcement. Price (1973) found that heterosexual volunteers who received analogue visual feedback as well as binary feedback, provided by a colored light once the needle had passed a pre-set criterion, showed a shorter latency to peak erection and maintained criterion erection longer than a control group receiving no feedback. Both groups were listening to erotic audio tapes. Rosen (1973) demonstrated significant suppression of tumescence in a group of heterosexual volunteers provided with response contingent signal lights. A group receiving non-contingent feedback did not show this effect. In a technical paper, Laws and Pawlowski (1973) have suggested audio feedback of tumescence as a treatment for deficits in sexual arousal.In the clinic, Harbison, Quinn and McAllister (1970), in an uncontrolled case study, reported increasing heterosexual responsiveness in homosexuals through reinforcement of erection. In one of their homosexual patients they were able, over a long series of trials, to increase erection to a heterosexual stimulus (female slide) through rewarding progressively larger responses with sips of iced lime after the patient was water deprived. In addition to the reinforcement, this S was given feedback, of sorts, in that a light was flashed for each successful trial. A second homosexual patient was similarly rewarded for maintaining progressively longer and clearer fantasies of heterosexual behavior. Since other treatments were also applied and no experimental analysis was performed, it is not possible to evaluate the effectiveness of the procedure.In the present experiment the separate effects of feedback and reinforcement to increase heterosexual arousal in homosexuals was experimentally evaluated using single case experimental design methodology (Barlow and Hersen, 1973). Since each experiment was somewhat different in design and purpose, each will be described separately.     

The effect of S− on observing behavior

Eight pigeons were run on a one-key, discrete-trials observing procedure. Pecks during a trial produced S⁺ and S^?, colored key lights which signalled whether the trial would end with response-independent grain reinforcement or nonreinforcement. S⁺ and S^? were produced on a VI schedule which began operating at the onset of the trial. In the main experimental condition, only a response preceded by at least 6 sec of nonresponding could produce S^? on nonreinforced trials; any response which satisfied the VI requirement produced S⁺ on reinforced trials. This procedure allowed the birds to produce S⁺ on reinforced trials with or without producing S^? on nonreinforced trials. The subjects learned to produce fewer S^?s over sessions, indicating that S^? had a punishing effect on observing. The results were taken as evidence for the conditioned reinforcement hypothesis of observing and against the uncertainty reduction hypothesis.     

Sequential comparisons of relaxation training and biofeedback in the treatment of three kinds of chronic headache or,the machines may be necessary some time of the time

Two studies are reported in which patients with chronic headache, who did not improve significantly as a result of a 10-session, 8-week relaxation training program, were subsequently treated with biofeedback. For the tension headache sufferers, 36% of the relaxation non-responders showed significant improvement with frontal EMG biofeedback training. For those with vascular headaches, 44% of the relaxation non-responders showed significant improvement with thermal biofeedback. Vascular headache patients with combined migraine and tension symptoms did better than those with only migraine. Psychological test scores significantly differentiated successful vs non-successful biofeedback responders.     

Depression,restraint and eating behavior

Contrary to the belief that weight loss is a principal symptom of depression, several recent studies have suggested that certain people gain rather than lose weight when depressed. The present experiment concerned the effects of experimentally induced mood states on the eating behavior of high- and low-restraint persons. Sixty-eight female undergraduates were randomly assigned to one of three groups each designed to induce a different mood state (depressed, neutral or elated), and were classified as high or low restraint based on their responses to a questionnaire. During the mood induction procedure subjects were provided with the opportunity to eat. High-restraint persons induced into a depressed mood ate significantly more than high-restraint persons induced into neutral or elated moods, and more than low-restraint persons induced into a depressed mood. This effect was most prominent among subjects who scored high on the weight-fluctuation factor of the restraint scale. There was no evidence that this effect occurred among subjects who scored high on the concern for dieting factor. The role of emotional arousal on the self-control over eating behavior of high weight-fluctuation persons, and the implications of these findings for the evaluation of depression were discussed.