Clinical practice update. Incorporating mental health into primary care practice.
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Biomedical subjects
Publications and source records attributed to J D Haber.
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Migraine headaches are a common problem with many individuals and are usually treated by drug and/or biofeedback therapies. The following case history discussed the implementation of an operant approach to the modification of migraine headache, assumed to be associated with secondary gain and unresponsive to other treatment procedures. The operant program described below resulted in the elimination of head pain behaviors and a correlated increase in prosocial and well behaviors.
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Well-delineated models and procedural descriptions are noticeably missing from the clinical biofeedback literature dealing with the training of physiological self-control. As a consequence, optimal protocols for the assessment and training of self-control of physiological functions have not eventuated. The present article reviews evidence suggesting that researchers have (a) confused self-control training, assessment, and measurement of tonic response levels, (b) neglected to determine the degree of acquired physiological self-control, and (c) failed to report the relationship between level of acquired physiological control and clinical outcome. The article also proposes an assessment and training paradigm that may be useful in reducing these methodological problems in future biofeedback research.
Myofascial pain dysfunction (MPD) syndrome has received widespread attention in the dental and psychological literature. The present paper considers issues concerning a stress-related muscular hyperactivity theory of MPD syndrome. A review of the empirical evidence as well as methodological problems evident in these studies has been noted. In addition, definition aspects of stress and a conceptual model of stress in clinical use is presented. A functional analysis of the problem components will help determine a proper treatment protocol for patients suffering from stress-related myofascial pain. A discussion of the conceptual model for assessment and treatment purposes is presented and its implications for future research noted.
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The widespread utilization of frontalis electromyographic feedback as a general relaxation strategy far preceded empirical evidence demonstrating its efficacy for this purpose. This article reviews parametric studies testing the association between frontalis reduction and concomitant EMG decreases in nontargeted muscle groups. The current research supports the contention that biofeedback reinforces discriminative responding to a specific muscle group and not generalized relaxation to adjacent muscle groups. Methodological problems are noted, and implications for future research are addressed.
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