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Biomedical subjects

J G Arena

Publications and source records attributed to J G Arena.

At least 19 recordsLinked to original sources

Reliability of psychophysiological responding as a function of trait anxiety.

This study examined the temporal stability of three psychophysiological responses (frontal electromyographic activity, hand surface temperature, and heart rate) recorded over four sessions (days 1, 2, 8, and 28) on 34 subjects, 17 with high Spielberger Trait Anxiety Inventory scores and 17 with low scores. Each session consisted of a 20-minute adaptation period, a baseline condition, and two stressors (one cognitive, the other physical). Two forms of reliability coefficients were employed, intraclass correlations and Pearson Product Moment; the two types of reliability coefficients arrived at the same conclusions. Results indicated that reliability coefficients for the two anxiety groups did not differ on frontal EMG or heart rate responses; however, hand surface temperature responding was considerably less reliable for high anxious individuals than low anxious individuals. Reliability coefficients on absolute scores were, for the most part, reliable. Treating the responses as relative measures (percent change from baseline or simple change scores from baseline) produced smaller and less reliable coefficients. Magnitudes of the three physiological responses did not significantly differ as a function of high or low trait anxiety. Findings are discussed in terms of their clinical, as well as basic psychophysiological, importance.

Adult

Temporal stability of psychophysiological stress profiles: a re-analysis using intraclass correlation coefficients.

This is a re-analysis of data from a previous study which examined the temporal stability of three psychophysiological responses [frontal electromyographic activity (EMG), hand surface temperature, and heart rate]. Each response was recorded on 64 subjects over four sessions, each of which consisted of a 20-min, adaptation period, a baseline condition, and two stressors (one cognitive, the other physical). Rather than using Pearson product-moment correlations, as nearly all psychophysiological test-retest reliability studies have, we have now analyzed the data using intraclass correlation coefficients. This type of correlation allows one to incorporate more than two test-retest values on the same subjects. Analysis indicated that, with the exception of EMG during the physical stressor, the absolute values of the responses had quite significant reliability (.70 or greater). Treating the responses as relative measures (percent change from baseline or simple change scores from baseline) produced smaller and frequently less stable coefficients. It is concluded that statistical estimates of psychophysiological response reliability are functions of the design and particular reliability analysis employed.

Adolescent

Reliability of an ambulatory electromyographic activity device for musculoskeletal pain disorders.

A number of investigators in recent years have called for the development of devices that can monitor surface EMG levels in individuals' normal environments for use with patients who suffer from disorders in which the etiology or maintenance of the pathology is presumed to be due at least in part to musculoskeletal dysfunction, such as low back pain, phantom limb pain and tension headache. This study examined the test-retest reliability of just such a device. Twenty-six healthy controls wore a lightweight (24 ounce) device which measured bilateral upper trapezius EMG, as well as peak and integral motion, for 5 consecutive days for up to 18 h each day. ANOVAs on the four measures revealed no difference between any of the four measures over the 5 days. Intra-class correlation coefficients for the two EMG variables across 5 days were both significant with alpha levels set at 0.01. The two EMG measures were highly correlated (r = 0.77); the two motion measures were also highly correlated (r = 0.60), but at a lower magnitude than EMG values; the relationship between EMG and motion was significant, but the magnitude of the between EMG motion correlations (0.26 and 0.35) were lower than the within EMG or motion ones. It was concluded that the test-retest reliability of the ambulatory monitoring device is within acceptable limits. Implications for the use of the device with musculoskeletal pain disorders--particularly headache--are discussed.

Adult

Electromyographic biofeedback training for tension headache in the elderly: a prospective study.

This study evaluated the effects of a 12-session frontal electromyographic biofeedback training regimen on the headache activity of eight tension headache sufferers aged 62 and older. The biofeedback sessions were slightly modified for a geriatric population, essentially to increase comprehension and retention of rationale and instructions. Post-treatment assessment at three months revealed significant decreases in overall headache activity (50% or greater) in 50% of the subjects, and moderate improvement (35%-45%) in three of the remaining four subjects. Significant clinical and/or statistical pre-post differences were also found for the number of headache-free days, peak headache activity, and medication index. This is the first prospective study of biofeedback training for tension headache in an elderly population and, unlike previous retrospective studies, suggests that such therapy may be an effective intervention in the treatment of tension headaches in the elderly.

Aged

Effect of movement and position on muscle activity in tension headache sufferers during and between headaches.

