Self-instructed relaxation: a therapeutic alternative

A self-instructed relaxation program was compared with therapist-instructed relaxation and waiting list controls. Self-report anxiety measures ( IPAT and STAI ) and a psychophysiological stress profile (frontal EMG, GSR, heart rate, finger temperature monitored under relaxation and stressor conditions) were utilized pre- and posttreatment to determine efficacy. Self-monitored heart rate, respiration rate, and finger temperature were used to monitor home practice sessions. Subjects reported increased ability to relax and control stress; however, frontal EMG measured under stressor conditions was the only dependent measure to confirm this perception. No between-group differences on any other dependent measures were observed. Reliable changes on all self-monitored home practice measures were observed, suggesting that this procedure is a useful gauge of home practice.     

Biofeedback-based stress management training with a population of business managers

A biofeedback-based stress management training program was experimentally evaluated using populations of middle-level managers from a large corporation. The training program, once-weekly 1-hour sessions for 6 weeks, combined frontal and other site EMG biofeedback, progressive relaxation and breathing exercises, cognitive stress management, and generalization techniques. Control groups participated in either the assessment procedures only or the assessment procedures and six once-weekly discussions of stress and the job on both an individual(two sessions) and group(four sessions) basis. Significant effects were found in self-report measures, state and trait anxiety, experience of stress; in physiological measures, basal frontal EMG and frontal EMG during recovery from stress, and finger temperature; and in ratings of overall job performance. However, no consistent advantage for the training group or either control group was found. Several possible explanations for the failure of the biofeedback-based stress management training condition to achieve a consistent advantage over the control conditions are presented.     

Effectiveness of multiple-site EMG biofeedback in the reduction of arousal

During the training phase, 36 subjects received (a) EMG biofeedback from multiple muscle sites, (b) EMG biofeedback from the frontal site, or (c) no biofeedback. Results indicated that neither biofeedback procedure reduced self-reports of anxiety, but that multiple-site biofeedback was effective in reducing several indices of autonomic arousal (pulse rate, finger pulse volume, and skin temperature) while frontal biofeedback was not. During the generalization/stress phase, all subjects were threatened with and received electric shocks and were told to apply the relaxation techniques they learned during the training phase even though no additional biofeedback would be provided. Results indicated that multiple-site biofeedback was effective in reducing self-reports of anxiety and autonomic arousal but that frontal biofeedback was not. These results confirm previous data indicating that frontal biofeedback is not an effective procedure for controlling stress, but suggest that EMG biofeedback can be effective in reducing self-reported anxiety and autonomic arousal if a multiple muscle-site feedback procedure is employed.     

Locus of control and frontal electromyographic response training

Forty-eight normal subjects from a college population, representing extreme internal and external orientations on a locus of control scale, were provided an auditory signal in a laboratory relaxation setting. For one group (feedback) the pitch of the signal varied as a function of frontal electromyographic (EMG) levels, while for another group (control) the pitch was constant. The feedback subjects acquired lower EMG potentials than did the control subjects, and the internal subjects in the feedback condition acquired lower levels than did the external subjects. In the control condition, no consistent differences in EMG levels between internal and external subjects were obtained. These results were stable across two replications, three ethnically distinct groups, and both sexes. Additional measures designed to reflect the effects of the frontal EMG training as a generalized relaxation technique for this population, including finger temperatures and a variety of postexperiment questionnaire ratings of relaxation, yielded negative results. Tests of other predictions from the locus of control construct are also discussed.This research was supported by NIMH Special Postdoctoral Fellowship No. MH58202-01.     

Frontal electromyographic feedback

This study evaluated the effects of one session of frontal electromyographic (EMG) feedback on (1) frontal EMG, (2) frontal EMG response to stress, (3) cardiovascular variables, and (4) cardiovascular responses to stress. Eighteen male and female undergraduate volunteers received either frontal EMG feedback or a relaxation instructions control procedure and were then exposed to a fear stimulus (visualization of a feared situation) and a post-stress adaptation period while several cardiovascular measures were monitored. In comparison to the control group, frontal EMG feedback significantly reduced resting levels of frontal EMG and frontal EMG response to stress but had no significant effect on cardiovascular measures. The results of this study suggest that one session of frontal EMG feedback may attenuate response to stress but, within the paradigm utilized, may be confined to the specific muscle groups monitored. Additional areas of needed research were noted including individual differences in generalization, the effects of EMG feedback from multiple sites sequentially and concomitantly, and the generalized effects from symptom-specific sites.     

Frontal electromyographic feedback. Stress attenuation and generalization.

