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[Functional speech system disorder in stuttering].

The author studied the EMG or orbicular muscles of the mouth, respiration, pulse frequency, SGR, EEG registration during the pronunciation of words out loud and to onself, during the orientation reflex to sound and verbal stimuli. These indices were mainly studied during autogenic training in patients with neurotic stuttering (the 1st group) and in patients with organic lesions of the CNS and stuttering (the 2nd group). The first group of patients demonstrated formed motor verbal sterotypes. A disturbance of the correct programme of action in the functional speech system is due to an increase of the activity in the limbico-reticular system. The 2nd group exhibits the absence of the correct programme of action in the accomplishment of motor speech stereotypes. The abnormal programme of the activity is formed from the beginning of the speech activity and is fixed in the ontogenetical memory.

Adolescent↗

Examination of the effectiveness of various treatment techniques for reducing tension.

The effectiveness of various tension-reducing techniques was investigated. Sixty-three subjects were randomly assigned to four treatment groups (EMG feedback, finger temperature feedback, EMG plus finger temperature feedback, autogenic training), a placebo control group, and a waiting-list control group. Physiological as well as a variety of cognitive measures were used to monitor changes in tension. The results showed no significant difference in effectiveness between the six groups. On virtually all cognitive measures there were significant decreases in tension, but not on the physiological measures. The decreases in tension on the cognitive measures were interpreted to be the results of non-specific (placebo) effects. These non-specific effects were not short-term, but did persist for at least three months after completion of treatment.

Affective Symptoms↗

A comparison of relaxation techniques with electrosleep therapy for chronic, sleep-onset insomnia a sleep-EEG study.

Two methods of relaxation therapy, electromyograph biofeedback and autogenic training, were compared to a nonrelaxation treatment, electrosleep therapy, in reducing sleep latency among 22 chronic, sleep-onset insomniacs. While none of the electrosleep patients improved on all-night laboratory electroencephalographic sleep records or daily home sleep logs, approximately one-half of the relaxation-treated patients showed marked improvement, which was sustained over a 1-month follow-up period. Although some sleep and treatment variables differentiated relaxation therapy responders from nonresponders, external stress appeared to be the most salient factor. Successful and unsuccessful patients could not be differentiated on any of the psychological variables studied.

Adult↗

Initial relaxation response: contrasts between clinical patients and normal volunteers.

The effectiveness of EMG biofeedback, progressive muscle relaxation, autogenic training, and self-relaxation were compared using a within-subjects design. Thirteen clinical subjects and 48 normal volunteers participated in 4 counterbalanced relaxation sessions using one of the techniques. Frontalis EMG and surface skin temperature were monitored throughout the sessions. For reducing EMG, biofeedback was more effective than the other three techniques. A significant interaction of treatment X subjects was found for changes in skin temperature. Clinical subjects had the greatest increase in skin temperature with EMG biofeedback and analog subjects responded best to self-relaxation. There were no significant differences in initial measures of EMG or skin temperature for the two samples.

Adolescent↗

[Experiences in implementing a dynamically oriented group therapy in myocardial infarct patients and their spouses].

It is reported on the performance of dynamically orientated group talks with 5 patients with myocardial infarction and their wives within the psychic rehabilitation in phase II. 30 group meetings of a duration of 2 hours each were performed in the outpatient department in a weekly rhythm. At the beginning the implementation of a relaxation method, the autogenic training, for furthering the motivation of the patient for an independent elaboration of the problem in the group as well as for reducing the inability to relaxation often existing in patients with myocardial infarction proved to be favourable. Before the beginning and after the end of the group talks psychodiagnostic tests were carried out. Though scarcely significant differences were the results in the test values, the course of the group talks is to be estimated as successful. The aim reflexion and analysis especially of the interactions between the partners could be obtained after a relatively long initial phase. Conclusions were made for further work in this field.

Acute Disease↗

The management of chronic hysteria: a review and double-blind trial of electrosleep and other relaxation methods.

The effectiveness and mode of action of electrosleep therapy in chronic hysteria was evaluated in a double blind trial with a 1 month follow-up. Matched groups of hysterics were treated with central electrical stimulation and relaxation, peripheral electrical stimulation and relaxation, or relaxation only. Autogenic training exercises were used initially to standarize the relaxation instructions for all the patients. Central electrical stimulation has no specific benefit for hysteria. Rhythmic peripheral stimulation does increase the effect of verbal suggestions to relax initially but has no long term advantage over relaxation alone. Regular brief periods of relaxation can improve the mood and diminish the anxiety level of psychiatric outpatients with hysteria but have no persistant benefit for sleep disturbance or hypochondriasis. The best treatment of depression in chronic hysterics was found at follow-up to be relaxation without electrostimulation. Specialized somatic and psychotherapeutic methods have no advantage over treatment with low doses of anxiolytic drugs, reassurance, suggestion, and regular periods of relaxation.

