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PubMed1992

[Psychosomatic aspects of stress].

We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

Adult↗
PubMed1983

Relaxation therapy: adjunctive therapy for the physician.

Relaxation therapy is one of the new modalities in the area of behavioral medicine which physicians may wish to use for tense patients as adjunctive to purely medical treatment. Efficacy of the specific therapy and patient compliance may be improved by use of relaxation therapy. This paper gives details on how to provide the basics in relaxation training. These techniques were used in a research program developed at Howard University Medical School. The beginning steps in controlled, relaxed breathing; progressive relaxation; autogenic training; and simple mental imagery are described. It is emphasized that time is required for the patient to acquire these skills. The skills are cumulative and, once learned, can lead to self-regulation and self-discipline to assist individuals in dealing with stress.

Humans↗
PubMed2004

Effectiveness of complementary and self-help treatments for anxiety disorders.

OBJECTIVES: To review the evidence for the effectiveness of complementary and self-help treatments for anxiety disorders. DATA SOURCES: Systematic literature search using PubMed, PsycLit, and the Cochrane Library. DATA SYNTHESIS: 108 treatments were identified and grouped under the categories of medicines and homoeopathic remedies, physical treatments, lifestyle, and dietary changes. We give a description of the 34 treatments (for which evidence was found in the literature searched), the rationale behind the treatments, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. CONCLUSIONS: The treatments with the best evidence of effectiveness are kava (for generalised anxiety), exercise (for generalised anxiety), relaxation training (for generalised anxiety, panic disorder, dental phobia and test anxiety) and bibliotherapy (for specific phobias). There is more limited evidence to support the effectiveness of acupuncture, music, autogenic training and meditation for generalised anxiety; for inositol in the treatment of panic disorder and obsessive-compulsive disorder; and for alcohol avoidance by people with alcohol-use disorders to reduce a range of anxiety disorders.

Adolescent↗
PubMed2001

Relaxation therapy in adult asthma. Is there new evidence for its effectiveness?

Studies of relaxation training for adult asthma patients were reviewed for the period between 1980 and 2000. Six controlled and three uncontrolled studies were identified, employing a variety of methods, such as progressive relaxation, functional relaxation, autogenic training, or yoga. Most studies had low sample sizes and suffered from one or more methodological deficiencies, such as suboptimal data analysis, high dropout rates, problematic measurement procedures, or insufficient descriptions of methodology and results. Overall effects on parameters of lung function, symptoms, medication consumption, and health care use were generally negligible. Problems with the underlying rationale of relaxation therapy in asthma are discussed from a psychophysiological viewpoint. Examples are given of potential beneficial and detrimental effects of these techniques on lung function with respect to emotional processes, the musculoskeletal system, and ventilation as targets of a relaxation intervention. It remains to be demonstrated that relaxation training can significantly contribute to the standard treatment of asthma in adult patients.

Adult↗
PubMed1997

[The preparation for elective interventions--the spectrum and dissemination of somatic and psychological measures in Germany].

INTRODUCTION: The positive effects of preoperative preparation on postoperative recovery in patients undergoing elective surgery have been demonstrated. On that account, we surveyed the practice procedures of preoperative preparation for elective surgery patients at German hospitals. METHODS: During November 1994, we sent 1500 questionnaires to the directors of anaesthesiology departments in Germany. A total of 590 questionnaires (39.3%) were completed and returned. The participating hospitals range in size from 20 to 2600 beds (mean = 364; s = 334,97), totalling together more than 1.7 million surgical operations per year. RESULTS: The surveyed hospitals used one or more of the following procedures for pre-operative preparation: 573 (98.6%) of the replying hospitals used medical anxiolysis, 415 (71.3%) applied preoperative respiratory therapy. Furthermore, 222 (38.5%) of the studied hospitals trained their patients in postoperative relevant behaviour (respiratory therapy n = 167; physiotherapy n = 63 and patient-controlled analgesia n = 41). 74 (13%) offered psychological counselling, 29 (5%) made use of other psychological techniques (muscle relaxation; autogenic training, biofeedback) and 26 (4%) used other preparatory methods like video tapes (n = 13), music (n = 5), acupuncture (n = 4). DISCUSSION: Nearly all hospitals prepared their patients for surgery with a pre-op visit and anxiolytic medications. Further preparatory methods in most surveyed hospitals are only used on a case-by-case basis. At present psychological methods of preoperative preparation are not routinely used in clinical practice in Germany. CONCLUSIONS: Existing possibilities for optimising preoperative preparation in patients undergoing elective surgery are not used regularly. Preoperative preparation needs to be improved, especially in patients undergoing major surgery. Standardisation of management procedures and integration of several professional groups and regular application of known procedures for preoperative preparation may lead to cost-saving optimisation of the duration of hospital stay.

