A longitudinal study of the development of anticipatory nausea and vomiting in cancer chemotherapy patients: The role of absorption and autonomic perception.

Interviewed 70 cancer patients (aged 20–74 yrs) receiving chemotherapy at home before their 2nd treatment session to obtain baseline measures of absorption, autonomic perception, depression, state–trait anxiety, and basic demographic information. Ss were then interviewed before each of their next 6 treatment sessions, at which time measures of depression, state anxiety, severity and duration of postchemotherapy nausea and/or vomiting (PCNV), and experience of anticipatory nausea and/or vomiting (ANV) were obtained. Ss with ANV scored significantly higher on measures of absorption and autonomic perception than Ss who did not develop ANV. Those variables hypothesized to mediate conditioning (i.e., toxicity of treatment drugs, severity of PCNV, levels of state anxiety) accurately predicted which patients developed ANV. Absorption and autonomic perception added significantly to the prediction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy.

50 cancer patients receiving chemotherapy (25 by push injection and 25 by drip infusion) were assigned to 1 of 3 conditions for their chemotherapy treatments: (a) progressive muscle-relaxation training plus guided-relaxation imagery; (b) therapist control, in which a therapist was present to provide support and encouragement but did not provide systematic relaxation training; and (c) no-treatment control. Ss participated in 1 pretraining, 3 training, and 1 follow-up session. Results indicate that during the training sessions, Ss who received relaxation training (a) reported feeling significantly less anxious and nauseated during chemotherapy, (b) showed significantly less physiological arousal and reported less anxiety and depression immediately after chemotherapy, and (c) reported significantly less severe and less protracted nausea at home following chemotherapy. Data suggest that relaxation training may be an effective procedure for helping cancer patients cope with the adverse effects of their chemotherapy. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy.

Assessed the effectiveness of electromyograph (EMG) and skin-temperature (ST) biofeedback and relaxation training (RXT) in reducing the aversiveness of cancer chemotherapy (CHEMO). 81 cancer patients (aged 18–75 yrs) were randomized to 1 of 6 groups formed by a 3?×?2 factorial design. Outcome was assessed with physiological, patient-reported, and nurse-reported indices taken over 5 consecutive CHEMO treatments. RXT patients showed decreases in nausea and anxiety during CHEMO and physiological arousal after CHEMO. EMG and ST biofeedback reduced some indices of physiological arousal but had no other effects on CHEMO side effects. RXT may be effective in reducing the adverse consequences of CHEMO. It is suggested that the positive effects found for biofeedback were due to the RXT that was given with the biofeedback, not to the biofeedback alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conditioned side effects induced by cancer chemotherapy: Prevention through behavioral treatment.

Cancer patients receiving chemotherapy often experience nausea and vomiting that develop as a result of classical conditioning. In order to determine whether this nausea and vomiting could be delayed or prevented, 24 cancer patients were randomized either to a group that received progressive muscle relaxation training (PMRT) plus guided imagery (GI), or to a no-treatment control group. Relaxation training sessions were held before the initiation of chemotherapy and during the first three chemotherapy treatments. Results indicated that patients receiving PMRT and GI had significantly less nausea and vomiting and significantly lower blood pressures, pulse rates, and dysphoria, especially anxiety, than did control patients. Nurse observations corroborated patient reports. These data suggest that early training in PMRT and GI can reduce and perhaps prevent the development of conditioned nausea and vomiting, and can alleviate high anxiety levels in cancer patients who receive emetogenic chemotherapy. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of anticipatory nausea: A prospective analysis.

