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Biomedical subjects

E B Blanchard

Publications and source records attributed to E B Blanchard.

At least 19 recordsLinked to original sources
PubMed1992

Preliminary results from the self-regulatory treatment of high-medication-consumption headache.

Data are presented from a prospective clinical replication series of ten consecutive high-medication headache patients who presented for nondrug treatment of their headaches. For the first eight, an attempt was made to withdraw the patients from medication, with the assistance of relaxation training, prior to entering a comprehensive self-regulatory treatment program. For the last two, drug withdrawal accompanied the treatment. Six of the ten patients showed clinically significant reductions in headache activity, which held up over follow-ups of up to 12 months. Psychological tests provide some discrimination between success and failures.

Adult↗
PubMed1992

Prediction of outcome from cognitive-behavioral treatment of irritable bowel syndrome.

The presence of a diagnosable Axis I psychiatric disorder predicted significantly (P less than 0.001) lower likelihood of significant improvement among 90 irritable bowel syndrome patients given cognitive and behavioral treatments to help the disorder. Other psychological tests, including the MMPI, BDI, STAI, as well as demographic variables, failed to yield significant prediction.

Adolescent↗
PubMed1992

Physiological reactivity to stressors in irritable bowel syndrome patients, inflammatory bowel disease patients and non-patient controls.

Irritable Bowel Syndrome (IBS) patients were compared with Inflammatory Bowel Disease (IBD) patients and non-patient controls on four separate physiological measures (heart rate, finger-tip temperature, skin resistance level, and forehead EMG) for their physical reactivity to 'laboratory stressors'. It was predicted that the IBS patients would respond to these stressors with more physiological reactivity than the two other groups. There were initial basal differences among the groups on heart rate and finger-tip temperature: in general, the IBS patients had lower basal heart rates and the non-patient controls had lower finger-tip temperatures. These findings are contrary to the previous body of literature regarding possible sympathetic nervous system (SNS) arousal states in the IBS patient. The results also indicated IBS patients were not significantly different than the IBD patients or the non-patient controls in their reactivity to stressors. Previous literature has suggested that IBS in their reactivity to stressors. Previous literature has suggested that IBS patients have an enhanced SNS arousal or an SNS mediated reactivity to environmental stressors, our current study has not found these results.

Adult↗
PubMed1992

Two controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome.

We report two controlled comparisons of a previously validated multicomponent (relaxation, thermal biofeedback, and cognitive therapy) treatment for irritable bowel syndrome (IBS) to an ostensible attention-placebo control (pseudo-meditation and EEG alpha suppression biofeedback) and to a symptom-monitoring control. In Study 1 (n = 10 per condition) there were nonsignificant trends for the multicomponent treatment to be superior to the attention-placebo condition. In Study 2 (n = 30 per condition), we found no advantage for the multicomponent treatment over the attention-placebo condition. Subjects in both treatment conditions showed significant reductions in GI symptoms, as measured by daily symptom diaries, and significant reductions in trait anxiety and depression. The GI symptom reductions held up over a 6 month follow-up. Possible explanations for the results are explored.

Adult↗
PubMed1992

Psychological treatment of benign headache disorders.

This article presents a selective summarization and critique of research on the psychological treatment of headache, with the primary focus on research appearing since 1980. Suggestions for future research directions and methodological improvements are included.

Behavior Therapy↗
PubMed1992

Motor vehicle accidents, headaches and post-traumatic stress disorder: assessment findings in a consecutive series.

Results of 20 consecutive cases referred for post-traumatic headache (PT-HA) to a psychological practice were assessed for both psychiatric and neurological diagnoses. Nineteen of the 20 cases (95%) had a diagnosable psychiatric disorder, with 15 presenting with a post-traumatic stress disorder. Prior headache history was reported for only 25% of the referred patients, while a prior psychiatric disorder was found for 7 (35%) of the cases. Findings suggest that consideration of a psychiatric disorder should be made for PT-HA patients.

