Responses to Comments and Closer to a Definition of Applied Psychophysiology

This paper responds to the nine response papers to the initial paper in this series. This paper also presents a revised working definition of applied psychophysiology which is in concert with many of the responses.     

Applied Psychophysiology: Exclusions and Inclusions

Mark Schwartz has done a fine job in a systematic attempt to define applied psychophysiology. The present author disagrees on a few points concerning what areas will be included and what areas excluded from Schwatz's definition of this term.     

What is Applied Psychophysiology? Toward a Definition

This paper presents a proposed working definition of applied psychophysiology. The paper reviews the background for the term, reasons for formalizing a definition, and boundaries. The working definition, explanation of key terms, and inclusion and exclusion criteria are then presented. Selected questions are then addressed such as whether physiology always has to be measured, and the boundaries such as distinguishing applied psychophysiology from psychotherapy.     

Don't Fence Me In

There are many applications of applied psychophysiology. Some are relevant to AAPB's interests, some are not. However, in no case should we exclude them from our purview merely by defining them out of our existence.     

Is the Working Definition of Applied Psychophysiology Proposed by Schwartz Too Narrow/Restrictive?

This paper raises issues in further refining the working definition of applied psychophysiology proposed by Schwartz (1999). Issues to be addressed include defining what the word psycho means within the definition of applied psychophysiology and the implications of this word in practice. Other issues discussed include the meaning of the word applied, and how incorporating the acquisition of self-regulatory skills or behaviors as one aspect of the definition of applied psychophysiology would help differentiate applied psychophysiology from other specialty areas. Finally, a revised definition is proposed to stimulate further discussion.     

Applied Psychophysiology and Learned Physiological Regulation

This commentary emphasizes the importance of including animal research and basic human research, contrasts the present state of affairs for biofeedback in the United States versus Europe, and proposes an alternative, more expanded definition of applied psychophysiology, which includes research, diagnostics, and education, as well as interventions.     

An Alternative Perspective

The need for a revised definition is discussed and a more simplified alternative is suggested.     

Brief Comments on the Proposed Definition of Applied Psychophysiology

The definition proposed by Mark Schwartz is discussed in brief fashion and is found to be very useful and appropriate.     

Creating the Future of Applied Psychophysiology and Biofeedback: From Fantasy to Reality

AAPB and its membership are faced with a number of giant challenges, including but not limited to: (1) the cost savings efforts of third-party payors and managed care organizations; (2) the lack of public awareness of biofeedback and its usefulness; and (3) the lack of sufficient research data on both the effectiveness and efficacy of biofeedback. In spite of these challenges, there are windows of opportunity that have been or which could be created to move biofeedback further into the realm of conventional treatment. We must focus our efforts on working together to: (1) create strategic plans for creating the future of applied psychophysiology and biofeedback; (2) educate all decision makers, including the general public; (3) establish better relationships with other professionals with common interests; (4) conduct more efficacy and effectiveness research; and (5) create a demand for our services so that the public will be more willing to pay for our services out of their own pocket. In order for this to happen, we must stop fighting with each other and direct our energies to productive activities that can change fantasies into realities.     

The Definition of “Applied Psychophysiology”: A Dangerous Exercise in Exclusivity

Dr. Schwartz's (1999) definition of applied psychophysiology and his attempt to limit what can be presented at the society's meeting, published in its journal, and by extension, used by members of AAPB, are discussed. The exclusivity is seen as repressive and even dangerous. Examples from irritable bowel syndrome and chronic headache are provided.     

The Concealed Information Test as an Instrument of Applied Differential Psychophysiology: Methodological Considerations

In this interpretative paper, I consider four sets of methodological issues that may be relevant to improving the concealed information test (CIT) as an instrument of applied differential psychophysiology. The first set has to do with psychophysiological measurement in the CIT (e.g., specific sensitivity testing in lab vs. field). Secondly, I consider the relationships between the psychological process of deception and the CIT. Thirdly, I consider the problem of laboratory-to-field generalization of the CIT, a consideration that includes a discussion of whether the lab/field differences are merely quantitative or actually qualitative. Finally, I discuss theories concerning the hypothetical mechanisms underlying the CIT, and argue that while the purely cognitive, Sokolovian, orienting response (OR) account is widely accepted as the sole mechanism, there is evidence to suggest that not just motivational, but even emotional mechanisms are also relevant.

One Practitioner's Perspective

Comments are provided from the perspective of a practitioner.     

A Comparison of Tension Headache Sufferers and Nonpain Controls on the State-Trait Anger Expression Inventory: An Exploratory Study with Implications for Applied Psychophysiologists

Studies that have examined the relationship between personality characteristics and tension headache have arrived at conflicting and, for the most part, negative results. In recent years, a number of investigators have begun examining the relationship between anger and psychophysiological disorders, focusing mostly on anger which is suppressed or held in rather than expressed behaviorally. The present study explored the relationship between anger in 59 tension headache subjects and compared their results to 33 nonpain controls. Materials consisted of the revised research edition of the Spielberger State-Trait Anger Expression Inventory. As predicted, tension headache sufferers were found to have significantly more anger held inward than nonpain controls. Implications for applied psychophysiology treatment and future research directions are discussed.     