Employed a prospective design to identify patient- and treatment-related variables characteristic of patients who develop anticipatory nausea after receiving initial cancer chemotherapy treatment. 71 chemotherapy outpatients (mean age 59.8 yrs) were interviewed before and after each chemotherapy infusion during their first 6 mo of treatment. Ss also completed the State-Trait Anxiety Inventory and the Eysenck Personality Inventory. Hierarchical multiple regression analysis revealed that the 26 Ss who developed anticipatory nausea were characterized by more severe posttreatment nausea, more time-consuming treatment infusions, and greater state anxiety relative to the 45 Ss without anticipatory nausea. Results support a respondent learning conceptualization of the development of anticipatory nausea. Clinical implications of these findings for the prevention of anticipatory nausea are suggested. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Voluntary control of human heart rate: Effect on reaction to aversive stimulation: A replication and extension.

In anticipation of receiving painful stimuli, 20 female Ss learned to regulate their heart rate (HR) when provided with meter biofeedback and monetary bonuses for HR changes and instructions to increase or decrease their rate. Voluntary slowing of HR was associated with a relative reduction in perceived aversiveness of the stimuli, particularly in those Ss who scored high on a cardiac-awareness questionnaire (i.e., reported experiencing cardiac reactions to fear situations in daily life). These fingings replicate and extend previous findings by the authors (see record 1974-31631-001) on HR self-regulation, perception of aversive stimulation, and individual differences in cardiac awareness. They also provide further support for the hypothesis that biofeedback training for relevant physiological responses may serve as a behavioral strategy for changing anxiety and fear reactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral treatment of chemotherapy-induced nausea and vomiting

Nausea and vomiting associated with chemotherapy most commonly occur after administration of the drug regimen, but a substantial proportion of patients also develop these symptoms in anticipation of treatment, after one or more courses of chemotherapy have been given. Currently available pharmacologic agents are unable to provide complete protection from either anticipatory or post-treatment nausea and emesis associated with cancer chemotherapy. Since anticipatory nausea and vomiting are believed to become conditioned responses through the learning process of classical conditioning, behavioral treatments may be particularly appropriate. Progressive muscle relaxation training is effective in preventing as well as decreasing the frequency of postchemotherapy nausea and vomiting, whereas systematic desensitization has been found to be more effective against anticipatory nausea and emesis. Hypnosis and cognitive distraction have been used mainly in children and adolescents.     

Voluntary control of human heart rate: Effect on reaction to aversive stimulation.

In anticipation of receiving painful stimuli, 20 female 21-27 yr old Ss learned to control their heart rate when provided with external feedback and reward for criterion heart rate changes and were instructed to increase or decrease their rate. Voluntary slowing of heart rate led to a relative reduction in the perceived aversiveness of the stimuli, particularly for those Ss who reported experiencing cardiac reactions to fear situations in daily life. It is concluded that biofeedback training for relevant physiological responses may possibly serve as a behavioral strategy for changing anxiety and fear reactions. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interaction of Hsp70 chaperones with substrates

The purpose of this study was to examine the effectiveness of progressive muscle relaxation (PMR) in reducing the nausea, vomiting, and anxiety induced by chemotherapy in Japanese patients. Subjects comprised 60 cancer chemotherapy patients who were hospitalized in a cancer center. These subjects were randomly assigned to either the experimental or control group. In addition to routine nursing care, subjects in the experimental received PMR training, while those in the control received contact with the investigator. Results from this study verified the effectiveness of PMR in reducing total scores used to measure nausea, vomiting, and retching; subscale scores of nausea; and subjective feelings of anxiety. The efficacy of PMR to reduce subscale scores of vomiting was not verified, partly due to an extremely low incidence of vomiting.     

Effects of EMG biofeedback and relaxation training in the prevention of academic underachievement.

Examined whether 3 techniques commonly used to treat anxiety (anxiety management training, EMG biofeedback, and stress-management training) could be used to prevent the academic underachievement associated with anxiety in college students. 19 anxious freshman women (identified by a test battery that included the Achievement Anxiety Test, Eysenck Personality Inventory, and the State-Trait Anxiety Inventory) each completed 6 sessions of either anxiety-management or stress-management training with live instruction. Additionally, each S received 6 sessions of either EMG biofeedback or taped instruction. All 4 treatment combinations successfully reduced both somatic and cognitive anxiety symptoms. The average GPA of the experimental Ss was significantly higher than that of matched no-treatment controls. These findings suggest that early intervention for academic anxiety may be beneficial. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-discrepancies in clinically anxious and depressed university students.