Accidents, Traffic↗
PubMed1992

Two studies of the non-pharmacological treatment of menstrually-related migraine headaches.

In order to evaluate the effect of non-pharmacological treatment on menstrual and non-menstrual migraine headache (HA), 2 studies have been conducted. In Study 1 which was a retrospective examination of between group reactions to non-drug treatments, 37 self-defined menstrual migraineurs and 62 non-menstrual migraineurs showed comparable overall improvement (reduction in HA activity) after treatment, but menstrual migraineurs maintained larger usage of medication across time than non-menstrual migraineurs. In Study 2 which was a prospective examination of within subject reactions to non-drug treatments, 15 carefully documented menstrual migraineurs again showed comparable levels of overall improvement but also showed that level of menstrual headache activity remained higher across time than non-menstrual migraine HA. Because there were no interactions of time and type of migraine in either study, these results raise some questions about the existence of differential effectiveness of non-pharmacological treatment of menstrual vs non-menstrual migraine.

Adult↗
PubMed1992

Thermal biofeedback treatment of mild hypertension. A comparison of effects on conventional and ambulatory blood pressure measures.

Several studies have produced results suggesting that thermal biofeedback treatment is effective in lowering the blood pressure (BP) of individuals with both mild and moderate essential hypertension. This study used thermal biofeedback to treat 9 unmedicated individuals with mild hypertension. Subjects underwent 24-hour ambulatory BP monitoring both prior to and following the thermal biofeedback treatment regimen. Four of the subjects were considered treatment successes using standard office blood pressure assessments as the success-fail criteria. However, 24-hour ambulatory BP measures showed a markedly different pattern of results, with several subjects who were considered successes under conventional assessment techniques showing an increase in 24-hour ambulatory BP from pre- to posttreatment. There was a significant decrease in diastolic blood pressure for all subjects as measured by the ambulatory method. There was also a significant decrease in systolic and diastolic standing home blood pressure. The implications of these results are discussed.

Adult↗
PubMed1991

The psychophysiology of motor vehicle accident related posttraumatic stress disorder.

Heart rate, BP, and electrodermal responses of four individuals with PTSD secondary to motor vehicle accidents (MVAs) were measured while they imagined two separate scenes related to their MVA. Results showed reliable HR responses to these images. In addition, SBP and DBP also showed some responsivity to the images while skin resistance level changed reliably in only 2 of 4 subjects. Psychophysiological measurement could play a role in the assessment and treatment of MVA-related PTSD.

Accidents, Traffic↗
PubMed1991

The role of absorption capacity in thermal biofeedback treatment of vascular headache.

The clinical utility of Tellegen's Absorption Scale was examined using a sample of 32 chronic vascular headache patients drawn from a larger treatment study investigating the efficacy of thermal biofeedback with vascular headache. A regression analysis found that acquisition of the hand-warming response was directly related to increase in capacity for absorption. Conversely, a trend was found for absorption capacity to be inversely related to reductions in headache frequency and intensity. Reasons for these differences in process and outcome variables are discussed.

Analysis of Variance↗
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↗
PubMed1991

Evaluation of a psychological treatment for inflammatory bowel disease.

Inflammatory bowel disease (IBD) encompasses two related gastrointestinal-tract diseases, ulcerative colitis (UC) and Crohn's Disease (CD). This study, a randomized controlled trial, compared the effectiveness of a multi-component behavioral treatment package (n = 11), which included IBD education, progressive muscle relaxation, thermal biofeedback, and training in use of cognitive coping strategies, to the effectiveness of symptom-monitoring (n = 10) as a control condition; 8 controls subsequently completed treatment. At posttreatment, the treatment group showed mean reductions on 5 symptoms, while the symptom monitoring controls showed mean reductions on all 8 symptoms. On a measure of Total Symptomatic change, the controls showed more improvement than the treated group; the treated controls at posttreatment, showed increases on all 8 symptoms. However, treated subjects perceived themselves as coping better with IBD, as feeling less IBD-related stress, and as experiencing less depression and anxiety. It is hypothesized that inherent differences may have existed between CD and UC subjects which could have led to the differences seen in treatment responses.

