Treatment of childhood migraine using autogenic feedback training.

Assigned 28 7–16 yr olds who suffered from migraine headaches to 1 of 2 conditions (treatment group or waiting-list control group). All Ss recorded at breakfast, lunch, dinner, and bedtime whether they had a headache and its intensity. The records of headache index, frequency, duration, intensity, average intensity, and medication generated weekly scores. Analysis showed that Ss in the treatment condition were significantly improved at the end of treatment (7 wks) and at 1-mo follow-up. No improvement was found for control Ss. 93% of Ss in the autogenic feedback condition were clinically improved, using a criterion of 50% reduction of headache activity. Six months after treatment, Ss were asked to complete headache recordings. 13 Ss responded (8 Ss from the treatment groups and 5 from the control group). Treated Ss maintained significant improvement. Findings are important in light of the need for effective nonpharmacological treatment procedures for childhood migraine. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biofeedback treatment for pediatric migraine: Prediction of treatment outcome.

Despite a growing number of studies showing good effectiveness of nonpharmacological treatments such as thermal biofeedback (TBF) for pediatric migraine, little is known about psychosocial variables that might be predictive of treatment outcome. The identification of predictors appears especially important when children are treated in a home-based treatment format that tends to be somewhat less effective than a therapist-administered treatment. A total of 32 children between the ages 8 and 16 years completed a home-based TBF treatment program with treatment outcome being of similar magnitude as previously reported in the literature. Multiple regression analysis revealed externalizing behavior tendencies, initial level of psychosomatic complaints, and the child's age to be highly predictive of outcome, whereas dimensions of family functioning failed to exert a direct influence. The implications of these findings for the development and evaluation of future treatment programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of home practice in the thermal biofeedback treatment of migraine headache.

Examined the role of home practice of hand warming in the thermal biofeedback treatment of migraine headache. 17 female migraine sufferers were randomly assigned to 1 of the following conditions: thermal biofeedback with regular home practice (HP) or thermal biofeedback without home practice (NHP). Biofeedback treatment consisted of 12 training sessions over a 6-wk period, and all Ss completed 5 wks of headache monitoring before and after treatment. Results indicated that Ss in the HP condition experienced decreases in headache activity and medication intake that were both statistically and clinically significant compared with the NHP condition. None of the outcome measures revealed significant improvement in the NHP condition. Thus, regular HP appears to enhance the efficacy of biofeedback in the treatment of migraine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in migraine symptoms from childhood to adolescence

INTRODUCTION: Kaposi's disease is increasingly frequent in transplant recipients. The therapeutic approach in heart transplantation is not fully established. CASE REPORT: A 61-year-old male transplant recipient (June 1992) presented Kaposi's disease on the legs. Immunosuppressive therapy was reduced, cyclosporin by 20 p. 100, withdrawal of azathioprine and 40 p. 100 reduction in prednisone was insufficient to control the disease. Due to the extension of the lesions and the major functional handicap, bleomycin was given and led to complete regression of the lesions within 6 months. DISCUSSION: This case illustrates the difficult therapeutic situation encountered in heart transplant recipients. The situation may be life-threatening with organ rejection. The first step is to reduce immunosuppressive therapy. If this is insufficient or the Kaposi is particularly aggressive, bleomycin may be used. The efficacy of bleomycin observed in our case requires confirmation in multicenter studies.     

Employee responses to formal performance appraisal feedback.

Investigated the attitudinal impacts of receiving formal performance appraisal feedback. Based on the suggestion that the feedback that one is "satisfactory" will be disconfirming for many feedback recipients, it was hypothesized that attitudes toward the performance appraisal systems and organizational commitment will decrease and remain lower for those receiving satisfactory ratings, whereas the attitudes of those receiving higher appraisal ratings will remain unchanged. The hypotheses were tested on panels of management and nonmanagement employees (the latter receiving new appraisals 12 mo after their managers) in 2 federal agencies over a 30-mo period using perceived and actual performance ratings. There was a significant and stable drop in the organizational commitment of satisfactory employees after the introduction of formal appraisals, with mixed results for attitudes toward the appraisal system. Findings suggest that potentially negative consequences of implicitly comparative formal performance appraisals can occur for those performing at a satisfactory, but not outstanding, level. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnoses commonly missed in childhood. Long-term outcome and implications for treatment

Psychiatric and developmental disorders with onset in early childhood are often missed and commonly overlooked by adult psychiatrists. These disorders have important continuities into adulthood and are powerful predictors of chronicity, comorbidity, and severity. It is essential that they are recognized and taken into account in the assessment and treatment of the adult patient.     