This paper presents the results of two studies. In the first, 20 tension headache subjects were evaluated in both a headache and non-headache state on bilateral trapezius and unilateral frontalis electromyographic activity during six positions: standing, bending from the waist, rising, sitting with back unsupported, sitting with back supported, and prone. Results indicated no effect of headache state on either measure. In a second study, 11 of the tension headache sufferers in Study One and 11 age-matched controls were compared on the same measures (controls were assessed two times, with a one-week duration separating evaluations). Results indicated a diagnosis by position interaction, with post-hoc tests revealing the muscle activity of tension headache sufferers to be considerably higher during the prone position than that of non-headache controls. Non-significant trends were found when examining the data for clinically significant abnormalities (90% of the headache sufferers were found to have significant clinical abnormalities).

Adult

Development of an ambulatory recorder for evaluation of muscle tension-related low back pain and fatigue in soldiers' normal environments.

We have developed an ambulatory recorder capable of monitoring low back muscle tension, trunk motion, and ratings of pain and fatigue. It weighs 22 ounces, fits into a canteen belt, and records every second for 18 hours. Eleven subjects wore the recorder during all walking hours for between 3 and 5 days. Six subjects had chronic low back pain due to muscle tension, three experienced low back pain after labor, and two had no pain. Movement and muscle tension correlated highly when subjects were pain free but not when they were in pain. Muscle tension increased before pain was experienced.

Back Pain

The relationship between situational stress and phantom limb pain: cross-lagged correlational data from six month pain logs.

This study reports the results of the first investigation into the relationship between situational stress and phantom limb pain. Twenty-seven male amputees recorded their pain and overall stress levels daily for 180 days using a 1-10 rating scale. Three possible relationships into the etiology and/or maintenance of phantom limb pain were examined using cross-lagged correlational techniques: an isomorphic relationship (same time increases in pain lead to same time increases in stress and vice versa), a consequence relationship (increases in pain precede increases in stress), and a precursor relationship (increases in stress precede increases in pain). Thirty-seven per cent of subjects demonstrated some significant precursor relationship. Although support was found for all three hypotheses, the most frequently observed relationship was the isomorphic one. Seventy-four per cent of subjects demonstrated some significant stress-pain relationship. The results lend support to the psychological theory underlying the use of psychophysiological interventions such as biofeedback and relaxation therapy in amputees with phantom limb pain.

Adult

Temporal stability of paraspinal electromyographic recordings in low back pain and non-pain subjects.

This paper presents the results of two studies in which bilateral surface EMG recordings of paraspinal muscle tension were measured in 29 lower back pain and 20 normal subjects in 6 different positions (standing, bending from the waist, rising, sitting with back supported, sitting unsupported, prone) on two occasions, and a comparison of the data from both studies. Measures were highly reliable when examined using analysis of variance procedures. Statistically significant reliability coefficients were obtained when the absolute values of the measures were examined, although in some instances less than 20% of the variance was explained. When examined as relative [percent change from baseline (prone) condition] values, differences between the two groups were observed: the normals were statistically more reliable than lower back pain subjects during every condition. Implications for clinical work and both basic and applied research are discussed.

Adult

The mystery of phantom pain: growing evidence for psychophysiological mechanisms.

The direct, and much of the indirect, evidence supporting the existence psychophysiological mechanisms for phantom limb pain is reviewed. Phantom pain is shown to be a symptom class composed of different, but similarly described problems, each having its own underlying mechanisms. At least some descriptive types of phantom pain probably have mainly peripheral, as opposed to only central, origins. Although much of the direct data are preliminary, burning phantom pain is probably related to decreased blood flow in the residual limb, while cramping phantom pain is mainly related to spikelike muscle spasms in the major muscles of the residual limb. Little support is provided for psychological causes for phantom pain, but the expression of phantom pain does appear to be influenced by psychological mechanisms similarly to the ways other chronic pain conditions are influenced. The importance of a careful psychophysiological assessment of patients to treatment success is discussed. Because several different mechanisms are involved, no one treatment is likely to be effective for all of the different types of phantom pain. Appropriate combinations of self-regulation strategies aimed at controlling the underlying physiological problems are likely to be effective in reducing the incidence and severity of burning and cramping types of phantom pain.

Biofeedback, Psychology

Relaxation therapy for tension headache in the elderly: a prospective study.

We evaluated the effects of an 8-week progressive muscle-relaxation therapy regimen on the headache activity of 10 elderly tension-headache subjects. Posttreatment assessment at 3 months revealed significant decreases in overall headache activity (50% or greater) in 7 subjects. Significant clinical or statistical prepost differences, or both, were also found for the number of headache-free days, peak headache activity, and medication index. This is the first prospective study of tension headache in an elderly population, and, unlike previous retrospective studies, it suggests that relaxation therapy may be an effective intervention in the treatment of such headaches.

Aged

Highlighting specific patient education needs in an aging cardiac population.

