1
|
Asselmann E, Zenker M, Rückert F, Kische H, Pieper L, Beesdo-Baum K. Ecological momentary assessment and applied relaxation: Results of a randomized indicated preventive trial in individuals at increased risk for mental disorders. PLoS One 2023; 18:e0286750. [PMID: 37289760 PMCID: PMC10249886 DOI: 10.1371/journal.pone.0286750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Applied Relaxation (AR) is an established behavioral mental health intervention, but its efficacy in real life contexts remains unclear. Using randomized controlled trial data, we examined whether AR can effectively reduce mental health problems in daily life. A sample of 277 adults with increased psychopathological symptoms but without 12-month DSM-5 mental disorders at study entry was randomly assigned to an intervention group receiving AR training (n = 139) and an assessment-only control group (n = 138). Ecological momentary assessments were used to assess psychological outcomes in daily life over a period of seven days at baseline, post, and 12-month follow-up, respectively. Multilevel analyses indicated that all psychopathological symptoms decreased more in the intervention group than in the control group from baseline to post (range β = -0.31 for DASS-depression to β = -0.06 for PROMIS-anger). However, from post to follow-up, psychopathological symptoms decreased more in the control group than in the intervention group, so that only the intervention effects for PROMIS-depression (β = -0.10) and PROMIS-anger (β = -0.09) remained until follow-up. Moreover, positive affect (β = 0.19), internal control beliefs (β = 0.15), favorable coping (β = 0.60), and unfavorable coping (β = -0.41) improved more in the intervention group than in the control group, and these effects were mostly maintained in the long term. Some effects were stronger among women, older individuals, and individuals with higher initial symptoms. These findings suggest that AR can effectively reduce mental health problems in daily life. Trial registration. The trial has been registered at ClinicalTrials.gov (NCT03311529).
Collapse
Affiliation(s)
- Eva Asselmann
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
2
|
Beesdo-Baum K, Zenker M, Rückert F, Kische H, Pieper L, Asselmann E. Efficacy of Applied Relaxation as indicated preventive intervention in individuals at increased risk for mental disorders: A randomized controlled trial. Behav Res Ther 2022; 157:104162. [DOI: 10.1016/j.brat.2022.104162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/07/2022] [Accepted: 07/08/2022] [Indexed: 11/02/2022]
|
3
|
Kropp P, Meyer B, Dresler T, Fritsche G, Gaul C, Niederberger U, Förderreuther S, Malzacher V, Jürgens TP, Marziniak M, Straube A. [Relaxation techniques and behavioural therapy for the treatment of migraine : Guidelines from the German Migraine and Headache Society]. Schmerz 2019; 31:433-447. [PMID: 28364171 DOI: 10.1007/s00482-017-0214-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Besides pharmacological and interventional possibilities nonpharmacological options, deriving from behavioural approaches may be helpful in the treatment of migraine. Already consulting a patient reduces frequency of attacks. Relaxation (especially progressive muscle relaxation), endurance sports, and biofeedback as well as cognitive behavioural therapy are effective in treatment of migraine. The combination of these treatment options also with pharmacological treatment increase the positive effects.
Collapse
Affiliation(s)
- P Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Gehlsheimer Str. 20, 18147, Rostock, Deutschland.
| | - B Meyer
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Gehlsheimer Str. 20, 18147, Rostock, Deutschland
| | - T Dresler
- Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Tübingen, Deutschland.,Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Tübingen, Deutschland
| | - G Fritsche
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Deutschland
| | - C Gaul
- Migräne- und Kopfschmerz Klinik Königstein, Königstein im Taunus, Deutschland
| | - U Niederberger
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - S Förderreuther
- Neurologie, Ludwig-Maximilians-Universität München, München, Deutschland
| | - V Malzacher
- Neurologische Praxis, Reutlingen, Deutschland
| | - T P Jürgens
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - M Marziniak
- Klinik für Neurologie, Zentrum für Neurologische Intensivmedizin, kbo-Isar-Amper-Klinikum München-Ost, München, Deutschland
| | - A Straube
- Neurologie, Ludwig-Maximilians-Universität München, München, Deutschland
| |
Collapse
|
4
|
Graef JE, Rief W, Nestoriuc Y, Weise C. The More Vivid the Imagination the Better: The Role of the Vividness of Imagination in Vasoconstriction Training and Vasodilatation Training. Appl Psychophysiol Biofeedback 2017; 42:283-298. [DOI: 10.1007/s10484-017-9373-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
5
|
Wells RE, Smitherman TA, Seng EK, Houle TT, Loder EW. Behavioral and Mind/Body Interventions in Headache: Unanswered Questions and Future Research Directions. Headache 2014; 54:1107-13. [DOI: 10.1111/head.12362] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2014] [Indexed: 01/07/2023]
Affiliation(s)
- Rebecca E. Wells
- Department of Neurology; Wake Forest School of Medicine; Winston-Salem NC USA
| | | | - Elizabeth K. Seng
- Ferkauf Graduate School of Psychology; Yeshiva University; New York NY USA
- Albert Einstein College of Medicine of Yeshiva University; Bronx NY
| | - Timothy T. Houle
- Department of Anesthesiology; Wake Forest School of Medicine; Winston-Salem NC USA
| | - Elizabeth W. Loder
- Department of Neurology; Brigham and Women's Faulkner Hospital; Boston MA USA
| |
Collapse
|
6
|
Andersson G, Holmes EA, Carlbring P. Lars-Göran Öst. Cogn Behav Ther 2013; 42:260-4. [PMID: 24245706 DOI: 10.1080/16506073.2013.843581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Lars-Göran Öst is one of the most eminent clinical researchers in the field of cognitive behaviour therapy (CBT) and a founder of CBT in Sweden. He has recently retired from his position as professor in clinical psychology at Stockholm University, Sweden. In this paper, we sketch a brief description of the body of work by Öst. Examples of his innovative and pioneering new treatment methods include the one-session treatment for specific phobias, as well as applied relaxation for a range of anxiety disorders and health conditions. While Öst remains active in the field, he has contributed significantly to the development and dissemination of CBT in Sweden as well as in the world.
