Biofeedback, cognitive training and relaxation techniques as multimodal adjunct therapy for hospitalized adolescents: a pilot study

Modifications and adjuncts to traditional therapy techniques appear to be necessary for successfully treating hospitalized adolescents with impaired social and verbal skills, and a history of acting-out behavior. Modified therapy groups were combined with a structured biofeedback and cognitive training program to help these adolescents control anger and modify their behavior. Used in conjunction with training and practice in relaxation techniques, this multimodal treatment approach appeared to be helpful in both reducing incidents of acting out on residential units, and in reaching individualized therapeutic goals. The present paper describes use of this multimodal approach within selected residential settings, and outlines the structured materials developed by the authors.     

Adolescent eating disorder: bulimia

Bulimia, an eating disorder, recently has emerged as a major mental health problem, especially among adolescent females. The bulimic experiences periods of compulsive binge eating followed by purges to rid the body of unwanted calories. Binges are triggered by intense emotional experiences, such as loneliness, anger, rejection, or stress. Associated features of bulimia are secretiveness, depression, drug abuse, preoccupation with body image and sexual attractiveness, and an awareness that the behavior is abnormal. The physical side effects include dental problems, inflamed esophagus, EEG abnormalities, abdominal or urinary disturbances, and changes in blood sugar level. Cognitive disturbances related to binging and purging are perfectionistic, egocentric, and distorted thinking, misconceptions about nutritional requirements, unreasonable goals and expectations, and disturbed affect. Bulimics resist treatment; however, such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising.     

Variables which differentiate placement of adolescents into juvenile justice or mental health systems

Studies of the variables that determine whether an adolescent is placed in the mental health or juvenile justice system for treatment have led to conflicting conclusions based on impressionistic data. The primary hypothesis of this study--that demographic variables would and personality/psychopathology variables would not differentiate into which system a youth will be placed--was supported. Adolescents were studied at intake into both the juvenile justice system and the mental health system. Data were collected on demographics (structured interviews), personality/psychopathology (MMPI), social adjustment (CAAP), and academic achievement (PIAT). A discriminant function analysis identified eight statistically significant variables which differentiated the two groups. In order of decreasing importance they are: ethnicity, gender, MMPI-depression, previous mental health history, CAAP-productivity, drug use, parental marital history, and parental religious preference.