Anxiety↗

[Comparative analysis of mental health treatment of various groups of competitive athletes].

1) There is sense and necessity of psychohygiene in sports. This could be stated with 3 compared groups, namely: a national team, a team of handicapped, a team of juveniles. 2) We have used a complex program with integrated autogenic training (this however, not in an isolated way). Earlier experiences (of last author) over many years and hundreds of sportives were integrated in our evaluation. 3) Its to our knowledge the first time in world literature that effectiveness of psychohygiene within sports could be proved with statistical significance using world cup points within comparable groups. 4) Only possible can be possible, and psychohygiene will help to optimate this goal but not overrun it. This is main differentiation against doping. The human and the humanity is the main goal and not the so-called "necessities" of sport dictatorship. Its a good sign that several of our candidates told us that our psychohygienic program has reached over their period of sports activities into their "normal" lives.

Adaptation, Psychological↗

A randomized controlled trial of an internet-based treatment for chronic headache.

Chronic headache is a significant public health problem in Western nations. Although controlled trials demonstrate the efficacy and cost-effectiveness of face-to-face behavioral therapy, most headache sufferers have limited access to these treatments. Delivery of behavioral interventions using Internet technology has the potential to reach a larger number of headache sufferers and reduce the burden of disease. This randomized controlled study evaluated an Internet-delivered behavioral regimen composed of progressive relaxation, limited biofeedback with autogenic training, and stress management versus a symptom monitoring waitlist control. Treatment led to a significantly greater decrease in headache activity than symptom monitoring alone. Thirty-nine percent of treated individuals showed clinically significant improvement on self-report measures of headache symptoms at post-treatment. At two-month follow-up, 47% of participants maintained improvement. Treatment had a significant impact on general headache symptoms and headache-related disability. There was a 35% within-group reduction of medication usage among the treated subjects. The Internet program was more time-efficient than traditional clinical treatment. Treatment and follow-up dropout rates, 38.1% and 64.8%, respectively, were typical of behavioral self-help studies. This approach to self-management of headache is promising; however, several methodological and ethical challenges need to be addressed.

Adult↗

[Effects of relaxation therapy as group and individual treatment of chronic tinnitus].

42 patients, suffering from chronic tinnitus, participated in our psychological orientated treatment consisting of relaxation therapy with autogenic training according to J. H. Schultz. The results of individual therapy are compared with group therapy. Using visual analogy scales the therapeutical efficiency can be tested. The individual estimated loudness and annoyance of tinnitus are registered as well as a general emotional status. The results show a positive short-time effect in most cases. A reduction of tinnitus loudness and annoyance after individual and group therapy is seen directly. A positive effect throughout the whole treatment is only found in individual therapy. Concerning the group therapy, many of our patients reported an increase of the pretherapeutical estimation of tinnitus loudness and -annoyance. We believe that the permanent confrontation with the tinnitus problem may advance the psychological conflict in many cases. Therefore psychological management of tinnitus should be concentrated on a temporary limited support aiming to the neglect of tinnitus sensation.

Adaptation, Psychological↗

[Neurophysiologic and respiratory changes during the practice of relaxation technics].

A polygraphic study, of 40 minutes duration, among 10 subjects who practiced autogenic training (TA) and 10 subjects who practiced transcendental meditation (MT), compared to 10 control subjects, gave the following results: rarity of the number of sleeping episodes during relaxation, cardiac rhythm, significantly decreased in the TM group, increased stability of the E.D.G. during and after relaxation, respiratory rate decreased to a value of 33% of the initial rate, respiratory suspensions were frequent in the TM group, reaching a maximal duration of 50 seconds. The absence of compensatory hypercapnia and hyperpnea is an argument in favor of their central origin, lastly, the simple reaction time after relaxation is slightly decreased, whereas it is increased in the controls, this aerobic hypometabolic state, the stability of the autonomic nervous system and the maintenance of the vigilance, induced by deep relaxation, seems to be the opposite of the state which is induced by stress; therefore deep relaxation may play a role in a psycho-somatic approach to treating a variety of disease states.