Collapse
Affiliation(s)
- Gerhard Andersson
- a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden
| | | | | |
Collapse
|
7
|
Sun-Edelstein C, Mauskop A. Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments. Headache 2011; 51:469-483. [DOI: 10.1111/j.1526-4610.2011.01846.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
8
|
Nestoriuc Y, Martin A. Efficacy of biofeedback for migraine: A meta-analysis. Pain 2007; 128:111-27. [DOI: 10.1016/j.pain.2006.09.007] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Revised: 08/10/2006] [Accepted: 09/05/2006] [Indexed: 10/24/2022]
|
9
|
Kaushik R, Kaushik RM, Mahajan SK, Rajesh V. Biofeedback assisted diaphragmatic breathing and systematic relaxation versus propranolol in long term prophylaxis of migraine. Complement Ther Med 2005; 13:165-74. [PMID: 16150370 DOI: 10.1016/j.ctim.2005.04.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2003] [Revised: 06/04/2004] [Accepted: 04/27/2005] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To evaluate utility of biofeedback assisted diaphragmatic breathing and systematic relaxation in migraine and to compare their efficacy with propranolol in long term prophylaxis of migraine. METHODS 192 migraine patients were randomly distributed into two groups. Propranolol group received propranolol 80 mg/day while biofeedback group received electromyogram (EMG) and temperature biofeedback assisted diaphragmatic breathing and systematic relaxation training accompanied by home practice for 6 months. RESULTS Significant clinical response was seen with biofeedback in 66.66% and with propranolol in 64.58% of patients. Frequency, severity, duration of attacks and number of vomiting episodes were significantly reduced in both the groups at 6 months but inter-group differences were statistically insignificant. During 1 year post-treatment period, significantly lesser resurgence of migraine was seen in biofeedback group as whole (9.37%) and in biofeedback responders in biofeedback group (9.37%) in comparison to resurgence of migraine in propranolol group as whole (38.54%) and in propranolol responders in propranolol group (53.22%) respectively. CONCLUSIONS Biofeedback assisted diaphragmatic breathing and systematic relaxation were very useful in migraine and had significantly better long-term prophylactic effect than propranolol in migraine.
Collapse
Affiliation(s)
- Reshma Kaushik
- Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Nagar, Dehradun 248140, Uttaranchal, India.
| | | | | | | |
Collapse
|
10
|
|
11
|
Psychologic issues in chronic pain: Possible impediments to successful treatment outcome. ACTA ACUST UNITED AC 1997. [DOI: 10.1007/bf02938301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Gauthier JG, Ivers H, Carrier S. Nonpharmacological approaches in the management of recurrent headache disorders and their comparison and combination with pharmacotherapy. Clin Psychol Rev 1996. [DOI: 10.1016/0272-7358(96)00031-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
13
|
Abstract
Psychological and behavioral treatments for migraine are described and evidence for their efficacy is reviewed. Treatments for children, adolescents, and the elderly, and for menstrual migraine are then discussed. Biofeedback, relaxation, and stress-coping treatments have all demonstrated effectiveness. These treatments are effective for the majority of migraine sufferers and treatment effects are reliably maintained for periods of at least one year. Little is known about the mechanism behind the efficacy of psychological treatments. Suggestions for future research on treatment mechanisms, enhancement of treatment effectiveness, and increasing the acceptance of psychological treatments are provided.