Self-discrepancy theory proposes that anxiety and depression are the result of different types of conflicting self-beliefs. This study examined self-discrepancies in 4 groups of university students who completed a questionnaire assessing levels of self-discrepancy and were characterized by the following disorders: (1) depression, (2) anxiety, (3) both anxiety and depression, or (4) no psychiatric disorder. As predicted, Ss with anxiety or depressive disorders had higher levels of self-discrepancy than normal Ss. Depressive Ss had higher levels of actual:ideal discrepancies than nondepressive Ss. Anxious Ss (with or without depressive disorders) had higher levels of actual:ought discrepancies than nonanxious Ss (normals and depressed-only Ss). Results provided general support for self-discrepancy theory in accounting for depressive and anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Homeostatic reconditioning in stress-related disorders: A preliminary study of migraine headaches.

18 19–55 yr old migraine headache patients were assigned to a group that learned (1) to raise finger temperature, via visual biofeedback, after neutral imaginal experiences or (2) to raise finger temperature after stressful imaginal experiences. At the completion of training, Ss participated in an outcome session without feedback. Laboratory training, combined with home practice using the same respective imaginal experiences, resulted in Ss' being able, with on-task concentration, to raise finger temperature without feedback and also resulted in significant clinical reductions in headache activity. Improvement was more marked at 4-wk follow-up. Ss trained in vascular recovery after stress showed more improvement than did other Ss. Overall, the Ss who showed the most reliable vascular recovery conditioning effects were those whose migraine prodromal symptomatology was not an accurate predictor of headache or absence of headache. The significance of what is called homeostatic reconditioning, after stress, in stress-related disorders, rather than the "aspirin" approach of many biofeedback treatments, is discussed. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents.

30 moderately depressed high school students were randomly assigned to either cognitive-behavioral treatment, relaxation training, or a wait-list control condition. Treatment Ss met in small groups for 10 50-min sessions over 5 wks in a high school setting. Outcome measures included a modified Beck Depression Inventory, the Rosenberg Self-Esteem Scale, and the State-Trait Anxiety Inventory. The cognitive-behavioral and relaxation training groups were superior to the wait-list control group in the reduction of depressive symptoms at both posttest and 5-wk follow-up assessments. There was no significant difference between active treatments in their effectiveness for reducing depression. Ss in the cognitive-behavioral and relaxation training conditions went from moderate levels of depression at pretest to nondepressed levels at posttest, and they maintained these levels at follow-up. Improvements in anxiety and academic self-concept were also demonstrated by the active treatments. Findings demonstrate that these short-term group-administered therapies are effective in significantly decreasing depression in adolescents. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EMG biofeedback training of Type A and Type B behavior pattern subjects.

Assessed the relative efficacy of EMG biofeedback training to reduce tension levels in Ss characterized either by the presence of the coronary-prone behavior pattern (Type A) or by its absence (Type B). 55 college students, classified as Type A or B on the basis of Jenkins Activity Survey (Form T) scores, were randomly assigned to either a biofeedback or a control group. Ss met for 6 training sessions, then returned for a 7th session to perform without biofeedback a series of easy (4-digit recall) and difficult (7-digit recall) tasks. Biofeedback Ss attained a greater degree of relaxation during training than did control Ss, regardless of A/B status. Also, biofeedback Ss maintained greater relaxation during task performance than did control Ss. Across groups, Type A's performed significantly better than Type B's on difficult tasks, and although Type A biofeedback Ss had EMG levels as high as Type B controls for the actual duration of performance tasks, they maintained significantly lower EMG levels than either group prior to, between, and after performance tasks. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality factors associated with anticipatory nausea/vomiting in patients receiving cancer chemotherapy.

