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Biomedical subjects

K L Lichstein

Publications and source records attributed to K L Lichstein.

At least 37 records · Page 2Linked to original sources
PubMed1993

Relaxation for insomnia and hypnotic medication use in older women.

Relaxation therapy was given to 3 groups of older women (N = 57): (a) hypnotically medicated insomniacs, (b) nonhypnotically medicated insomniacs, and (c) noninsomniacs. Groups b and c were receiving antihypertensives. Self-reported sleep and medication data were collected for 1 week at pretreatment (except relaxation), posttreatment, and 6-weeks follow-up. Three relaxation sessions, a nondemanding, hybrid method, were administered with the rationale of helping insomnia or high blood pressure. Substantial sleep improvement occurred only for nonhypnotically medicated insomniacs. Substantial sleep medication reduction (47%) occurred only for hypnotically medicated insomniacs. This relaxation approach proved valuable, but the nature of the treatment effect was dependent on the medication status of the insomniac.

Aged↗
PubMed1992

Are insomniacs sleepy during the day? A pupillometric assessment.

A biodevelopmental model of insomnia is articulated specifying coordinated nighttime (disturbed sleep pattern) and daytime (no excessive daytime sleepiness) characteristics defining an insomnoid classification in at-risk groups: short sleepers and older adults. Pupillometry is proposed as a useful means of discriminating degree of daytime sleepiness to aid in the differential diagnosis of insomnia and insomnoid states, and the present study tested the discriminative validity of this approach. Noninsomniac (n = 34) and insomniac (n = 29) college students submitted to four 10 min pupillometry sessions tracking daytime sleepiness from morning arising to bedtime. Pupil diameter proved to be an able discriminator of these two groups though substantial overlap of the two distributions was also noted. The results supported the sensitivity of pupillometry in detecting daytime sleepiness, but yielded alternative interpretations. We observed statistical differentiation in insomniac and noninsomniac daytime sleepiness, but substantial, functional overlap between these groups. Assessment and treatment implications arising from the biodevelopmental model were hypothesized.

Adolescent↗
PubMed1991

Psychophysiological parameters of migraine and muscle-contraction headaches.

Previous headache studies have been unable to verify the presumed presence of headache. Attempting to correct this design fault, the present study assessed four psychophysiological measures (frontalis EMG, temporal BVP, temporal and finger skin temperature) and salient subjective measures in 13 migraineurs, eight muscle-contraction headache sufferers, and 13 age-matched normals. All subjects submitted to two 30-minute sessions of quiet monitoring, and for the headache subjects, one of the sessions was headache active. A bogus, but convincing preliminary "assessment" revealed insufficient headache activity in the headache active session, forcing subjects to reschedule that session in the future when a strong headache was present. A parallel manipulation was employed with the normal subjects. A MANOVA failed to discriminate within- or between-group differences on the psychophysiological measures. Self-reported pain was uncorrelated with the psychophysiological indices. These results cast further doubt on the validity of the psychophysiological measures employed in this study, the same ones routinely endorsed by headache researchers and therapists. We discuss problems of recruitment, compliance, and attrition in basic headache research.

Electromyography↗
PubMed1989

Biofeedback to enhance psychophysiological effects of imagery.

Unlike most applications of biofeedback, the outcome goal and the aim of the present investigation was to increase arousal by the provision of feedback. The ability to generate psychophysiological arousal during noxious imagery may be therapeutically beneficial to individuals receiving emotive imagery therapies, and in the present study we evaluated biofeedback as a means of correcting psychophysiological deficits in imagery. Thirty psychophysiologically unreactive undergraduates were randomly assigned to skin-resistance-level biofeedback, false-feedback, or no-feedback conditions for six sessions of assessment and treatment. The methodology controlled for placebo, practice, and initial value effects. Significant increases in skin resistance level, heart rate, and frontalis electromyography accrued to the biofeedback group but not the control groups, and these gains persisted when biofeedback was withdrawn. Subjective measures showed no changes. The results support the usefulness of biofeedback as a remedy for imagery underarousal.

Adult↗
PubMed1989

Leisure interest patterns and subjective stress in college students.

A first study of the Leisure Interests Checklist (LIC) is reported based on a large (N = 670) normative sample of college students. Acceptable reliability was found on the total interest scores, and on both rationally- and factorially-derived LIC subscales. The BAROMAS stress scales were also studied concurrently with the same college students, and normative data are provided from that sample. Interest in very active diversions and Sports on the LIC did correlate with confidence in doing sports on the BAROMAS. Otherwise, the two instruments showed little overlap. Comparisons between ethnic and gender groupings mainly agreed with advance expectations by disclosing culturally conventional differences in response patterns. The LIC appears promising for future use in both applied and research contexts.

