Effects on EMG feedback, diazepam and their combination on chronic anxiety

Biofeedback for psychiatric disorders: a systematic review

Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders, depression, dissociation, eating disorders, schizophrenia and psychoses] to date and provide a useful reference for consultation by clinicians and researchers planning to administer a biofeedback treatment. A systematic search of EMBASE, MEDLINE, PsycINFO, and WOK databases and hand searches in Applied Psychophysiology and Biofeedback, and Journal of Neurotherapy, identified 227 articles; 63 of which are included within this review. Electroencephalographic neurofeedback constituted the most investigated modality (31.7%). Anxiety disorders were the most commonly treated (68.3%). Multi-modal biofeedback appeared most effective in significantly ameliorating symptoms, suggesting that targeting more than one physiological modality for bio-regulation increases therapeutic efficacy. Overall, 80.9% of articles reported some level of clinical amelioration related to biofeedback exposure, 65.0% to a statistically significant (p < .05) level of symptom reduction based on reported standardized clinical parameters. Although the heterogeneity of the included studies warrants caution before explicit efficacy statements can be made. Further development of standardized controlled methodological protocols tailored for specific disorders and guidelines to generate comprehensive reports may contribute towards establishing the value of biofeedback interventions within mainstream psychiatry.

Effects of a behavioral stress-management program on anxiety, mood, self-esteem, and T-cell count in HIV positive men

This study evaluated the effects of a behavioral stress-management program on anxiety, mood, self-esteem, and T-cell count in a group of HIV-positive men who were asymptomatic except for T-cell counts below 400. The program consisted of 20 biweekly sessions of progressive muscle relaxation and electromyograph biofeedback-assisted relaxation training, meditation, and hypnosis. Ten subjects were randomly assigned to either a treatment group of a no-treatment control group, and the 2 groups were compared on pre- to posttreatment changes in the dependent measures. Analysis showed that, compared with the no-treatment group, the treatment group showed significant improvement on all the dependent measures, which was maintained at a 1-mo. follow-up. Since stress is known to compromise the immune system, these results suggest that stress management to reduce arousal of the nervous system and anxiety would be an appropriate component of a treatment regimen for HIV infection.

Alternative treatments for withdrawing the long-term benzodiazepine user: a pilot study

Anxiolytic therapy with benzodiazepines and their potential for dependence are reviewed. Relaxation training and biofeedback have been used for chemically dependent anxious patients. These techniques have been recommended for benzodiazepine-dependent patients, but not investigated. Previous withdrawal studies offer only limited follow-up data. Stress management treatment was based on a successful case study. Recruitment difficulties were encountered. However, seven patients were randomly assigned to stress management or brief psycho-therapy. All showed improvement, but three of four patients available for 1 year follow-up had returned to pretreatment dependence. These withdrawal difficulties suggest the need for more effective treatments and more adequate follow-up studies.

Clinical applications of relaxation training

Progressive muscle relaxation is a rational therapeutic alternative in such common functional syndromes as tension headache, migraine, and insomnia. Evidence of its efficacy and guidelines in clinical application are offered.

The effect of stressful life events on EMG biofeedback and relaxation training in the treatment of anxiety

The present study evaluated the effect of frontal EMG biofeedback and relaxation training on a group of 20 anxious patients experiencing stressful life events. The patients were divided into two groups, high and low in stress, based on their life change score on the Recent Life Changes Questionnaire. Patients were evaluated at pre, post, and 6-week follow-up. Treatment consisted of 10 sessions of biofeedback-assisted relaxation. Results indicated that the high stress group showed pre to post changes on anxiety, depression, symptoms, and EMG, while low stress showed no change. Post to follow-up comparisons showed maintenance of improvement for the high stress group and no change for low stress. From pre to follow-up assessment, the high stress group showed significant changes. Both groups reported internal attributions following biofeedback and relaxation training. The high stress group attributed their improvement to the belief they were in control of their minds and bodies, while the low stress group most frequently reported the effort put into the task. The results indicate support for a cognitive explanation for some of biofeedback's effects.

Heart rate and finger pulse amplitude during muscular relaxation with frontalis versus forearm EMG feedback

Twenty-nine volunteers participated in a one-session experiment consisting of 10 min rest followed by a 30 min treatment period. Brief relaxation instructions were given at the beginning of the rest period. The treatment was either frontalis EMG feedback, forearm EMG feedback, or non-contingent stimulation. The two feedback groups showed EMG decreases in their respective target muscles during the no-feedback rest period, with no further decrease during feedback training, indicating that feedback was no more effective than relaxation instructions. Heart rate decreased significantly in both feedback groups. Finger pulse amplitude decreased significantly in the forearm feedback group. It is pointed out that the latter change does not necessarily indicate peripheral vasoconstriction, but may be due to a fall in pulse pressure as a consequence of increased blood flow to the relaxing muscles. The results are unsupportive of the assumption that frontalis relaxation is particularly effective in inducing a generalized relaxation.

Effects of antianxiety agents on relaxation training: a preliminary investigation

The purpose of this preliminary study was to investigate the effects of certain antianxiety agents, that is, minor tranquilizers, sedatives, and hypnotics, on relaxation training. Twelve inpatients and two outpatients were referred to group relaxation training because of tension-anxiety complaints and underwent three training sessions. Results for those patients who were not having any psychotropic medication (Relaxation Only group) were compared with results for those who were receiving anxiolytic drugs (Medication-Relaxation group). Patients in the second group were on antianxiety medication prior to and during relaxation training. Self-report measures indicate that the Relaxation Only group benefited more from relaxation training and showed more treatment generalization effects. The results are interpreted as lending some support to the view that antianxiety drugs may have an interfering effect on relaxation training. Implications and limitations of the study are discussed.

alpha and EMG feedback training in the prevention of drug abuse. A controlled study

Seventy-five college students who were regular drug users were randomly assigned to five experimental groups: alpha feedback, EMG feedback, joked feedback, no-feedback and no-treatment. All treated subjects participated in twelve 30-minute training sessions, four in the laboratory and eight at the college, over a period of four weeks.

At the end of the final session, the alpha group had a significantly higher adjusted mean alpha level than the EMG and no-feedback groups but this disappeared during follow-up. The EMG group had a significantly lower adjusted mean EMG value than the alpha, no-feedback and no-treatment groups, which was maintained during follow-up while feedback was present and, to a less substantial degree, when feedback was not present. There were no significant differences between treatment groups as regards the adjusted mean alcohol or cigarette consumption and sleep parameters.

Concerning drug use, among medium users (6–13 times monthly), the EMG feedback group had a consistently significantly lower adjusted mean drug use after treatment and at the one- and three-month follow-ups than the no-treatment group. Among high users, subjects who received feedback (alpha, EMG or joked) tended to reduce their drug use compared to pre-treatment levels, whereas those in the no-feedback or no-treatment groups experienced an increase.

Since drug use was the only variable appreciably influenced by feedback training, the results tend to suggest that EMG feedback could serve as a means for the prevention of drug abuse, particularly for patients where anxiety is a predisposing factor.