Linking analytic performance goals to medical outcome

As laboratorians relate analytic performance to medical goals, they face complex choices among competing subjective and objective criteria for the assessment of acceptable analytic error. Defining desirable performance as some fraction of physiologic variability provides potentially excessive benchmarks for quality. More important than the recognition of health are the clinical decisions which deal with diseases, particularly the latters' degrees of severity and the different medical actions these prompt. It is equally essential to take into account the reasoning by which physicians arrive at these decisions, since their mental processes condition desirable performance goals. Considering these modalities, a universal model of analytic performance requirements uniformly applicable to all measured parameters clearly cannot be devised. Rather, tolerance limits for analytic error must be tailored to specific medical problems. To facilitate this seemingly Herculean task, this paper develops concepts and principles derived from operation research, and illustrates their application by three examples. The generic conclusion evidenced by the latter is that the linkage between analytic performance goals and medical strategies is reciprocal, namely that outcome can just as well be optimized by tailoring medical strategy to existing analytic performance as by adapting analytic performance to medical strategy.     

A controlled evaluation of thermal biofeedback and thermal biofeedback combined with cognitive therapy in the treatment of vascular headache.

One-hundred-sixteen patients suffering from vascular headache (migraine or combined migraine and tension) were, after 4 weeks of pretreatment baseline headache monitoring, randomly assigned to one of four conditions: (a) thermal biofeedback with adjunctive relaxation training (TBF); (b) TBF plus cognitive therapy; (c) pseudomeditation as an ostensible attention-placebo control; or (d) headache monitoring. The first three groups received 16 individual sessions over 8 weeks, while the fourth group continued to monitor headaches. All groups then monitored headaches for a 4-week posttreatment baseline. Analysis revealed that all treated groups improved significantly more than the headache monitoring group with no significant differences among the three treated groups. On a measure of clinically significant improvement, the two TBF groups had slightly higher (51%) degree of improvement than the meditation group (37.5%). It is argued that the attention-placebo control became an active relaxation condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of competition with outcome feedback on children's helping behavior.

80 2nd- and 5th-grade boys played a bowling game within either a competitive or noncompetitive atmosphere. Within the competition conditions, the children were randomly assigned outcomes (win, tie, or lose) and were given feedback accordingly. Each child was subsequently given the opportunity to donate to a charity. While competition with feedback was found to decrease altruism, one important limiting factor was found to be the individual's outcome within the situation. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prophylactic treatment of migraine with gamma-linolenic and alpha-linolenic acids

Polyunsaturated fatty acids (PUFA) were administered to 168 patients over a period of 6 months in an open-label uncontrolled study. In 129 patients available for study, 86% experienced reduction in severity, frequency and duration of migraine attacks, 22% became free of migraine and more than 90% had reduced nausea and vomiting. Self-medication changed to simple analgesics in the majority except in 14% of patients without improvement.     

Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic posttraumatic stress disorder

History of early childhood trauma was prevalent and highly correlated with Disorders of Extreme Stress Not Otherwise Specified (DESNOS) in a sample of veterans in inpatient treatment for chronic posttraumatic stress disorder (PTSD). DESNOS predicted reliable change on a variety of measures of psychiatric symptomatology (including PTSD) and psychosocial functioning independently of the effects of PTSD diagnosis and early childhood trauma history. DESNOS also predicted treatment outcome on PTSD and quality of life measures after controlling for the effects of ethnicity, war zone trauma exposure severity, initial level of symptomatic severity or quality of life, Axis I (PTSD and major depression) and Axis II (personality disorder) diagnostic status, and early childhood trauma history. Early childhood trauma was not predictive of outcome. DESNOS appears to play an important role in assessment and treatment planning for psychotherapeutic rehabilitation of chronic PTSD.     

EMG biofeedback to patients with Guillain-Barré syndrome.

Presents 4 cases in which electromyogram (EMG) biofeedback was used to improve upper extremity function in patients having Guillain-Barré syndrome. It is suggested that for those who experience recovery, biofeedback can enhance this natural process; for those who do not recover well, biofeedback may improve motoric status enough to provide greater independence and thereby enhance the quality of life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonverbal communication deficits and response to performance feedback in depression.