Adult↗

The relationship between maternal relaxation and plasma beta-endorphin levels during parturition.

beta-endorphin (beta-EP) levels increase in maternal plasma starting from the 10th to the 12th week of pregnancy and reach a peak during labor and at delivery. Respiratory autogenous training (RAT) has been acclaimed as one of the most effective non-pharmacological methods of obtaining hypoalgesia and relaxing perineal muscles during labor. In order to study the effects of the RAT method in both maternal and fetal beta-EP levels during labor, 28 pregnant women were enrolled in this study. Fourteen attended a RAT program, while the others (control group) did not. beta-EP levels in both groups were measured in maternal plasma at early and late labor, at delivery and on the 4th day of the puerperium and in umbilical cord blood at birth. From late labor on, beta-EP maternal plasma levels increased significantly less in the RAT group than in the control group. The gap in the beta-EP levels between both groups was still significant at puerperium and in umbilical cord blood. In conclusion, the RAT method favorably modulates the secretion of beta-EP during labor and at delivery. This result supports the effectiveness of the RAT method in reducing both maternal and fetal stress during labor.

Adult↗

Treatment motives as predictors of acquisition and transfer of relaxation methods to everyday life.

This article presents results from four studies of the significance of type and number of initial treatment motives for acquisition and transfer to everyday life of progressive relaxation (PR) and autogenic training (AT). On the basis of theories of treatment motivation and compliance, we hypothesize that motives for participation are determinants of learning and transfer. Results are reported from (1) two studies with 113 participants in introductory courses on AT and 94 participants in introductory courses on PR and (2) two replication studies with 94 (AT) and 101 participants (PR). Participants indicated their motives for participation. Short-term indicators of treatment success include number of dropouts and subjective evaluations of relaxation exercises; long-term outcomes include transfer of relaxation exercises to everyday life and evaluations of exercise evaluations at follow-up 3 to 6 months after the end of course. Results suggest that for both AT and PR, dropout and subjective relaxation exercise evaluations can be predicted from participation motives. Long-term outcomes can be predicted only for AT. However, for both PR and AT it is shown that for up to four motives, the number of initial course motives is correlated with short-term and long-term predictors of course outcome. We conclude that motivation for participation is highly relevant to client-course matching and adaptive indication of relaxation therapies. Results lead to a threshold hypothesis about the relationship between the number of participation motives and short-term as well as long-term learning and transfer outcome.

Adolescent↗

[Efficacy of stress management classes at a health center].

Although interest in mental health promotion has recently been increasing, the most appropriate approaches remain to be determined. Therefore we conducted Stress Management Classes (SMCs) at Higashi Osaka City Naka Health Center in an attempt to help residents to improve their mental health. The purpose of this study was to evaluate the efficacy of SMCs, held four times over 2 months, with an educational program including the concept of stress and instruction in autogenic training as a relaxation technique. Subjects who attended a Health Promotion Class (HPC) at Osaka Prefectural Kaizuka Health Center were used as controls for the study. The aim of the HPC was to prevent chronic physical diseases such as hypertension, diabetes, and hyperlipidemia, with the program consisting mainly of exercise once a week for 3 months. The results were as follows: 1) People who attended SMCs were more likely to have mental health problems than those who attended the HPC. As a result, mentally ill patients could be diagnosed and receive psychiatric treatment at an early stage in the SMC group. 2) Both SMC and HPC attenders reported improvement of their mental health status with the use of POMS (Profile of Mood States). 3) Both SMC and HPC attenders exhibited significant decrease of blood pressure. Although attenders of both classes improved their mental health status, it is important to be able to attract individuals who are in a poor mental condition in case of mental health promotion. In this trial, we found that the term "stress management" was very useful because people who suffered stress were likely to be interested in it. After the Community Health Law was established in 1994, the flow of community health activities has been shifting from the prefectural government to the municipality. However, promoting mental health and welfare is still mainly the role of the prefectural government. In this sense, health centers are appropriate institutions to hold classes as in this trial.

Autogenic Training↗

[Professional concept of physicians in child and adolescent psychiatry in former East Germany (1990)].

For this study the authors prepared a questionnaire for 662 child and youth psychiatrists with a return quota of 45%. Careerwise most medical doctors--working as psychiatrists and psychotherapists with an equal distribution in hospitals and offices--acquired further special training and education, particularly in Pediatrics, Psychotherapy and Autogenous Training. Work performance meets general agreement: a noticeable lack of corresponding doctors offices, mainly due to the economic situation. Unequivocal agreement exists concerning the necessity of diagnosis, the necessity of out-patient and in-patient therapy, as well the necessity of interdisciplinary cooperation. The views, however, on the quality of cooperation and the hierarchy within the team show differences. Views on self-concept almost equally determined an identification as doctor and as psychotherapist. The main professional motivations were enjoyment, success and ability. The professional concept was unvocally agreed upon. The survey revealed a poor reputation of child and adolescent psychiatrists. Professional basics include preserving the complexity in the field of child and adolescent psychiatry including medical assignments onesidedness rejected. Conflicts arise concerning the "professional self concept", resulting from the thin line between the required separation of child and adolescent psychiatry and associated professions and the required cooperation with associated professions.

Adolescent Psychiatry↗

[Pain management in patients with chronic rheumatic pain--a model for primary medical care].