Anti-Anxiety Agents↗
PubMed1998

Comparison of integrated group therapy and group relaxation training for fibromyalgia.

OBJECTIVE: The efficacy of an integrated, psychological treatment program was tested in a controlled study involving 27 patients with chronic musculoskeletal pain (fibromyalgia). DESIGN: The experimental treatment program consisted of instruction in various self-help techniques (e.g., cognitive behavioral strategies, relaxation, physical exercises) as well as information on chronic pain. Control groups were instructed only in autogenic training. Measures of pain, daily activities, general symptoms, and psychological functioning were assessed before and after treatment, as well as at 4 months after termination of therapy (follow-up). RESULTS: At the end of treatment, 7 patients from the experimental group and 2 from the control group showed significant clinical improvement in 3 of 6 parameters (NS). At follow-up, the improvement was still present in 5 experimental cases but in none of the controls (p = 0.024). Successful patients had been sick for a shorter period of time and were less impaired by their condition. CONCLUSIONS: Psychological interventions in combination with physiotherapy can be effective in treating fibromyalgia patients, especially if applied early.

Female↗
PubMed1981

Relaxation training tapes: preferences and effects of gender and background.

Relaxation training tapes vary in voice gender and background, but little has been published regarding the preferences and effects of these parameters. Four classes, totalling 40 male and 36 female undergraduates, listened to parts of two commercially available sets of relaxation tapes. Both sets offered progressive relaxation and autogenic training in a choice of a male or a female voice. One set also provided a musical and environmental background. Tape segments were randomly assigned to the classes and balanced for gender and background. Subjects indicated a preference for the female voices. In addition, there was a significant association between sex of subject and voice gender preference, with males preferring female voices and females preferring male voices. However, the choices of the "best" tapes and actual ratings of relaxation indicated no significant voice-gender preferences associations. Preferences for the facilitating effects of the tapes with musical and environmental backgrounds were reflected in significant preferences for tape sets, tape choices, and relaxation ratings. The clinical implications and limitations of these findings were discussed.

Adolescent↗
PubMed2004

Sleep management training for cancer patients with insomnia.

Insomnia is a common phenomenon in cancer patients; nevertheless, there are only a few intervention results published covering this topic. We examined the effects of a multi-modal psychological sleep management programme combining relaxation techniques, sleep hygiene, cognitive techniques and advice in stimulus control technique on various sleep and quality-of-life variables. We compared two intervention groups up to 6 months after treatment, one with progressive muscle relaxation (n=80), the other with autogenic training (n=71). A control group (n=78) received only a standard rehabilitation programme. It was a heterogeneous sample of adult patients (mean age 58 years) predominantly with breast, kidney or prostate cancer staying for 3 or 4 weeks in an oncological rehabilitation clinic. In comparison to the control group, the analysis of variance for repeated measures (R-MANOVA) showed significant improvements over time, indicating that intervention group participants benefited with moderate- or large-scale effects on sleep latency (p<0.001), sleep duration (p<0.001), sleep efficiency (p<0.001), sleep quality (p<0.001), sleep medication (p<0.05) and daytime dysfunction (p<0.05). In quality-of-life subscales, there was mainly improvement over time. This may indicate a benefit of the rehabilitation treatment in general. No evidence was found for any differences between the two intervention groups. The results suggest that the use of a multi-modal psychological sleep intervention could enhance various sleep parameters and well being of patients. The efficacy on quality of life is still under review.

Attitude to Health↗
PubMedDate not supplied

Teaching hypnosis within a family practice residency program.

As a result of increasing interest in medical hypnosis, a curriculum has been developed for teaching clinical hypnosis to family practice residents within a Canadian two-year training program. History and theories, demonstrations of techniques, practice of inductions, and clinical applications are presented to all second-year residents within a course titled "Behavioral Medicine in Family Practice." Individual supervision is offered within the family practice teaching unit as well as a one-month elective in behavioral medicine. Residents are encouraged to attend workshops offered by the Canadian Society of Clinical Hypnosis and invited to attend an autogenic training group for patients. Evaluation of continuing use of learned skills in practice settings is in process.