This study evaluated the effects of one session of frontal electromyographic (EMG) feedback on (1) frontal EMG, (2) frontal EMG response to stress, (3) cardiovascular variables, and (4) cardiovascular responses to stress. Eighteen male and female undergraduate volunteers received either frontal EMG feedback or a relaxation instructions control procedure and were then exposed to a fear stimulus (visualization of a feared situation) and a post-stress adaptation period while several cardiovascular measures were monitored. In comparison to the control group, frontal EMG feedback significantly reduced resting levels of frontal EMG and frontal EMG response to stress but had no significant effect on cardiovascular measures. The results of this study suggest that one session of frontal EMG feedback may attenuate response to stress but, within the paradigm utilized, may be confined to the specific muscle groups monitored. Additional areas of needed research were noted including individual differences in generalization, the effects of EMG feedback from multiple sites sequentially and concomitantly, and the generalized effects from symptom-specific sites.     

Live and taped relaxation instructions: effects of procedural variables

Two experiments were designed to assess the effects of relaxation training, therapist presence or absence, live versus taped voice, and response-contingent versus noncontingent instructional progress on measures of subjective relaxation and frontal EMG. In the first experiment, it was found that subjects receiving taped instructions showed greater within-session subjective relaxation and lowering of within-session frontal EMG than subjects in a control condition. No differential training effects of therapist presence or absence was noted. In a second experiment, no significant differences in relaxation measures were found between subjects receiving live, response-contingent instructions and subjects receiving live, noncontingent instructions. Moreover, no meaningful differences in relaxation measures were found between subjects receiving live and taped instructions.     

The relative effectiveness of three techniques to induce the trophotropic response.

The purpose of this study was to examine the relative effectiveness of electromyographic biofeedback training (EMG BFT), meditation, and progressive muscle relaxation (PMR) in eliciting a relaxation or trophotropic response as measured by frontalis muscle tension, heart rate, electrodermal response, respiration rate, and skin temperature. Fifty-four college students were randomly assigned to one of five groups: (1) control, (2) placebo control, (3) EMG BFT, (4) meditation, (5) PMR. After baseline measures were obtained subjects were trained in 10 30-minute training sessions and posttested. Comparisons by ANOVAs indicated there was a significant decrease in muscle tension in the EMG BFT and meditation groups and significant decreases in respiration rate in the meditation and PMR groups. No other changes were attributed to treatment.     

Live and taped relaxation instructions: Effects of procedural variables

Two experiments were designed to assess the effects of relaxation training, therapist presence or absence, live versus taped voice, and response-contingent versus noncontingent instructional progress on measures of subjective relaxation and frontal EMG. In the first experiment, it was found that subjects receiving taped instructions showed greater within-session subjective relaxation and lowering of within-session frontal EMG than subjects in a control condition. No differential training effects of therapist presence or absence was noted. In a second experiment, no significant differences in relaxation measures were found between subjects receiving live, response-contingent instructions and subjects receiving live, noncontingent instructions. Moreover, no meaningful differences in relaxation measures were found between subjects receiving live and taped instructions.This research is based on a dissertation by the first author, under the direction of the second author. The authors thank James E. Hastings and the dissertation committee, Jeffrey M. Lohr, Dennis Bonge, and Honore M. Hughes, for their assistance and helpful comments. This research was supported by the Marie Wilson Howells Research Fund.     

Slowed respiration training

A method of slowed respiration rate (RR) training is described that uses visual feedback of the respiratory cycle. Subjects assigned to the slowed RR training procedure were compared with subjects assigned to either a traditional frontal electromyographic (EMG) biofeedback condition or a control condition where no feedback was presented. RR, frontal EMG, heart rate, digital temperature, and skin conductance level were monitored simultaneously. The results indicated that RR training was effective in reducing RR, that RR training had little systematic effect on the other physiological variables, and the frontal EMG procedure did not in itself reduce RR. The advantages of the current methodological approach and the importance of respiration training were discussed along with a literature review. The relationship between RR training and the complexities of respiratory phenomena was discussed, as well as ways that future research using this method may help clarify current issues within respiration training.This research was supported by grant No. 2-S06RR08038-19 from the National Institutes of Health. The able work of Nora Barker and Robert Longoria is acknowledged, who served as biofeedback technicians.     