A rheumatologist and a medical psychotherapist collaborate in offering periodically a cognitive behavioral treatment program for pain control for the patients of a rheumatological practice. The program consists of a biopsychosocial model of chronic pain, individualized relaxation training combining progressive muscle relaxation and some elements of autogenous training and meditation, several attention-related techniques and cognitive restructuring. From 1993 to 1995, 50 patients took part in five training courses. The compliance of the patients was satisfactory and the drop-out rate low (8%). In a post hoc interview 4 weeks later and another 2 years after the end of the training most of the patients assessed the program as useful for reduction of pain, increase of activity and enhancement of mood. Psychotherapeutic experience in group therapy or special training for non-psychotherapeutic physicians with continuous supervision is necessary in order to conduct a qualified treatment program. Within medical primary care, rheumatologists can motivate their patients towards active pain management, which can help to prepare patients for further psychotherapy in cases with psychiatric disorders and/or severe psychosocial strains.

English Abstract↗

How does biofeedback reduce clinical symptoms and do memories and beliefs have biological consequences? Toward a model of mind-body healing.

Changes in the magnitude and direction of physiological measures (EMG, EEG, temperature, etc.) are not strongly related to the reduction of clinical symptoms in biofeedback therapy. Previously, nonspecified perceptual, cognitive, and emotional factors related to threat perception (Wickramasekera, 1979, 1988, 1998) may account for the bulk of the variance in the reduction of clinical symptoms. The mean magnitude of these previously nonspecified or placebo factors is closer to 70% when both the therapist and patient believe in the efficacy of the therapy. This powerful placebo effect is hypothesized to be an elicited conditioned response (Wickramasekera, 1977a, 1977c, 1980, 1985) based on the memory of prior healings. These memories of healing are more resistant to extinction if originally acquired on a partial rather than continuous reinforcement schedule. High and low hypnotic ability in interaction with threat perception (negative affect) is hypothesized to contribute to both the production and reduction of clinical symptoms. High and low hypnotic ability respectively are hypothesized to be related to dysregulation of the sympathetic and parasympathetic arms of the autonomic nervous system. Biofeedback is hypothesized to be most effective for reducing clinical symptoms in people of low to moderate hypnotic ability. For people high in trait hypnotic ability, training in self-hypnosis or other instructional procedures (e.g., autogenic training, progressive muscle relaxation, mediation, CBT, etc.) will produce the most rapid reduction in clinical symptoms.

Anxiety Disorders↗

The effects of biofeedback and guided imagery on finger temperature.

This study was concerned with a comparison of the effects of biofeedback and of imagery on finger temperature increase. Twelve volunteer unpaid adults were randomly allocated to one of two groups: finger temperature biofeedback or guided imagery. All subjects received two baseline and five 15 min treatment sessions, during which stimulus presentation was carefully controlled. The biofeedback group rapidly established a superior ability to increase finger temperature; whereas guided imagery was consistently associated with temperature decrease. Some tentative evidence was produced which questioned the alleged importance of cognitive and interpersonal factors in biofeedback training. Implications for theoretical accounts of the mechanism of finger temperature control (via autogenic training or biofeedback), and for developing effective biofeedback procedures are drawn.

Adult↗

[Processes of body perception and their therapeutic use in pediatrics. From nonspecific relaxation therapy to training to recognize disease-specific symptoms].

Focussing on processes of body perception is a major pathway of relaxation therapies (progressive relaxation, autogenic training, guided imagery, hypnotherapy, biofeedback). Traditionally its application has been related to psychosomatic and psychotherapeutic indications. Beyond this classical approach, recent behavioral medicine has emphasized the relevance of interoception processes and adequate attribution patterns concerning bodily sensations as a major source of adequate coping and self-management with somatic illness. Clinical application may refer to an improved cognitive-behavioral pain management in disease and treatment related conditions. Especially children and adolescents suffering from chronic conditions that may exacerbate rapidly may benefit from an education approach that teaches them to perceive their disease-related complaints and symptoms accurately and to attribute them correctly. A precise, panic-free and immediate symptom recognition of sudden airway obstruction is an important precondition of adequate coping with acute asthma crisis and starting risk orientated antiasthmatic treatment. In a similar way, the child with diabetes mellitus may identify early signs of hypoglycemia by self-observation, recognition and discrimination of physical, vegetative and psychological indicators of blood glucose decline that enable the child to take appropriate countermeasures. Other childhood disorders that offer chances for symptomatic self-monitoring and self-control comprise atopic dermatitis or epileptic seizures. Training young patients in precise symptom recognition may not only empower them in handling acute crisis but also strengthen global development of autonomy, control beliefs, self-responsibility and self-esteem.

Asthma↗