Adaptation, Psychological↗
PubMed1985

Progressive versus self-control relaxation to reduce spontaneous bleeding in hemophiliacs.

Motivated by previous reports of relaxation successes with hemophiliacs, we sought to isolate the value of relaxation strategies. The effects of progressive and self-control relaxation on spontaneous bleeding and collateral symptoms were tested with seven hemophiliacs in a combined multiple-baseline partial-crossover design. Following 6 or 12 weeks of training in either or both relaxation methods, there was no strong evidence that the treatment affected bleeding or perceived pain in these subjects. These disappointing results were obtained despite within-session physiological evidence of relaxation induction and self- and spouse reports of faithful relaxation practice. The present results failed to replicate previous findings, cast doubt on the stress theory of spontaneous bleeding, and recommend further research to clarify the role of psychological interventions for hemophiliacs.

Adaptation, Psychological↗
PubMed1983

Blood volume pulse biofeedback treatment of chronic cluster headache.

Behavioral interventions shown to be clinically effective in the treatment of migraine headache have generally not been employed for cluster headache. Herein, we report on the treatment of a severe case of chronic cluster headache with a common method of migraine treatment, temporal blood volume pulse (BVP) biofeedback. The patient was a 61-year-old male, medically diagnosed as suffering from chronic cluster headaches for over 20 years. Following an 18-day baseline, 14 BVP biofeedback sessions were conducted over a 7-week period. By the last 2 weeks of treatment, there was a 70% reduction in daily headache frequency and a 45% decrease in headache severity. Improvement was maintained at 1, 3, 6, 12, and 21 months follow-up. Large decreases in the consumption of migraine abortives , narcotic analgesics, and antiemetics were also observed. These encouraging results call for further evaluation of the efficacy of BVP biofeedback treatment of chronic cluster headache.

Biofeedback, Psychology↗
PubMed1983

An integrated blood volume pulse biofeedback system for migraine treatment.

A blood volume pulse (BVP) biofeedback system is described that integrates BVP amplitude to provide a signal appropriate for auditory feedback. In comparison to binary BVP feedback methods, this integrated system offers the advantages of continuous feedback and increased scoring ease. The validity of this system was established by correlating the integrated BVP output with trough-to-peak measurements of the raw BVP signal during unassisted relaxation and temporal BVP biofeedback with eight migraine headache patients. Within-subject correlations of the integrated and raw BVP outputs ranged from .82 to .98 (means = .95). Although the integrated method admits unwanted BVP changes in rate, correlation analyses showed this confound factor to be small. Increments in biofeedback training effects were observed during the treatment course. Substantive migraine relief was achieved by the end of treatment and therapeutic gains were maintained at 1-year follow-up. In conclusion, it appears that this method successfully presents continuous auditory feedback from an integrated BVP signal resulting in therapeutic benefits to migraineurs.

Adolescent↗
PubMed1982

Analysis and management of geriatric anxiety.

In this essay, the prevalence, negative health implications, and clinical management of geriatric anxiety are reviewed. Despite disproportionately high rates of anxiety amongst the elderly, little research effort has been directed at this problem. An interactive model of geriatric anxiety is proposed, whereby physical disease and anxiety processes enter into reciprocal stimulation as a function of 1) diminished capacity to withstand stress, and 2) hypervigilance of stress symptomatology. To date, pharmacotherapy has been virtually the sole approach to managing geriatric anxiety, although special hazards accrue to the elderly when anxiolytics are used. Potentially useful psychological treatments including relaxation, cognitive restructuring, activity structuring, and prevention are outlined. It is concluded that the potential human and financial rewards of increased understanding and control or geriatric anxiety are substantial.

Aged↗
PubMed1981

Self-reinforcement and the work ethic.

The current usage of the self-reinforcement paradigm within psychology is described and then extrapolated to the sociocultural level. It is suggested that this model offers a useful heuristic device for viewing the sequence of work and leisure habits. The interface of moral considerations and leisure activities is then considered using the problems of drug abuse to illustrate possible conflicts and solutions offered by this perspective. Historical and religious perspectives are presented as they relate to a complete understanding of the potential use and abuse of leisure behaviors. Finally, it is concluded that current economic trends justify the creation of a technology of leisure skills training as well as a technology of morality.

Employment↗