Given the utility of a multifactoral approach to cardiac rehabilitation and the importance of tailoring such an approach to the needs of the specific cardiac population being treated, early assessment of targeted risk factors and health-related practices is becoming increasingly indicated. The present article describes how, by using a paper-and-pencil multiple-risk-factor assessment instrument referred to as the Heart Health Assessment Questionnaire, the specific educational needs of an aging veteran population were more clearly identified. Among the health areas found in need of particular attention were patient smoking behavior, medication education, and reported tension and worry over health problems. In addition, given the large unemployment rate within this population, the need for the adoption of activities such as physical exercise and hobbies that could have a positive impact on self-esteem and quality of life was strongly indicated. These and other findings are discussed in relation to the pivotal role of the health education professional for older cardiac populations.

Alcohol Drinking

Psychophysiological comparisons of three kinds of headache subjects during and between headache states: analysis of post-stress adaptation periods.

Twenty-eight chronic headache sufferers of three headache types (migraine, tension and combined migraine-tension) selected on the basis of explicit inclusion and exclusion criteria and matched on five demographic characteristics were assessed in a headache and non-headache state on a number of psychophysiological measures (frontalis, forearm and neck EMG; cephalic vasomotor response; hand surface temperature; heart rate and skin resistance level) and a number of stimulus conditions (baseline, self-control, cognitive and physical stressors). Results indicated no significant differences between the three headache groups or headache states on any measure during baseline condition. Analyses of post-stress adaptation periods led to the area of most significant differences, with a number of findings lending support for Sternbach's inadequate homeostatic responding hypothesis of migraine, but not tension, headache. No support was found for the sustained levels of muscle tension hypothesis of the etiology of tension headache. Implications for the etiology and treatment of headache are discussed.

Adaptation, Psychological

Psychometric properties of the SUNYA revision of the Psychosomatic Symptom Checklist.

The Psychosomatic Symptom Checklist (PSC), a questionnaire assessing psychosomatic symptoms, was administered to two separate samples of college students. For Sample 1 (N = 698), the questionnaire was readministered to three separate subsets at intervals of either 1 week (N = 143), 4 weeks (N = 74), or 8 weeks (N = 48). Each subset of subjects recompleted the PSC on only one of the three retest intervals. Based on the initial administration an analysis of the normative data revealed a mean total score of 23.7, suggesting a relatively low degree of psychosomatic symptoms in this group. Although total scores decreased slightly over time, test-retest correlations remained high (r greater than 0.80, P less than 0.0001). Individual item correlations was greater than r = 0.50 throughout. Sample 2 (N = 249) completed the PSC, Beck Depression Assertiveness Scale (RAS), and intercorrelations were computed between these measures. This analysis revealed little overlap between the psychosomatic complaints assessed by the PSC and other commonly used measures of psychological distress. Finally, a factor analysis revealed one major factor on which all but 2 of the 17 questionnaire items loaded significantly. These results suggest that the PSC is sensitive to psychosomatic distress and remains reliable over time.

Adolescent

Behavioral treatment of chronic cluster headache in a geriatric patient.

While nonpharmacological treatment of migraine and tension headache has increasingly been demonstrated to be efficacious, relatively little attention has been focused upon treatment of the more severe cluster headache. This has particularly been the case for the type of cluster headache known as chronic cluster. The present case study focused upon the treatment of a 69-year-old male with a 37-year history of headache activity. The description of headache matched those criteria currently considered to be indicative of chronic cluster headache. Following 6 weeks of baseline, during which daily ratings of head pain and daily ingestion of "as needed" (PRN) pain medication were collected, a 7-week treatment phase was implemented. Treatment consisted of thermal biofeedback coupled with a spouse contingency program (i.e., directing the spouse to avoid consequating subject reports of head pain). During the treatment phase, a near-100% reduction in amount of weekly PRN pain medication ingested was noted, along with a decrease in self-reports of head pain. Both of these decreases were maintained at 1-month, 4-month, and 15-month follow-ups. Implications for treatment of chronic cluster headache were discussed.

Aged

The role of affect in the etiology of chronic headache.

Three hypotheses regarding the possible etiological relationship between affect and headache activity were examined through the use of cross-lagged correlational analyses: (1) the relationship between headache activity and affect (anger, anxiety and depression) is isomorphic, that is, increased headache activity is associated with same day increases in emotionality; (2) increased affect precedes (and thus possibly causes) increased headache activity; and, (3) increased headache activity precedes (and thus possibly causes) increased affect. Only hypothesis one was supported in the present study, and the relationship was found to be weak and only to approach significance (r = 0.163, p less than 0.09). These findings cast serious doubt upon many psychological theories regarding the etiology of headache and on the relationship between affect and headache in general.

Adult