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)     

Development of physiological response patterns concomitant with the learning of voluntary heart rate control.

36 male undergraduates were instructed to raise or lower heart rate (HR) in a 7-session biofeedback experiment. HR, systolic and diastolic blood pressure, frontalis EMG activity, and skin conductance level were simultaneously recorded throughout biofeedback training. Principal axes factor analyses showed that physiological response patterning concomitant with the development of HR control was different early in training than later in training for both speeding and slowing conditions. These results indicate that Ss used different HR control strategies. Also indicated was a tendency for greater HR response specificity as training progressed for both speeding and slowing. HR speeding sessions (but not slowing) were also found to be associated with a significant increase in perceived state anxiety as measured by the State-Trait Anxiety Inventory. (14 ref) (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)     

Biofeedback as a placebo: Anxiety reduction facilitated by training in either suppression or enhancement of alpha brainwaves.

Assessed the differential effects (on experiential reports of anxiety) of actual performance and perceived success at an EEG biofeedback task. 10 college students who were high in trait anxiety (MMPI, State-Trait Anxiety Inventory) underwent training in either the suppression of enhancement of EEG alpha activity with the expectation that success at their biofeedback task would result in reductions of chronic anxiety levels. Both groups experienced significant reductions in both trait and state anxiety. Anxiety reductions were highly correlated with the trainees' ratings of perceived success at the feedback task but were unrelated to either the direction or magnitude of the changes in their alpha activity. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A controlled evaluation of paraspinal EMG biofeedback in the treatment of chronic low back pain.

66 chronic low back pain sufferers (aged 20–65 yrs) were randomly divided into 3 equal groups. Ss completed a psychological test battery that included the Beck Depression Inventory and the State-Trait Anxiety Inventory; pain monitoring measures, including the McGill Pain Questionnaire (MPQ); and measurement of paraspinal electromyogram (EMG). One group then received paraspinal EMG biofeedback, 1 group received placebo treatment, and the 3rd group received no intervention. All Ss were reassessed immediately after treatment and at 3-mo follow-up. Results show that all groups showed significant reductions in pain, anxiety, depression, and paraspinal EMG following treatment and at follow-up, but there were no differences between groups. A regression analysis failed to identify Ss' characteristics that predicted positive outcome in the biofeedback group. However, high scores on the Evaluative scale of the MPQ and high hypnotizability were significant predictors of positive outcome for the placebo group. It is concluded that paraspinal EMG biofeedback is not a specific treatment for chronic low back pain in a nonhospitalized population. (31 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)     

Comparison of electromyographic feedback and progressive relaxation training in treating circumscribed anxiety stress reactions.

Examined the effects of EMG feedback and progressive relaxation training on the anxiety stress reactions of patients having recurrent, negative reactions to dental treatment. 21 21–48 yr old Ss were randomly assigned to 1 of 3 groups: EMG feedback, progressive relaxation, or control. Four dependent measures—EMG level, Dental Anxiety Scale (DAS), and State–Trait Anxiety Inventory (A-State and A-Trait)—were collected for dental appointments before and after training. Results show significant, comparable decreases in EMG levels across dental appointments for both EMG feedback and progressive relaxation groups but not for the control group. On the DAS and A-State measures, significant decreases in all groups were found. Although the decreases shown by the EMG feedback and progressive relaxation groups did not differ significantly from each other, they were both significantly greater than the decrease shown by the control group. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group vicarious desensitization of test anxiety.

Examined whether vicarious desensitization, using videotapes and a small group format, could be used as a treatment for test anxiety. 43 test anxious college students were administered the Test Anxiety Inventory and the State-Trait Anxiety Inventory. Ss received either vicarious desensitization, study skills training, or both treatments; there was also a no-treatment control condition. Self-report measures indicated that vicarious desensitization resulted in lower test and trait anxiety than study-skills training alone or no treatment. Academic performance measures, obtained posttreatment and at a 3-mo follow-up, indicated no differential effectiveness. (10 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)     

Application of electromyographic biofeedback to the relaxation training of schizophrenic, neurotic, and tension headache patients.