Religious Coping with Chronic Pain

This study examined the role of religious and nonreligious cognitive-behavioral coping in a sample of 61 chronic pain patients from a midwestern pain clinic. Participants described their chronic pain and indicated their use of religious and nonreligious cognitive-behavioral coping strategies. Results supported a multidimensional conceptualization of religious coping that includes both positive and negative strategies. Positive religious coping strategies were associated significantly with positive affect and religious outcome after statistically controlling for demographic variables. In contrast, measures of negative religious coping strategies were not associated significantly with outcome variables. Several significant associations also were found between nonreligious cognitive-behavioral coping strategies and outcome variables. The results underscore the need for further research concerning the contributions of religious coping in adjustment to chronic pain. Practitioners of applied psychophysiology should assess their chronic pain patients' religious appraisals and religious coping as another important stress management strategy.     

Applied Psychophysiology: Beyond the Boundaries of Biofeedback (Mending a Wall, a Brief History of Our Field, and Applications to Control of the Muscles and Cardiorespiratory Systems)

The field of applied psychophysiology overlaps a number of others, from behavioral and psychosomatic medicine to Eastern disciplines and complementary medicine. Although the proliferation of societies and professional identities across these fields emphasizes this diversity, it also may hinder growth. The history of our field is one of innovation, often at odds with conventional wisdom and practice. It is important that this innovativeness not be sacrificed in a justified quest for professional respectability. This paper reviews the earliest research in biofeedback and applied psychophysiology, and modern applications and interpretations in the areas of muscular and autonomic control, including progressive relaxation and heart rate variability biofeedback, and draws parallels to disciplines of Yoga, QiGong, and Zen practices and their psychophysiological effects.     

Neither a mentalist nor a reductionist be!

There is basis for concern that applied psychophysiology, if not the field of biofeedback, is being coopted by, and merged into, a reborn inner model, with the return of cognition to preeminence in the psych and neuro disciplines. Despite currently fashionable views that such mentalistic inventions and neuro/psychological developments somehow illuminate behavior or offer simpler accounts of behavioral facts, there is little or no evidence that any such construction has ever told us anything new about behavior.Preparation of this article was supported in part by the following PHHS Grants: NHLBI HL 34034, NIDA DA 03476, NIDA DA 04130, NIDA DA 02490, NIDA DA 04133, NIDA DA 01147, NIDA DA 04731, and NIDA contract 271-86-8113.     

Hot Flash,Hot Topic: Conceptualizing Menopausal Symptoms From a Cognitive-Behavioral Perspective

While most healthy women report that the menopausal transition is nondistressing, a subset of women does report that symptoms significantly interfere in their lives. The most common reason that women seek treatment during this time is for vasomotor symptoms, namely, hot flashes and night sweats. Research has suggested that reports of distress during flashing are only weakly related to more objective measures of the flash, including duration and frequency and that differences in treatment-seeking during the menopausal transition may be better accounted for by differences in symptom awareness mediated by a variety of personality and stress factors. This paper discusses hot flashes and night sweats from a cognitive-behavioral perspective, taking into account individual difference variables that may also affect the experience of menopausal symptoms.Terms such as menopause, menopausal transition, perimenopause and postmenopause have been used interchangeably with determination of reproductive status based primarily on age and symptoms. The Stages of Reproductive Aging Workshop (STRAW; Soules et al., 2001) set out to provide a better 7-level staging system to describe midlife reproductive status in healthy women. The new staging system takes into account menstrual cyclicity, endocrine changes, fertility, signs/symptoms in other organs, and uterine/ovarian anatomy. The staging system is anchored around the permanent cessation of menses (final menstrual period; FMP), with stages –5 to –3 characterizing the early, peak, and late reproductive period, –2 and –1 representing the early and late menopausal transition and +1 and +2 indicating postmenopause. Vasomotor symptoms are the most common and tend to increase in intensity in stages –1 and +1.     

Future perspectives for applied psychophysiology and biofeedback

Current circumstances in both the health science and health care delivery systems in our country have created serious problems for health professionals, particularly for those of us in the relatively young field of biofeedback. At the same time, recent and emerging developments in the neurosciences and in technologies for biological measurement offer exciting new opportunities for the applied psychophysiology upon which our field is based. Examples of these developments include the elucidation of potential neurophysiological mechanisms that may mediate the psychophysiology of immune system responses, and technical achievements leading to on-line, noninvasive magnetic resonance imaging of brain neurochemistry. The issue of perspective is raised in relation to our response to both the challenge and the opportunities of our times.     

Creating our future

The evolving health-care system in the United States increasingly rewards successful efforts to keep people healthier and more productive. This is exactly what applied psychophysiology and biofeedback have to offer. However, if we wait to be included in the system, we will wait forever. Inclusion can only come as a result of our efforts to educate decision-makers about the value of our research and services. That education won't take place unless we have an instructional plan and materials. Detailing that plan and producing those materials is the immediate challenge to this Association.This paper was presented as a presidential address at the annual meeting of the Association for Applied Psychophysiology and Biofeedback in Cincinnati, Ohio, March 10, 1995.