Adaptation, Psychological↗
PubMed1991

Evaluation of thermal biofeedback treatment of hypertension using 24-hr ambulatory blood pressure monitoring.

Ten male hypertensives, whose BPs were controlled on a combination of sympatholytic and diuretic medications, were given 16 sessions of thermal biofeedback prior to attempting withdrawal from the sympatholytic drug. Results were evaluated using 24-hr ambulatory BP monitoring (ABPM) as well as clinic and home BPs, both in multi-baseline-across-subject designs and as a single group. Results showed significant treatment effects on 24-hr ABPM data, both at the individual level (SBPs only) and in the aggregate analyses (SBP and DBP). BPs assessed in the clinic by random zero sphygmomanometer and patient-assessed home BPs were also reduced.

Aged↗
PubMed1991

The impact of family presence on the physician-cancer patient interaction.

Physician behaviors were studied in 473 interactions between oncologists and adult cancer outpatients. Ninety-nine of these interactions occurred when family members were present during the visit. Patients with family members present were likely to be sicker as demonstrated by a poorer performance status. Contrary to earlier reports, age of the patient did not predict whether the patient was likely to be accompanied by a family member. The physician behaviors were factor analyzed to produce six factors and a multivariate analysis of variance was conducted using the presence of family and performance status as independent variables. The time the physician spent in the patient's room, patient satisfaction and quality of life were also examined in separate analyses. The time the physician spent with the patient was greater when family were present. The results showed that, in general, physicians provide more information when patients are accompanied by family members, or if no family are present, when the patient has a worse performance status. Patient satisfaction and quality of life were rated lower for patients with a worse performance status and were not impacted by physician behaviors. Physicians' behavior was affected by both the presence of a family member, and the patient's performance status.

Evaluation Studies as Topic↗
PubMed1991

The role of regular home practice in the relaxation treatment of tension headache.

This study evaluated the contribution of regular home practice in the treatment of tension headache (HA) with progressive muscle relaxation (PMR) by giving 14 tension HA sufferers 10 sessions (over 8 weeks) of standard PMR with home practice and application instructions while 13 additional patients received the same PMR training (except for the omission of cue-controlled relaxation) with no home practice or application instruction. A third group of 6 patients merely monitored HA activity. Both treated groups showed significant reduction in HA activity, whereas the symptom monitoring group did not change. The 2 treated groups did not differ. On a measure of clinically significant reduction in HA activity (at least 50% reduction in HA activity), however, the group receiving home practice instruction (50%) showed a trend (p = .056) to improve more than did those receiving PMR without home practice (15%).

Adult↗
PubMed1991

The role of home practice in thermal biofeedback.

The role of regular home practice of hand warming was examined in the thermal biofeedback (TBF) treatment of vascular (migraine and mixed migraine and tension) headache (HA) by giving 12 sessions (over 6 weeks) of TBF to two groups of vascular HA patients (n = 23 per group). One group was asked to practice regularly at home with a home trainer between clinic sessions, whereas no mention of practice was made to the other group. A third group merely monitored HAs. Treatment was superior to no treatment. There was no advantage for the group receiving home practice, either in headache reduction or in acquisition of the hand-warming response.

Adult↗
PubMed1991

Psychophysiological responses in the diagnosis of posttraumatic stress disorder in Vietnam veterans.

In one sample of 104 male Vietnam combat veterans, we found that five heart rate parameters from a psychophysiological assessment could correctly discriminate 75% of the sample into those with PTSD and those without it. Using a stepwise approach, we found adding 10 blood pressure parameters increased discrimination to 80%, while adding five parameters from frontal electromyograms did not increase discrimination. Cross-validation of the heart rate parameters on a new sample of 96 veterans resulted in 83% correct discrimination.

Adult↗