Examined the effects of EMG biofeedback on tension reduction by schizophrenic, neurotic, and tension headache patients. 14 patients (mean age 39 yrs) participated voluntarily in at least 10 weekly EMG biofeedback sessions at a public outpatient clinic. All had complained of chronic tension. Ss showed significant decreases in their muscle tension levels with successive biofeedback training sessions. No significant differences were found between the schizophrenic, neurotic, and tension headache groups. A further contribution is the finding that patients with diverse socioeconomic and educational levels benefited similarly from EMG biofeedback training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting the Differential Effectiveness of Relaxation Training With the Multimodal Structural Profile Inventory.

Seventy-eight individuals were assessed with the Multimodal Structural Profile Inventory (Multimodal SPI) and subsequently treated with 4 different forms of relaxation training in a group format. Treatments were presented to the different clients in counterbalanced order. After each session of training, levels of anxiety were assessed with the State-Trait Anxiety Inventory. Following the completion of all sessions of treatment, clients were asked to rank order the different forms of therapy for preference. Analyses indicated that it is possible to predict which forms of treatment are likely to be most effective and preferred, on the basis of clients' scores on the Multimodal SPI. (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)     

The role of EMG awareness in EMG biofeedback learning

Underlying most research on biofeedback learning is a theoretical model of the processes involved. The current study tested a prediction from the Awareness Model: High initial EMG awareness should facilitate response control during EMG biofeedback training. Seventy-two undergraduates were assessed for forehead EMG awareness by asking them to produce target responses from 1.0 to 5.0 microV every 15 s for 16 trials. Based on this assessment, two groups (high and low awareness) were trained for 64 trials to produce these target levels with either EMG biofeedback, practice (no feedback), or noncontingent EMG feedback. A transfer task was identical to the initial assessment. During training, the biofeedback group deviated less from target than the practice and noncontingent groups. The biofeedback group was the only group to improve from initial EMG awareness activity. During transfer, only the low awareness biofeedback group remained below initial EMG awareness level. These findings can be interpreted in terms of the Two-Process Model.     

Comparison of psychoanalytic and a client-centered group treatment model on measures of anxiety and self-actualization.

30 volunteer graduate counseling students were randomly assigned by sex to 1 of 4 treatment groups involved in either a psychoanalytic or a client-centered group treatment model. One male and 1 female group leader led 1 group in each model. All groups met for 2 4.5-hr sessions on consecutive Saturdays or Sundays. The State-Trait Anxiety Inventory was administered toward the end of the 1st day. The Personal Orientation Inventory (POI) was used to measure self-actualization before, immediately after, and 1 mo following treatment. Data were analyzed on 19 Ss who completed both days of treatment. Significant differences were found between treatment models in levels of group anxiety and in gains in self-actualization. The psychoanalytic groups reported higher anxiety, and the client-centered groups showed greater initial gains on the POI and maintained these gains at follow-up. Sex of leader was not a major source of difference between group treatment models. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a workshop fee on women's stress management skills and evaluations.

Investigated the effects of a workshop fee on stress-management skills and workshop evaluations of 34 women (aged 24–62 yrs) who participated in a 2-evening stress-management workshop. Ss were randomly assigned to 1 of 2 groups: $30 treatment fee or no fee (control). At the conclusion of training, all Ss completed the State scale of the State-Trait Anxiety Inventory twice (before and after using stress reduction techniques), a cognitive recall test, and a workshop evaluation. Two weeks after training, Ss responded to a scale measuring their present level of experienced stress. Significant differences were found between the groups: Those paying for the workshop scored significantly higher in content recall of stress reduction techniques and significantly lower in follow-up stress levels than Ss who paid no fee. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Electromyograph feedback as a relaxation technique.