Variations in digital temperature during frontal EMG biofeedback training in normal subjects

During frontal EMG biofeedback training, the relationship between frontal EMG and digital skin temperature was investigated in two experiments, which varied the number of baseline and feedback sessions. The results of Experiment 1 suggested a "general relaxation effect," where digital temperature increased as frontal EMG decreased, especially for subjects with initially low hand temperature. Experiment 2 extended the number of baseline and feedback sessions and qualified the results of Experiment 1. EMG and digital temperature did not simultaneously converge toward general relaxation over the extended baseline or feedback sessions in Experiment 2. Furthermore, when the feedback signal was introduced, digital temperature dropped quickly but recovered to baseline levels within three feedback sessions; this drop in digital temperature was interpreted within the context of attentional demands of the biofeedback task. The results appeared consistent with the view that frontal biofeedback training teaches a discriminative skill of lower frontal EMG, and that this skill does not readily generalize to digital skin temperature.     

Variations in digital temperature during frontal EMG biofeedback training in normal subjects

During frontal EMG biofeedback training, the relationship between frontal EMG and digital skin temperature was investigated in two experiments, which varied the number of baseline and feedback sessions. The results of Experiment 1 suggested a general relaxation effect, where digital temperature increased as frontal EMG decreased, especially for subjects with initially low hand temperature. Experiment 2 extended the number of baseline and feedback sessions and qualified the results of Experiment 1. EMG and digital temperature did not simultaneously converge toward general relaxation over the extended baseline or feedback sessions in Experiment 2. Furthermore, when the feedback signal was introduced, digital temperature dropped quickly but recovered to baseline levels within three feedback sessions; this drop in digital temperature was interpreted within the context of attentional demands of the biofeedback task. The results appeared consistent with the view that frontal biofeedback training teaches a discriminative skill of lower frontal EMG, and that this skill does not readily generalize to digital skin temperature.This research was supported by Grant 2 S06RR08038-17 funded by the National Institutes of Mental Health.     

Feedback delays and relaxation expectancies in EMG biofeedback

The use of noncontingent feedback controls in studies of the efficacy and process of electromyographic (EMG) biofeedback may yield results confounded by differential expectancies for relaxation. Furthermore, the role of expectancies in producing psychological and physical relaxation as well as reducing muscle activity is unclear. This study investigated the effects of feedback delays and induced relaxation expectancies on EMG activity and experienced relaxation. One hundred four non-clinical subjects participated in one auditory frontal EMG biofeedback training session. Subjects were assigned to one of four computerized feedback delay conditions (0.0037, 0.7493, 2.2481, 6.7444 s) and to one of two relaxation expectancy conditions (positive or negative). During 20 minutes of biofeedback training, all groups decreased frontal activity. Feedback delays interacted with training epochs in affecting EMG; the longest delay group reduced frontal activity more slowly than the shortest delay group during training. Positive relaxation expectancies produced greater experienced relaxation than did negative relaxation expectancies. Instrumental and expectancy factors in EMG biofeedback appear to operate independently of each other by reducing physiological activity and producing psychological relaxation respectively.This study was completed by the first author under the direction of the second author in partial fulfillment of the requirements for the Master of Arts degree. We gratefully acknowledge the computerization advice and assistance provided by Larry Wheeler, and the assistance in data collection provided by Dawn Dexter and Michael Winstanley.     

The relative effectiveness of three techniques to induce the trophotropic response

The purpose of this study was to examine the relative effectiveness of electromyographic biofeedback training(EMG BFT), remeditation, and progressive muscle relaxation(PMR) in eliciting a relaxation or trophotropic response as measured by frontalis muscle tension, heart rate, electrodermal response, respiration rate, and skin temperature. Fifty-four college students were randomly assigned to one of five groups:(1) control,(2) placebo control,(3) EMG BFT,(4) meditation,(5) PMR. After baseline measures were obtained subjects were trained in 10 30-minute training sessions and posttested. Comparisons by ANOVAs indicated there was a significant decrease in muscle tension in the EMG BFT and meditation groups and significant decreases in respiration rate in the meditation and PMR groups. No other changes were attributed to treatment.     

The effect of stress imagery on arousal and its implications for biofeedback of the frontalis muscles

The purpose of this study was to determine whether the frontal muscles of the forehead during the imagination of an individualized stress situation reflect general arousal. Physiological arousal and subjective feelings of tension were measured during a stress and a relaxing imaginative situation, utilizing a counterbalanced design. Frontalis EMG during stress imagination was raised and was paralleled by more reported tension, elevated skin conductance, and trends toward increments in heart rate and respiration rate. The raised frontalis EMG can be seen as a consequence of the greater effort spent in the stress imaginative situation than in the relaxing one. This experiment supports an important assumption of the clinical application of frontalis EMG biofeedback to stress-related disorders. Other assumptions still remain to be examined.     