British Columbia↗
PubMed1987

Changes in cortisol level in saliva following relaxation-activation autoregulative intervention.

The relaxation-activation autoregulative method (RAM) is a psychoregulative procedure characterized by typical autonomic patterns of relaxation and activation phases (blood pressure, electric skin resistance, heart beat, EEG, etc.). They are used as feedback information in the training of autoregulative abilities. RAM has a multidimensional (non-specific) tuning effect which is manifested by changes in the psychophysiological state (emotional tuning, physiological functioning and performance). It has a therapeutical effect on disorders with a psychic pathogenic component, e.g., essential hypertension. The increased production of adrenaline following the application of RAM was found in previous experiments.--The present experiment with a sample of six persons well mastering RAM has shown that the cortisol level following this psychoregulative intervention also rises significantly and that this rise has been recorded over three days, i.e., over the whole period of saliva sampling. It may be said that RAM has a non-specific, ergotropic (activating) subsequent effect and that this effect has the character of stress, more accurately eustress. Autogenic training, on the other hand, reduces the cortisol level.

Autonomic Nervous System↗
PubMed1978

Temperature biofeedback in the treatment of migraine headaches: a controlled evaluation.

After an initial four-week baseline phase, during which daily records of headache frequency and intensity and daily medication records were kept, 30 patients with frequent (at least one per month) migraine headaches were randomly assigned to three conditions: (1) temperature biofeedback, autogenic training, and regular home practice; (2) progressive relaxation with regular home practice; and (3) a waiting-list control condition. Comparisons of headache data from the four weeks of baseline and last two weeks of treatment showed that both the relaxation and biofeedback groups improved significantly on total headache activity, duration of headaches, and peak headache intensity and reduced consumption of analgesic medication, while the waiting list control group did not. All three groups showed significant decreases in headache frequency. Although the relaxation training was more effective than biofeedback training at the last week of treatment, follow-up data at one, two, and three months showed no differences between the two treated groups on any dependent measure.

Adult↗
PubMedDate not supplied

Health care professionals' familiarity with non-pharmacological strategies for managing cancer pain.

Many studies have confirmed unnecessary suffering among cancer patients, due to the inadequate use of analgesic medication and other effective interventions. While pharmacological treatments are appropriately the central component of cancer pain management, the under-utilization of effective nonpharmacological strategies (NPS) may contribute to the problem of pain and suffering among cancer patients. The purpose of this study was to determine health care professionals' familiarity with, and perceptions regarding, NPS for managing cancer pain, and to assess their interest in learning more about NPS as adjuncts to pharmacological analgesics. Two-hundred and fourteen health care professionals were surveyed at two cancer treatment centres in Ontario, Canada. The self-report questionnaire included questions regarding 11 psychological strategies (e.g. imagery) and eight other NPS (e.g. acupuncture). The response rate was 67% (141/214). Subjects were found to be the least familiar with autogenic training, operant conditioning, and cognitive therapy. Other than radiation and surgery, subjects most commonly reported recommending support groups (67%), imagery (54%), music or art therapy (49%) and meditation (43%) for managing cancer pain. Participants were most interested in learning more about acupuncture, massage therapy, therapeutic touch, hypnosis, and biofeedback. Participants were somewhat familiar with most of the 19 NPS presented; however, they use or recommend few NPS for managing cancer pain. Health professionals' interest in NPS has important implications for the supportive care of cancer patients.

Adult↗
PubMed1981

Stress management skill for nursing students.

Assessed the effectiveness of a 10-session, 5-week, group-administered stress management program for nursing students. The stress management group included sessions on progressive relaxation, deep muscle relaxation, autogenic training, visual imagery and modified systematic desensitization. Ten female nursing students participated in the stress management group. A second group of nursing students (7 female and 1 male) served as a control group. State and trait anxiety measures were taken before the group began and immediately prior to both mid-term and final examinations. The stress management group effectively reduced trait anxiety (p less than .05), while the control group's trait anxiety levels remained relatively unchanged. The experimental group showed a reduction in state (test-taking) anxiety from mid-semester to final examinations, while the control groups showed a slight increase from mid semester to final examination.

Anxiety↗
PubMed1991

A preliminary investigation of prediction of mean arterial pressure after self-regulatory treatments.

