The use of biofeedback in a behavioral program designed to teach an anxious child self-catheterization

This paper presents a case study of a 7-year-old girl with a noncompliant bladder who was trained to self-catheterize using biofeedback and behavior therapy techniques. Initial attempts to train her to self-catheterize were unsuccessful owing to excessive amounts of fear, muscle tension, and refusal. After seven treatment sessions in which she was instructed in proper self-catheterization technique by a urology nurse clinician and coached in biofeedback-assisted relaxation by a clinical psychologist, the child successfully learned to self-catheterize. EMG readings showed a decrease in quadriceps muscle tension levels across sessions. Eight additional sessions were held in order to train the child's parents in proper technique and coaching procedures. Through the use of portable biofeedback equipment during actual training sessions, the biofeedback served as a cue—first to the child and coach, and later to the child and parents—for when the child needed to stop and relax. This case illustrates the usefulness of biofeedback in a comprehensive behavioral program designed to teach self-catheterization to fearful children.     

Effects of an EMG biofeedback relaxation program on the control of diabetes

It was hypothesized that EMG biofeedback relaxation training, applied to a diabetic patient, would result in a decreased level of insulin with fewer episodes of ketoacidosis. A 20-year-old female, diabetic since age nine, kept daily records of insulin doses and rated herself on an emotionality and a diabetic scale. A full-semester baseline was taken. This was followed by a semester-long training program during which the patient practiced relaxing her frontalis muscle with a portable EMG feedback unit which produced a geiger-counter-like click feedback. A cassette-tape series was used along with the portable EMG. The patient was encouraged to practice twice each day and to attempt to maintain a relaxed state even when not in the practice situation. The daily use of the portable unit was terminated at the end of the semester. In addition, the patient ceased practicing twice daily with the cassette tape. Daily insulin averaged 85 units for the six-week baseline and 59 for the final six weeks of the training period. Moreover, at the end of the training period the average dose had reached 43 units. During the training period the patient rated herself as decreasing in emotionality and in diabetic fluctuations.Supported by the National Institute of Mental Health Grant MH-15596.     

How to use Hydra as a model system to teach biology in the classroom

As scientists it is our duty to fight against obscurantism and loss of rational thinking if we want politicians and citizens to freely make the most intelligent choices for the future generations. With that aim, the scientific education and training of young students is an obvious and urgent necessity. We claim here that Hydra provides a highly versatile but cheap model organism to study biology at any age. Teachers of biology have the unenviable task of motivating young people, who with many other motivations that are quite valid, nevertheless must be guided along a path congruent with a 'syllabus' or a 'curriculum'. The biology of Hydra spans the history of biology as an experimental science from Trembley's first manipulations designed to determine if the green polyp he found was plant or animal to the dissection of the molecular cascades underpinning, regeneration, wound healing, stemness, aging and cancer. It is described here in terms designed to elicit its wider use in classrooms. Simple lessons are outlined in sufficient detail for beginners to enter the world of 'Hydra biology'. Protocols start with the simplest observations to experiments that have been pretested with students in the USA and in Europe. The lessons are practical and can be used to bring 'life', but also rational thinking into the study of life for the teachers of students from elementary school through early university.     

The use of temperature biofeedback in the treatment of chronic pain due to causalgia

A patient with chronic pain due to a reflex sympathetic dystrophy in his hand and arm was successfully treated with temperature biofeedback after several months of conservative standard medical care brought little relief. Over the 18 treatment sessions the patient learned to emit a reliable handwarming response of 1 to 1.5°C. Coincident with his learning, the pain in his hand and arm decreased markedly and remained absent at 1-year follow-up.The author wishes to acknowledge the assistance of Dr. Kit S. Mays and the staff of the Pain Clinic of the University of Tennessee Center for the Health Sciences.     

The behavioral immune system is designed to avoid infected individuals,not outgroups

What is the adapted structure of the behavioral immune system? By definition, the behavioral immune system motivates pathogen avoidance. One prominent suggestion is that the behavioral immune system also contains an additional component that generates motivation to avoid individuals from unfamiliar outgroups. The evolvability of this component has recently been questioned, however, and it has been noted that all supportive evidence stems from WEIRD samples. In this paper, we conducted between-subject experiments in large samples of adult residents of the USA (N = 1615) and India (N = 1969). In the experiment, we measured comfort with physical contact with a depicted individual. The individual was either from an ethnic ingroup or outgroup and either showed a pathogen cue or not. Results were inconsistent with the view that the behavioral immune system motivates the avoidance of individuals from unfamiliar outgroups. Instead, the results strongly supported that the system simply motivates the avoidance of any infected individual regardless of their group membership.     