Evaluated aspects of recent behavioral and cognitive theories of depression. Social-skill concepts were conceived as involving 2 component processes, termed receptive and expressive communication, and the ability of depressed Ss to engage in these behaviors was studied within a nonverbal communication paradigm. Three groups of 10 females—depressed, psychiatric control, and normal control—had their facial expressions videotaped while exposed to a differential classical conditioning procedure, with pictorial stimuli following 1 CS, auditory stimuli following a 2nd CS, and a neutral event following a 3rd CS. In a 2nd session, the Ss observed the videotapes of other Ss, one from each diagnostic group, and judged which type of conditioning trial the observed S was undergoing, in addition to predicting their anticipated performance prior to each set of judgments. Results indicate that the depressed Ss were the most difficult to judge correctly; this deficit did not seem to be attributable to idiosyncratic response predispositions on the part of the depressives. This finding is interpreted as consistent with P. M. Lewinsohn's (see PA, Vol 53:7587) theory. Predictions of performance did not differ significantly between groups, failing to support one aspect of A. T. Beck's (1967) theory. For all groups, changes in Ss' ratings of their anticipated performance were highly correlated with the discrepancy between predicted and actual performance on previous trials. This finding is contrary to a prediction derived from M. E. Seligman's (see record 1973-06430-001) model of depression. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal assessment of applicant reactions to employment testing and test outcome feedback.

Following a justice framework, the present study examined actual candidates taking selection tests to gain full-time employment. The reactions of 144 applicants for an entry-level accounting job were examined in a real employment testing context at 3 time periods: before testing, after testing but before feedback on whether they passed or failed the test, and after test performance feedback. With controls for pretest perceptions, several of the 5 procedural justice measures (information known about the test, chance to perform, treatment at the test site, consistency of the test administration, and job relatedness) predicted applicant evaluations regarding the organization, perceptions of employment testing, and applicant test-taking self-efficacy. Test outcome favorability (passing or failing the employment test) predicted outcomes beyond initial reactions more consistently than procedural justice perceptions. Procedural justice perceptions explained incremental variance in some analyses after the influence of outcome favorability was controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical treatment of migraine: from mechanisms of action to contraindications

Management of migraine patients with or without aura must include appropriate medication to treat the attack and long-term preventive therapy, especially if the frequency of the attacks is greater than 2-4 per month. In both cases the choice of treatment depends on its efficacy and side effects. With regard to acute drug therapy, group studies do not suggest that ergot derivatives and sumatriptan are superior to simple analgesics and anti-inflammatory drugs, particularly if a prokinetic agent is added. These new substances are indicated for severe attacks refractory to more conventional therapy. Chronic drug abuse may induce drug-induced or rebound headaches. As regards long-term prophylaxis, group studies suggest that calcium antagonists and 5-HT-influencing drugs are superior concerning attacks frequency to beta-blocking agents, but involve very frequent side effects (weight gain and somnolence). Interesting preliminary results have also been reported with valproate and enalapril, which will confirmation by controlled studies. Finally, the choice of drug must take into account the patient's comorbidities (cardiovascular diseases, asthma, diabetes etc).     

Exteroceptive suppression of temporalis muscle activity during migraine attack and migraine interval before and after treatment with sumatriptan

Acute myocardial infarction is difficult enough to manage without the complications that commonly occur in the first days and weeks that follow. This article covers the most frequent complications, outlining when they are likely to occur, what the symptoms are, how they are best treated, and what sort of prognosis can be expected. In this way, the author provides a "map" of the days after infarction, showing the pitfalls and sand traps of clinical management.     

Long-term socioeconomic outcome following surgical intervention in the treatment of refractory epilepsy in childhood and adolescence

Surgical treatment of refractory epilepsy in childhood and adolescence has been shown to be effective in reducing the seizure frequency. This paper examines the question: "Does this result in a better socioeconomic outcome in later years?" Patients who underwent a surgical procedure for the treatment of their medically refractory epilepsy at our hospital, had more than 2-years' follow-up, and were less than 18 years old at time of survey were included. From a retrospective chart review, age at onset and at surgery, duration of seizures prior to surgery, years of follow-up, type of surgery, and neurological status were obtained. From a telephone survey, seizure frequency after surgery, marital, financial and driving status, level of education, and employment status were ascertained. Sixty-four patients in our epileptic surgical series meet entry criteria. Significantly higher levels of education, employment status and independence were found in patients with a class I Engel outcome compared to other Engel outcomes.