Collapse
Affiliation(s)
- G J Reid
- Psychology Department, IWK-Grace Health Centre, Halifax, Nova Scotia, Canada
| | | |
Collapse
|
14
|
|
15
|
Haag G, Weinzierl R, Thoden U, Niederberger U. [The "Freiburg Migraine Study". Results of the psychological therapy.]. Schmerz 1993; 7:298-303. [PMID: 18415394 DOI: 10.1007/bf02529866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED This study was designed to evaluate the efficacy of different strategies for migraine prophylaxis over a fairly long period. Metoprolol alone was compared with psychotherapy alone and with a combination of metoprolol and psychotherapy. The psychological programme was planned for future use in preventive treatment. In this paper only the results of the psychological therapy are described. PATIENTS AND METHODS Criteria for inclusion of patients were: migraine without aura or with short aura for at least 2 years, and 2-10 attacks per month. In all, 63 patients (11 men and 52 women) were each randomized for participation one of the three kinds of treatment. All patients declared their willingness to participate in all three different therapies. After neurological and psychological diagnosis the baseline phase of 2 months was started, followed by the intensive therapy phase lasting 3 months. The end of the intensive therapy is followed by a first 2-month follow-up period. A second follow-up of 2 months was started 6 months after the end of intensive therapy. Psychological diagnosis involved the following elements: a migraine questionnaire, a list of patient's complaints, a depression scale and a psychological exploration. All patients kept a diary during all phases of the study with daily descriptions of their headaches, the therapy and their mood. The psychological programme lasted for 12 sessions of 2 hours each. A psychologist worked with small groups of up to 5 patients This programme was composed of progressive relaxation techniques (Jacobson) and techniques aimed at overcoming pain and stress. The data on diagnosis, the baseline phase, the intensive therapy phase and the two follow-up phases were analysed by conventional statistics (comparison of mean values,t-test, variance analysis, non-parametric tests) and by time series analysis. The parameters analysed were: frequency of attacks, mean headache intensity, duration of headache and migraine, consumption of analgesic drugs and mood. Analysis of the questionnaires and the different diagnostic data revealed no significant differences between the three different groups of therapy. RESULTS A significant improvement in one or at least two measured parameters is shown in Table 1. The results, with 62.5% responders for one parameter in the first follow-up phase are rather positive. If two variables are required to improve significantly the results become worse. Over the different phases the results improve slightly, probably due to the effect of training. In the time series analysis the percentage of responders was calculated to show the number of responders for a particular variable (Table 3). For the different parameters the percentage of responders varied between 0 and 31.3%. CONCLUSIONS According to the results, the efficacy of the psychological treatment increases only gradually, as it has also been demonstrated for biofeedback and relaxation training [9]. Subjectively, patients rate the results of psychotherapy higher than those demonstrated by statistics. This may depend on the selection of patients, but also on the fact that subjective criteria of improvement are not contained in statistical evaluation. Responders and non-responders had initial differences regarding vegetative, hormonal and psychological factors. Responders had a more stable circulatory status, suffered more rarely from menstrual migraine and normally took significantly fewer analgesic drugs. On the whole, this psychological programme has proved quite effective.
Collapse
Affiliation(s)
- G Haag
- Abteilung für Rehabilitationspsychologie der Universität Freiburg/Psychosomatische Klinik Windach, Deutschland
| | | | | | | |
Collapse
|
16
|
Cott A, Parkinson W, Fabich M, Bédard M, Marlin R. Long-term efficacy of combined relaxation: biofeedback treatments for chronic headache. Pain 1992; 51:49-56. [PMID: 1454404 DOI: 10.1016/0304-3959(92)90008-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Thirty-four patients having chronic idiopathic headaches participated in a long-term study comparing autogenic relaxation training alone (REL) with combinations of relaxation and electromyographic biofeedback (REL + EMG) or relaxation and temperature biofeedback (REL + TEMP). Assignment to treatment conditions was balanced on demographics and clinical characteristics, as well as headache classification according to muscle contraction or vascular headache symptomatology. The results indicate that REL + TEMP produced no additional improvements over REL following the 8-week treatment program, or at 6-month, or 12-month follow-up. However, REL + EMG produced significantly greater reductions in headache activity measures than the REL and REL + TEMP conditions at all post-treatment time points. Headache activity continued to improve over the follow-up period independent of treatment condition. These data indicate that EMG biofeedback augments long-term clinical improvements in headache patients who undergo autogenic relaxation training.
Collapse
Affiliation(s)
- Arthur Cott
- Departments of Medicine, McMaster University, Hamilton, OntarioCanada Departments of Psychology, McMaster University, Hamilton, OntarioCanada
| | | | | | | | | |
Collapse
|
17
|
Lisspers J, Öst LG, Skagerberg B. Clinical effects of biofeedback treatment in migraine: The relation to achieved self-control and pretreatment predictors. ACTA ACUST UNITED AC 1992. [DOI: 10.1080/16506079209455912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
18
|
Abstract
A finding of significant sex differences in finger temperature responses to stimuli would have implications for a variety of situations in which finger temperature changes in combination with other psychophysiological measures are employed as indicators of psychological and/or physiological states. In the present study, each subject listened to one of two distinct musical selections for 3-minutes and 40-seconds after being allowed to adapt for one of five durations ranging from 4 to 20 minutes. Females' finger temperatures decreased more or increased less than did males' finger temperatures. This finding held no matter which music was played and was true for all but the shortest adaptation duration. Control data indicated that the sex difference would not have occurred in the absence of the music, and thus the results suggest that females' finger temperatures decrease more than males' only when stimulation occurs. Possible causes of the sex difference are discussed as well as possible implications for studies in which finger temperature is employed as a dependent variable.
Collapse
Affiliation(s)
- R A McFarland
- Psychology Department, Calif. State Univ., Fullerton 92634
| | | |
Collapse
|