Evaluation of a minimal-therapist-contact thermal biofeedback treatment program for essential hypertension

We compared a clinic-based regimen of 16 individual sessions (2 per week) of thermal biofeedback with a largely home-based regimen of 5 sessions (spread over 8 weeks) for the treatment of essential hypertension in patients who required at least two drugs to maintain control of blood pressure (BP). On the basis of the clinical end point of being successfully withdrawn from the second stage medication while BP remained under control, the clinic-based regimen (5 of 9) was superior (X<(1)=4.0,p<.05) to the home-based regimen (1 of 9). Internal analyses point to more frequently obtaining a hand temperature of at least 95° F by the office-based patients as possibly the reason for the difference.This research was supported by a grant from NHLBI, HL-27622.     

Evaluation of a minimal-therapist-contact thermal biofeedback treatment program for essential hypertension

We compared a clinic-based regimen of 16 individual sessions (2 per week) of thermal biofeedback with a largely home-based regimen of 5 sessions (spread over 8 weeks) for the treatment of essential hypertension in patients who required at least two drugs to maintain control of blood pressure (BP). On the basis of the clinical end point of being successfully withdrawn from the second stage medication while BP remained under control, the clinic-based regimen (5 of 9) was superior (chi less than (1) = 4.0, p less than .05) to the home-based regimen (1 of 9). Internal analyses point to more frequently obtaining a hand temperature of at least 95 degrees F by the office-based patients as possibly the reason for the difference.     

The use of EMG biofeedback with insulin-dependent diabetic patients

A recent report on the use of EMG biofeedback with an insulin-dependent diabetic is discussed. An examination of the role of EMG biofeedback in the management of carbohydrate metabolism is presented. While still an empirical question, it is concluded that EMG biofeedback will prove most useful in cases where a demonstrable relationship between stress and carbohydrate metabolism is evidenced.     

The use of temperature biofeedback in the treatment of chronic pain due to causalgia.

A patient with chronic pain due to a reflex sympathetic dystrophy in his hand and arm was successfully treated with temperature biofeedback after several months of conservative standard medical care brought little relief. Over the 18 treatment sessions the patient learned to emit a reliable handwarming response of 1 to 1.5 degrees C. Coincident with his learning, the pain in his hand and arm decreased markedly and remained absent at 1-year follow-up.     

The use of EEG theata biofeedback in the treatment of a patient with sleep-onset insomnia

In this report, the treatment of a 42-year-old female with a complaint of chronic sleep-onset insomnia is described. Following the unsuccessful use of relaxation training, treatment consisted of 11 sessions of EEG theta rhythm (4–7 Hz) biofeedback. Theta density and five sleep indices were monitored throughout baseline, placebo, and treatment sessions. A significant increase in theta density was accompanied by reports of a decrease in sleep latency and an increase in total sleep time. This improvement was maintained after withdrawal of medication and at 3-month follow-up.Appreciation is expressed to Dr. R. Muir, for medical supervision of the patient, and to Mr. D. F. Peck and Dr. J. I. Evans, for their comments on earlier drafts of this paper.     

Efficacy of a training programme designed to teach cervical smear screeners to identify ocular surface squamous neoplasia using conjunctival impression cytology

Efficacy of a training programme designed to teach cervical smear screeners to identify ocular surface squamous neoplasia using conjunctival impression cytology
Ocular surface squamous neoplasia (OSSN) is a recently proposed term introduced to encompass both intraepithelial neoplasia and invasive squamous cell carcinoma of the conjunctiva and cornea. A teaching programme incorporating a manual, slide sets, and an evaluation test was developed. The aim was to teach experienced cervical smear screeners to evaluate ocular surface specimens collected by conjunctival impression cytology, with a minimum of individual tuition. The use of the manual was well accepted and half of the original six candidates were able to master the new skill adequately within 8 h. It was considered that the differences between the cytology of OSSN and the equivalent lesions of the uterine cervix are sufficient to prevent some experienced screeners acquiring these skills rapidly.     