Compared an EMG feedback group of 10 normal undergraduate males with 2 control conditions of 10 Ss each. One control group was told to relax but given no specific instructions nor feedback, only a constant tone. The 2nd control group was given instructions about relaxation, a constant tone but no feedback. The feedback group received variable-tone feedback from the frontalis muscle. Every S had 1 baseline session and 7 21-min practice sessions over a 2-wk period. The feedback group achieved significantly lower EMG scores than the 2 control groups, which did not significantly differ between themselves. Measures of subjective anxiety (Mattsson's Anxiety Scale) showed significant decreases between the beginning and end of each session for all 3 groups, but only 1 of the 6 measures of state anxiety (e.g., Taylor Manifest Anxiety Scale, Nowlis Mood Adjective Check List, and Mooney Problem Checklist) favored the feedback group over the controls. No differences between groups emerged on measures of trait anxiety. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety as a predictor of behavioral therapy outcome for cancer chemotherapy patients.

Studied whether baseline anxiety levels are predictive of outcome on treatments designed to reduce the negative affect and conditioned nausea associated with cancer chemotherapy. 72 18–79 yr old patients classified as having low, moderate, or high anxiety received progressive muscle relaxation training, electromyograph (EMGH) biofeedback, and/or skin temperature biofeedback. Physiological, multiple affect adjective checklist, and postchemotherapy ratings were obtained during baseline, training, and follow-up sessions. Compared with moderate- and high-anxiety Ss, low-anxiety Ss reported less anxiety and depression before behavioral training but nonetheless exhibited significantly greater reductions in anxiety, depression, and diastolic blood pressure as a result of training. Baseline anxiety levels were not related to reduced nausea. Overall, these data suggest that cancer patients who have higher baseline levels of anxiety and who are perhaps most in need of an effective behavioral treatment may be the least likely to benefit from behavioral treatments aimed at reducing the distress associated with chemotherapy. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential shaping of EEG theta rhythms

Heart rate, EEG, frontal EMG, and forearm EMG were recorded in 20 subjects for 3 baseline, 8 feedback, and 2 postbaseline sessions in order to compare two biofeedback methods of teaching subjects to increase theta EEG activity. Subjects were divided into high- and low-EMG groups. Five high-EMG subjects, and 5 low-EMG subjects then received 8 sessions of strictly theta feedback. The remaining 10 subjects, 5 from the high-EMG group, and 5 from the low-EMG group, received a "graduated" training which involved shaping the target response. This procedure consisted of 4 initial sessions of EMG feedback, followed by a second phase consisting of 4 sessions of theta feedback. Results showed a clear relationship between subjects' baseline frontal EMG levels and the effect of the training methods. Although subjects with high-EMG baseline increased their theta output only with the two-phase training, subjects with low-EMG baseline levels performed better when given theta feedback only. This result shows not only that amounts of theta can be reliably increased, but that training techniques should be adapted to the physiological characteristics of the individual--in this case, baseline levels of frontal EMG levels.     

Managing organizational stress: A field experiment.

79 public agency employees (mean age 39 yrs) were randomly assigned to stress-management training or control conditions. The training program consisted of 16 hrs of group exposure over 8 wks. Using procedures based on those developed by D. H. Meichenbaum (1975), treatment Ss were taught to recognize and alter their cognitive interpretations to stressful events at work. Ss were also taught progressive relaxation techniques to supplement this process. Dependent variables were epinephrine and norepinephrine excretion at work, anxiety (State-Trait Anxiety Inventory), depression, irritation, and somatic complaints, all measured at 3 times (pretest, posttest, and 4 mo after treatment). Treatment Ss exhibited significantly lower epinephrine and depression levels than did controls at posttest, and 4-mo follow-up levels did not regress to pretest levels. However, treatment effects were not replicated in a subsequent intervention on the original control group. The general adoption of such stress management programs is not recommended. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic effectiveness of voluntary heart rate control in reducing anxiety.

Demonstrates the therapeutic effectiveness of heart rate control training in the treatment of a phobia. The S was a male college student who experienced a high degree of anxiety in association with receiving injections. S received 14 1-hr sessions of biofeedback training over the course of 2 mo and was encouraged to practice heart rate control between sessions. A time-series analysis of pretreatment and posttreatment assessment indicated significant fear reduction due to the biofeedback intervention. Results serve to further illustrate that learned control of heart rate deceleration is an effective self-control skill for coping with anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)