This study investigated the ability of pretreatment variables from three different domains (social-demographic, psychological, and psychophysiological) to predict posttreatment mean arterial pressure (MAP) for 59 unmedicated males with mild hypertension who were participating in a cross-cultural (USA-USSR) comparison of autogenic training and thermal biofeedback to a self-relaxation control. The overall multiple regression equation consisted of two variables and indicated that higher diastolic blood pressures during a cold pressor task were predictive of greater MAP reductions while higher scores on the Irritability subscale of the Buss-Durkee Hostility Scale were predictive of less MAP reductions. Suggestions for future research in this area are provided.

Adult↗
PubMed1996

Evaluation by multidimensional instruments of health-related quality of life of elderly cancer patients undergoing three different "psychosocial" treatment approaches. A randomized clinical trial.

Our study belongs to the clinical trials in which the health-related quality of life (HQL) evaluation constitutes the primary endpoint. It was carried out with the aim of comparing the impact of three different types of psychological intervention, namely a psychopharmacological treatment alone, the same treatment plus social support carried out by volunteers (SSV) and a third treatment modality including "structured psychotherapy" (autogenous training), on improving the HQL of elderly cancer patients undergoing antineoplastic therapy with symptoms of anxiety and/or depression related to their disease. The eight questionnaires used for HQL evaluation were generally self-rated and multidimensional but unidimensional models were also employed. Seventy-four patients aged over 65 years with either solid tumors in different sites or hematological malignancies, generally in advanced stages (III-IV), were enrolled in the study. Of these patients, 72 (42 men and 30 women, mean age 70.68 years, range 66-85) were evaluable. Our study highlighted the usefulness of the pharmacological therapy (alprazolam + sulpiride) and of other specific ancillary treatments in reducing the incidence of the main HQL-related side-effects of antineoplastic therapy and the superiority of an "integrated" strategy, based both on psychopharmacology and psychosocial interventions, such as SSV with or without structured psychotherapy. The one-way analysis of variance carried out by us did not allow us to draw definitive conclusions about which of the two integrated treatments was to be considered the treatment of choice, as they proved to be almost equally effective.

Aged↗
PubMed1999

Psychological characteristics of patients with normal-tension glaucoma.

BACKGROUND: A study was carried out to evaluate the extent of psychosomatic complaints in patients with normal-tension glaucoma. METHODS: Twenty-four patients (M:F=3:21; mean age 58+/-15.3 years) with normal-tension glaucoma were rated according to the von Zerssen Symptom List (psychosomatic discomfort), the Maudsley Personality Inventory (MPI-N, emotional status and MPI-E, extroverted-introverted), the Beck Depression Inventory (BDI), and the Sixteen Personality Factor Questionnaire (16PF). An age- and sex-matched control group (n=24; M:F=3:21; mean age 56+/-13 years) without any ocular or other general chronic disease was selected. RESULTS: In comparison with the control group the patients with normal-tension glaucoma showed significantly more complaints (von Zerssen Symptom List) and were more emotionally unstable (MPI-N). No group differences were found regarding extroversion-introversion (MPI-E) and depression (BDI). In the 16PF, patients with normal-tension glaucoma were remarkable, only for a significant negative correlation between the duration of illness and psychic endurance. CONCLUSION: The results demonstrate that patients with normal-tension glaucoma show evident psychosomatic involvement. However, the sequence of the pathogenetic development remains unclear. Therefore, it is not known whether these psychological disturbances are factors contributing to the development of normal-tension glaucoma or whether they are a result of normal-tension glaucoma. Nevertheless, some patients with normal-tension glaucoma had these disturbances. Besides reduction of intraocular pressure and improvement of vascular condition, those who display psychological disturbances should receive psychological support, such as autogenic training.

Adult↗
PubMed2004

[Tension headache].

The life time prevalence of episodic tension headache ranges between 13-66%, of chronic tension headache between 1-3%. In most studies a slight preponderance of women was found. Approximately 20% of persons afflicted by tension headache seek for medical help. The costs of tension headache are mainly indirect ones due to lost work days. Increased pain sensitivity of the pericranial muscles, psychosocial stress and psychiatric disorders are discussed as main pathophysiological mechanisms. Taking into consideration the uncertainty of the entity "tension headache" tricyclic antidepressants and psychotherapy (biofeedback, stress management therapy, autogenic training) are effective. The superiority of a multicomponent therapy with tricyclic antidepressants and stress management therapy over pharmaceutical and psychotherapeutic treatment or placebo alone was demonstrated in one study.

Female↗