Cost effectiveness of biofeedback and behavioral medicine treatments: a review of the literature

This paper reviews multicomponent behavioral medicine studies that contain cost-effectiveness and or cost-benefit data relevant to the field of biofeedback and relaxation training, primarily when assisted by biofeedback, with or without stress management, in the treatment of psychosomatic illness and pain. A model for evaluating biofeedback treatment is presented. Cost-effectiveness data concerning reduction in physician visits and/or medication use, decrease in medical care costs to patients, reduction in hospital stays and rehospitalization, reduction of mortality, and enhanced quality of life are reviewed. Evidence suggests that multicomponent behavioral medicine treatments are cost-effective on all dimensions reviewed. Cost/benefit ratios range between 1:2 and 1:5, with a median of 1:4. Evidence that could increase the cost effectiveness of biofeedback is reviewed.     

The use of EEG theta biofeedback in the treatment of a patient with sleep-onset insomnia.

In this report, the treatment of a 42-year-old female with a complaint of chronic sleep-onset insomnia is described. Following the unsuccessful use of relaxation training, treatment consisted of 11 sessions of EEG theta rhythm (4--7 Hz) biofeedback. Theta density and five sleep indices were monitored throughout baseline, placebo, and treatment sessions. A significant increase in theta density was accompanied by reports of a decrease in sleep latency and an increase in total sleep time. This improvement was maintained after withdrawal of medication and at 3-month follow-up.     

The use and utility of EMG biofeedback with chronic schizophrenic patients

This study examined the efficacy of muscle relaxation training via electromyographic (EMG) biofeedback from the frontalis and forearm extensor muscles of schizophrenic inpatients. Thirty chronically hospitalized patients were randomly assigned to one of three conditions: EMG biofeedback from the forearm extensor and frontalis muscles, progressive relaxation, and a control group. Treatment consisted of one session of orientation and baseline, and six sessions of training. The results indicated that the schizophrenic patients receiving EMG training had significantly lower EMG recordings than the progressive relaxation group, which, in turn, was significantly lower than the control group. Analyses of covariance on the Tension-Anxiety scale from the Profile of Mood States revealed no significant effects, while finger-tapping rates were significantly improved only for the arm receiving feedback training in the EMG group. On the Nurses Observation Scale for Inpatient Evaluation the biofeedback group significantly improved on the Social Competence and Social Interest factors.     

The use and utility of EMG biofeedback with chronic schizophrenic patients

This study examined the efficacy of muscle relaxation training via electromyographic (EMG) biofeedback from the frontalis and forearm extensor muscles of schizophrenic inpatients. Thirty chronically hospitalized patients were randomly assigned to one of three conditions: EMG biofeedback from the forearm extensor and frontalis muscles, progressive relaxation, and a control group. Treatment consisted of one session of orientation and baseline, and six sessions of training. The results indicated that the schizophrenic patients receiving EMG training had significantly lower EMG recordings than the progressive relaxation group, which, in turn, was significantly lower than the control group. Analyses of covariance on the Tension-Anxiety scale from the Profile of Mood States revealed no significant effects, while finger-tapping rates were significantly improved only for the arm receiving feedback training in the EMG group. On the Nurses Observation Scale for Inpatient Evaluation the biofeedback group significantly improved on the Social Competence and Social Interest factors.We would like to express our appreciation for the contributions the following people made to this project: Drs. Barry Smith, Robert Steele, Agnes Hartfield, Jeffrey Barth, Althea Wagman, and the late Harold Weiner; Earl Downs and the participating staff at Springfield State Hospital Center; and Robert Kline and Michael Kelley, who performed the data analyses. This research was supported in part by a grant from the Computer Science Center at the University of Maryland.     

MATCH-UP/MATRIX: a microcomputer program designed to search for protein primary structure homology

MATCH-UP/MATRIX is a program designed to aid the investigatorinterested in determining primary protein structure. It is writtenin Applesoft BASIC for the Apple lle microcomputer. MATCH-UPwill survey any set of proteinaceous materials for amino acidsequence homology; however, it is primarily intended to comparethe structures of newly sequenced peptides with the establishedstructure of a protein with suspected homology. Any peptide-to-proteinalignment which shows a homology greater than or equal to thepercentage specified by the user will result in output. MATRIXwill compare the sequences of two proteins (peptides) in whateveralignment specified by the user and is intended to spot insertionsand/or deletions between structures. Received on December 2, 1985; accepted on March 10, 1986