Biofeedback and relaxation training in the treatment of psychophysiological disorders: or are the machines really necessary?

The literature on the use of biofeedback and various forms of relaxation training in the treatment of psychophysiological disorders was reviewed; special attention was devoted to studies in which biofeedback and some form of relaxation training were compared. Based on this review, we conclude that there is no consistent advantage for one form of treatment over the other with any psychophysiological disorder for which a comparison has been made, e.g.

Temperature biofeedback in the treatment of migraine headaches: a controlled evaluation.

After an initial four-week baseline phase, during which daily records of headache frequency and intensity and daily medication records were kept, 30 patients with frequent (at least one per month) migraine headaches were randomly assigned to three conditions: (1) temperature biofeedback, autogenic training, and regular home practice; (2) progressive relaxation with regular home practice; and (3) a waiting-list control condition. Comparisons of headache data from the four weeks of baseline and last two weeks of treatment showed that both the relaxation and biofeedback groups improved significantly on total headache activity, duration of headaches, and peak headache intensity and reduced consumption of analgesic medication, while the waiting list control group did not. All three groups showed significant decreases in headache frequency.

Birth order and perceptual motor performance.

To examine the relationship between performance on the Frostig Developmental Test of Visual Perception and birth order, 578 first-graders were tested. Later-born children performed significantly better than did firstborns on specific subtests of the Frostig (Visual-motor Coordination and Figure-ground Perception). There was a significant interaction on Perceptual Constancy which indicated that later-born males performed significantly better than did firstborn males.

Psychological treatment of cardiovascular disease.

Recent clinical research on the psychological treatment of cardiovascular diseases is reviewed in four categories: hypertension, cardiac arrhythmias, coronary artery disease, and peripheral circulatory disease. In the treatment of hypertension biofeedback of blood pressure, electromyography and galvanic skin responses both seem useful, as does systematic relaxation training of either an active or passive-meditative nature. Biofeedback of heart rate has shown some utility in treating premature ventricular contractions and sinus tachycardia.

Single-case designs and clinical biofeedback experimentation.

Rigorous evaluation of the effects of biofeedback with clinical populations is necessary, but practical problems often preclude utilization of between-groups experimental designs involving large numbers of clients with clinically relevant problems. Single-case experimental designs provide a viable alternative for answering most research questions. In addition, single-case designs possess several distinct advantages for biofeedback research, including a focus on clinical significance, the use of variability as data not error, unique procedures for establishing generality of findings, and an ability to deal with ethical concerns in clinical research.

Gender identity change in a transsexual: an exorcism.

Gender identity change in a conservatively diagnosed 21-year-old transexual after faith healing was fortuitously observed, was objectively and independently measured, and is reported. This case, and other recent developments, suggests a reexamination of the possibilities of psychosocial intervention to modify atypical gender identity.

The components of rapists' sexual arousal.

The erections of rapists and nonrapists were measured during audio descriptions of rape and nonrape sexual scenes. On the basis of their erection measures, rapists were separated from nonrapists in that the former developed erections to rape descriptions while the latter did not. The method also discriminated those rapists with the highest frequency of rape, those who had injured their victim, and those who chose children as victims.

Biofeedback, self-control, and self-management.

A common goal of biofeedback is self-control of physiologic responses. The conceptions and paradigms of the literature on self-control of motoric and cognitive responses were surveyed to provide a basis for the self-control of physiologic responses. An operational definition of self-control was advanced, and self-control was placed in the framework of a general self-management strategy which included discrimination and maintenance components.

The use of feedback training and a stimulus control procedure to obtain large magnitude increases in heart rate outside of the laboratory.

A series of eight single-subject experiments were performed to test the feasibility of using a stimulus control procedure to teach subjects to control heart rate in the absence of feedback and outside of the laboratory. Four of the six subjects who completed the experiments were able to demonstrate increases in heart rate of from 15 to 35 beats per minute without the assistance of feedback and outside of the laboratory. These increases were consistently produced over six daily sesssions.

The effect of the absence of close supervision on the use of response cost in a prison token economy.

A naturally occurring experiment, in which direct supervision of a token economy in a penal system was removed and re-instated, is reported. A retrospective analysis revealed that in the absence of close supervision the use of response cost rose dramatically, both in terms of categories of behaviors for which response costs were levied and in the frequency of their use. The return of direct supervision led to a decreased use and and an end to the growth of categories of behaviors punished.

The impact on patient satisfaction of the introduction of family medicine residents into a model practice facility.

This study examines the effects on patient satisfaction of the introduction of family medicine residents into the staff of an ongoing private practice that joined a Department of Family Medicine. Questionnaires were administered to clinic patients during a four-week period four months prior to when residents began seeing patients at the clinic and again five months after residents joined the clinic staff. Satisfaction at both times was high; however, significant declines from Time 1 to Time 2 were noted on most items.

A comparison of direct blood pressure feedback and electromyographic feedback on the blood pressure of normotensives.

Groups of 20 normotensive subjects were assigned to one of three conditions to help them lower their blood pressure: (1) intermittent visual feedback of blood pressure; (2) continuous analogue auditory feedback of frontal EMG; (3) an instructed, no-feedback condition. Both groups receiving feedback showed greater within-session lowering of systolic blood pressure than the no-feedback control group. Although the group receiving intermittent visual feedback of blood pressure lowered blood pressure more than the EMG feedback group at the first session, in three subsequent sessions, the two feedback groups did not differ.

The young widow: depressive symptomatology throughout the grief process.

The purpose of this investigation was to examine patterns of abatement of depressive symptomatology in 30 young widows at three time periods: immediately following the death of the husband, a year later, and at present. Data on all three time periods were gathered during one interview. The study thus provides retrospective information on patterns of depressive symptomatology.

Effect of operant conditioning of heart rate on plasma renin activity.

Cardioacceleration produced by operant conditioning was associated with elevation of plasma renin activity. This study suggests that emotional stimuli, which produce cardioacceleration, may also cause increased renin secretion, thus providing a mechanism by which factors operating through the mind and sodium intake could summate in the production of hypertension.

Behavioral treatment of hysterical neurosis: symptom substitution and sympton return reconsidered.

One of the major areas of disagreement between therapists working within the psychodynamic and behavioral frameworks involves the issues of symptom substitution and symptom return, the psychodynamicists holding that treatment of symptoms alone cannot result in permanent improvement, and the behavioral therapists arguing that it can. However, a reexamination of the data indicates that psychoanalysts base their conclusions primarily on cases of hysterical neurosis whereas the behaviorists base their conclusions primarily on the treatment of phobia. Heeding the call of the recent American Psychiatric Association Task Force on Behavior Therapy (1973), in this paper we seek to reconcile the apparently contradictory data, illustrating our arguments with case reports.

Measurement of sexual arousal in male homosexuals: effects of instructions and stimulus modality.

Erections were measured in 20 male homosexual subjects under three instructional conditions and within three stimulus modalities. The three conditions were arousal (e.g.