生物反馈在功能性结直肠病中的应用及体会

生物反馈作为一种新兴的行为疗法,在治疗功能性结直肠病中发挥着越来越重要的作用,主要用于治疗功能性大便失禁和功能性便秘。根据目前的研究,依从性和心理状况是影响生物反馈疗效的主要因素。本文就生物反馈在功能性结直肠病中的应用及体会做一综述。     

Neurofeedback Treatment of Depression and Anxiety

A robust body of research documents that there are biological predispositions that often exist for depression, anxiety, and obsessive–compulsive disorder. However, new research has shown that medication is only mildly more effective than placebo in the treatment of these problems. In treating these conditions, neurofeedback (EEG biofeedback) may offer an alternative to invasive treatments such as medication, ECT, and intense levels of transcrancial magnetic stimulation. This paper reviews the neurofeedback literature with these problems, finding particularly positive research support for the treatment of anxiety disorders. New findings on the neurofeedback treatment of depression are presented.     

Walking versus biofeedback: a comparison of acute interventions for stressed students

Background: High rates of stress-related problems in college students and low utilization of treatment options demonstrate the need for effective stress-reducing interventions that can be self-regulated. This study compared the effect of brief paced-breathing with biofeedback and exercise interventions on heart rate variability, state anxiety and affect. Methods: Students (n?=?32) with high levels of perceived stress completed three 10-min interventions on separate days: paced-breathing with biofeedback (Biofeedback), a self-paced walk (Exercise), and an attention control condition of quiet studying (Quiet Study). Anxiety and affect were measured before (Pre), immediately after (Post0) and 15 mins after (Post15) the intervention. Heart rate variability was measured pre- and post-intervention using electrocardiogram. Results: Biofeedback reduced anxiety more than the exercise condition (Pre to Post0: Biofeedback d?=??0.48, Exercise d?=??0.13). Secondly, Exercise temporarily increased energy (Pre to Post0: d?=?0.67), whereas Biofeedback temporarily increased calmness (Pre to Post0: d?=?0.51). All conditions significantly increased total heart rate variability (p?Conclusions: Biofeedback and Exercise interventions improved emotional states in high-stress college students, but the type of change observed (i.e. energizing, calming or anxiety reducing) depended upon the condition.     

A behavioral medicine intervention as an adjunctive treatment for HIV-related illness

Abstract

This investigation assessed the efficacy of a behavioral medicine intervention in the adjunctive treatment of symptomatic HIV seropositive men. Twenty-six, well coping, seropositive gay males were randomly assigned to either a treatment group or a waiting list control group. The treatment group received eight weeks of training in thermal biofeedback, guided imagery and hypnosis Significant results (p < 0.05) indicated that HIV-related symptoms (fever, fatigue, pain, headache, nausea and insomnia) decreased and that vigor and hardiness increased. No significant changes were found in absolute numbers of CD4 cells, tension-anxiety or depression.     

MODIFICATION OF COMBINED MIGRAINE-MUSCLE CONTRACTION HEADACHES USING BVP AND EMG FEEDBACK

The effect of blood volume pulse (BVP) and frontalis muscle action potential (EMG) feedback on control of vasoconstriction of the temporal artery and frontalis muscle activity in combined migraine-muscle tension subjects was investigated in a multiple baseline design (across subjects and responses). The data indicated: (a) both subjects obtained an ability to control BVP during BVP feedback and EMG during EMG feedback; (b) there were decreases in frequency of migraine headaches during BVP feedback and decreases in muscle contraction headaches during EMG feedback. The results of this study supported the theoretical explanation of two pain mechanisms involved in combined muscle contraction-migraine headaches as well as the effectiveness of biofeedback procedures that target directly the specific pain mechanism in the elimination of the two types of head pain.     

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.     

Neurotherapy with Adults

Several possible conceptualizations of neurotherapy are discussed: EEG operant conditioning; EEG homeostatic normalization; and utilization of EEG biofeedback as a means of accessing particular states of consciousness. Attention is given to how neurotherapy is actually done and when it may be a useful adjunct to psychological or medical therapies. Integration of neurotherapy with the larger framework of cognitive behavior therapy and the biopsychosocial model is discussed. Three case studies of adults involving the use of neurotherapy are described.     

Análisis experimental del efecto placebo

Resumen

La concepción tradicional del placebo considera este fenómeno como un procedimiento inespecífico para el problema que está siendo tratado (generalmente se refiere a intervenciones médicas o psicológicas). Se supone que el mecanismo de acción es psicológico: sugestión, expectativas, credibilidad, variables del terapeuta, condicionamiento, etc. No obstante, tales variables no son inocuas ni inespecíficas en psicología.

En este trabajo exponemos nuestra concepción del placebo y aportamos apoyo experimental a las predicciones de este modelo teórico.     

EMG scanning: Normative data

Surface EMG was recorded from both right and left aspects of 18 muscle groups for the purpose of establishing a data base of normative EMG levels. A scanning electrode permitted easy and rapid EMG measurement from 52 male and 51 female college students, both sitting and standing. Several a posteriori analyses of variance revealed sex differences in the masseter, occipital, posterior cervical, upper trapezius, latissimus dorsi, and anterior tibialis. Similarly, there were side differences for the anterior temporalis, occipitalis, splenius capitus, trapezius, paraspinalis, and soleus. The analyses also revealed interactions among sex, position, and side for various measures on the trapezius. The data show that females tend to muscle brace more than males in the upper extremities. The study provides data for normative comparisons and helps to plan and interpret future EMG studies.