Feedback delays and relaxation expectancies in EMG biofeedback

The use of noncontingent feedback controls in studies of the efficacy and process of electromyographic (EMG) biofeedback may yield results confounded by differential expectancies for relaxation. Furthermore, the role of expectancies in producing psychological and physical relaxation as well as reducing muscle activity is unclear. This study investigated the effects of feedback delays and induced relaxation expectancies on EMG activity and experienced relaxation. One hundred four non-clinical subjects participated in one auditory frontal EMG biofeedback training session. Subjects were assigned to one of four computerized feedback delay conditions (0.0037, 0.7493, 2.2481, 6.7444 s) and to one of two relaxation expectancy conditions (positive or negative). During 20 minutes of biofeedback training, all groups decreased frontal activity. Feedback delays interacted with training epochs in affecting EMG; the longest delay group reduced frontal activity more slowly than the shortest delay group during training. Positive relaxation expectancies produced greater experienced relaxation than did negative relaxation expectancies. Instrumental and expectancy factors in EMG biofeedback appear to operate independently of each other by reducing physiological activity and producing psychological relaxation respectively.     

Cardiodynamic response to psychological and cold pressor stress: further evidence for stimulus response specificity and directional fractionation

In the present study 36 police officers were exposed to a psychological stressor (IQ quiz) and to cold pressor stress while several cardiovascular variables were monitored. Impedance cardiography was used to provide measures of heart rate, stroke volume, cardiac output, myocardial contractility, and total peripheral resistance. In addition, measures of systolic and diastolic blood pressure and peripheral skin temperature were obtained. A multivariate analysis of variance (MANOVA) indicated that significant increases in diastolic and systolic blood pressure during the cold pressor test were mediated by large increases in total peripheral resistance, whereas blood pressure elevation during the IQ quiz were accompanied by significant increases in heart rate and, to a lesser extent, cardiac output. Peripheral skin temperature decreased in response to each stressor. Additional analysis indicated a degree of stimulus specificity for several variables. For example, diastolic blood pressure showed greater increases to cold pressor than quiz, whereas systolic blood pressure increased more with the psychological than the physical stressor. Directional fractionation occurred for both myocardial contractility and cardiac output.     

Stress management techniques: Are they all equivalent,or do they have specific effects?

This article evaluates the hypothesis that various stress management techniques have specific effects. Studies comparing various techniques are reviewed, as well as previous literature reviews evaluating the effects of individual techniques. There is evidence that cognitively oriented methods have specific cognitive effects, that specific autonomic effects result from autonomically oriented methods, and that specific muscular effects are produced by muscularly oriented methods. Muscle relaxation and/or EMG biofeedback have greater muscular effects and smaller autonomic effects than finger temperature biofeedback and/or autogenic training. EMG biofeedback produces greater effects on particular muscular groups than progressive relaxation, and thermal biofeedback has greater finger temperature effects than autogenic training. Disorders with a predominant muscular component (e.g., tension headaches) are treated more effectively by muscularly oriented methods, while disorders in which autonomic dysfunction predominates (e.g., hypertension, migraine headaches) are more effectively treated by techniques with a strong autonomic component. Anxiety and phobias tend to be most effectively treated by methods with both strong cognitive and behavioral components.This work was supported by grants Nos. HL-34336 and HL-44097 from the Heart, Lung, and Blood Institute of the National Institutes of Health. Material in this article has been condensed and updated from three chapters in Lehrer, P. M., and Woolfolk, R. L. (1993).Principles and practice of stress management, Vol. 2, New York: Guilford Press.     

Cardiodynamic response to psychological and cold pressor stress: Further evidence for stimulus response specificity and directional fractionation

In the present study 36 police officers were exposed to a psychological stressor (IQ quiz) and to cold pressor stress while several cardiovascular variables were monitored. Impedance cardiography was used to provide measures of heart rate, stroke volume, cardiac output, myocardial contractility, and total peripheral resistance. In addition, measures of systolic and diastolic blood pressure and peripheral skin temperature were obtained. A multivariate analysis of variance (MANOVA) indicated that significant increases in diastolic and systolic blood pressure during the cold pressor test were mediated by large increases in total peripheral resistance, whereas blood pressure elevation during the IQ quiz were accompanied by significant increases in heart rate and, to a lesser extent, cardiac output. Peripheral skin temperature decreased in response to each stressor. Additional analysis indicated a degree of stimulus specificity for several variables. For example, diastolic blood pressure showed greater increases to cold pressor than quiz, whereas systolic blood pressure increased more with the psychological than the physical stressor. Directional fractionation occurred for both myocardial contractility and cardiac output.