100 cancer chemotherapy patients were interviewed, rated the severity of pre- and posttreatment nausea and emesis, and completed the State-Trait Anxiety Inventory. In addition, scores on the Millon Behavioral Health Inventory were obtained for 59 Ss. 33% of the Ss reported having experienced anticipatory nausea, and 11% reported having experienced anticipatory vomiting. Ss who experienced anticipatory nausea had more posttreatment nausea and vomiting, were more depressed, and were characteristically more anxious than other Ss. Future despair, social alienation, inhibited personality style, gastrointestinal susceptibility, chronic tension, and confident personality style were variables that best distinguished Ss who experienced anticipatory nausea. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of daily impairment in COPD.

Examined 16 adult patients with severe chronic obstructive pulmonary disease (COPD), as indicated by spirometry testing. Ss reported the degree of difficulty in performing 10 tasks of daily living and completed the SCL-90-R to assess affective and somatic states. Results indicate that while restriction of 3 activities was correlated with severity of lung impairment, difficulty in performing daily activities appeared more consistently correlated with emotional functioning. In particular, SCL-90-R subscales of somatization, anxiety, and depression were correlated with behavioral impairment of multiple daily activities. Implications for psychosocial interventions in the rehabilitation of COPD patients are discussed, including the differential impact of stress management training and treatments for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of electromyographic biofeedback and cue-controlled relaxation in the treatment of test anxiety.

Studied the effect of using electromyographic (EMG) biofeedback to increase the efficacy of cue-controlled relaxation training in the treatment of test anxiety. 40 college undergraduates scoring in the upper third on the Test Anxiety Scale were randomly assigned to 1 of 4 treatment conditions—EMG-assisted cue-controlled relaxation, cue controlled relaxation alone, attention-placebo relaxation, and no-treatment control. Pre–post self-report measures of test anxiety, state anxiety, and trait anxiety (State-Trait Anxiety Inventory) were obtained. In addition, a performance measure (Otis-Lennon Mental Abilities Test) was administered. Ss from the 3 relaxation groups received 6 45-min individual sessions over 2 wks. All treatments were conducted using audiotape recordings. Results indicate that cue-controlled relaxation is effective in increasing test performance for test anxious Ss, that EMG biofeedback does not contribute to the effectiveness of this procedure, and that self-report measures of anxiety are susceptible to a placebo effect. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological and physical benefits of circuit weight training in law enforcement personnel.

The effects of circuit weight training on mood, perceived stress, job satisfaction, and physical symptoms were investigated in a sample of state law enforcement officers. 43 male officers who were not regularly exercising were assigned to either 4 mo of circuit weight training or a wait-list control condition. Four months of circuit weight training led to a significant increase in strength on cardiovascular fitness. Ss also demonstrated significant improvements in mood, including decreases in somatization, anxiety, depression, and hostility. Circuit weight training also resulted in a decrease in reports of physical symptoms and in improvements in job satisfaction. Results indicate that Ss who dropped out of the exercise training program evidenced significantly greater anxiety, depression, and hostility at pretreatment than Ss who completed the program. These findings suggest that circuit weight training programs may contribute to important psychological benefits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EMG biofeedback training versus systematic desensitization for test anxiety reduction.

Investigated EMG biofeedback training as a method to reduce test anxiety among 40 university students. A procedure combining EMG biofeedback training with systematic desensitization (SD) was compared to an automated SD program not using EMG feedback. The study also evaluated the effectiveness of EMG feedback relaxation training without SD. Ss were randomly assigned to 1 of 4 groups: (a) EMG biofeedback training with SD, (b) EMG biofeedback relaxation training, (c) automated SD, and (d) no-treatment control. At the end of the program, all participants were administered the Suinn Test Anxiety Behavior Scale, Sarason's Test Anxiety Scale, and an anagrams test, given under threat conditions. Results suggest that EMG biofeedback training is a useful technique for reducing test anxiety, but not necessarily more effective than SD. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)