生物反馈放松疗法对冠心病疗效的临床研究

目的 探讨生物反馈放松训练对冠心病患者疗效、焦虑及抑郁情绪的影响.方法 将100例住院冠心病患者随机分为干预组和对照组各50例,对照组进行常规心内科治疗,干预组在常规治疗基础上实施为期8周的生物反馈放松训练.采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)对两组受试者分别于入组及随访结束时进行评估.结果 ①随访结束时干预组的焦虑量表评分显著低于治疗前(t=13.272,P＜0.001)及对照组(t=10.912,P＜0.05);②干预组的抑郁量表评分显著低于治疗前(t=11.343,P＜0.001)及对照组(t=6.920,P＜0.05);③干预组的匹兹堡睡眠质量指数显著低于治疗前(t=7.900,P＜0.05)及对照组(t=6.080,P＜0.05);④干预组临床疗效显著高于对照组(x2=13.272,P＜0.05).结论 生物反馈放松训练有助于减轻冠心病患者焦虑、抑郁情绪,改善睡眠,提高临床疗效.     

大学生的睡眠质量与抑郁、焦虑的关系

目的:探讨大学生的睡眠质量与抑郁、焦虑症状严重程度的关系。方法:选取580名大学生,采用匹兹堡睡眠量表(PSQI)、抑郁自评量表(SDS)、焦虑自评量表测试(SAS)分别测查其睡眠质量以及抑郁、焦虑症状严重程度。SDS标准分≥53分为抑郁组,53分为无抑郁组;SAS标准分≥50分为焦虑组,50分为无焦虑组。结果:PSQI总分与SDS得分、SAS得分正相关(r=0.58、0.47,均P0.01)。得到抑郁组39例、无抑郁组488例,焦虑组147例、无焦虑组380例;其中抑郁症状的大学生PSQI总分高于无抑郁症状者[(9.2±2.2)vs.(5.5±2.2),P0.01],有焦虑症状的大学生PSQI总分高于无焦虑症状者[(7.2±2.6)vs.(5.3±2.1),P0.01];且PSQI总分对SDS得分和SAS得分的主效应均有统计学意义(F=22.64、14.00,均P0.01)。PSQI总分与SDS得分正向关联(β=0.58,P0.01),对SDS得分解释率为33.4%;PSQI总分与SAS得分正向关联(β=0.47,P0.01),对SAS得分的解释率为22.1%。结论:大学生睡眠质量是衡量抑郁、焦虑严重程度的重要指标。     

放松训练对脑电、情绪的影响及与人格特征的关系

目的:探讨放松训练对脑电、情绪的影响以及与受试者人格、行为类型的关系.方法:68名医科大学生集体进行放松训练2个月,比较训练前后的焦虑自评量表(SAS)和匹兹堡睡眠质量指数(PSQI)得分,评估训练前后脑电、肌电、皮肤温度的变化,以及脑电指标改善程度与受试者个性特征的关系.结果:放松训练后受试者SAS、PSQI得分降低,与训练前相比差异有极显著性意义(t=3.7及5.2,P均<0.01).脑电、肌电、皮肤温度改善,脑电指标改善程度与艾森克个性问卷(EPQ)的N纬度得分、A型行为类型问卷的TH分、总分呈正相关(r=0.25～0.46).结论:放松训练可以改善大学生的生理、心理状况,脑电指标改善程度与受试者的人格特征和行为类型相关.     

原发性开角型青光眼患者睡眠质量指数、抑郁和焦虑评分及其相关

目的:研究原发性开角型青光眼(POAG)患者的心理因素和睡眠质量。方法:选取我院2014年6月-2015年12月眼科收治的122例POAG患者为观察组,另选取122例健康志愿者为对照组。对比两组的抑郁自评量表(SDS)得分、焦虑自评量表(SAS)得分和匹兹堡睡眠质量指数(PQSI)得分。结果:观察组的PSQI得分为(7.44±0.37)分,显著高于对照组的(4.17±0.29)分(t=76.830,P0.001);观察组的SAS得分为(45.67±9.88)分,显著高于对照组的(35.51±9.20)分(t=8.313,P0.001);观察组的SDS得分为(49.07±12.28)分,明显高于对照组的(40.33±13.09)分(t=5.379,P0.001);观察组的睡眠质量、入睡时间、睡眠时间、睡眠效率、失眠及日间功能障碍得分均明显高于对照组,差异有统计学意义(P0.05);两组的催眠药物使用次数的差异无统计学意义(P0.05);焦虑评分和抑郁评分呈正相关(r=0.522,P=0.000),失眠和焦虑呈正相关(r=0.244,P=0.008),抑郁和失眠无相关性。结论:POAG患者的心理护理对治疗POAG有积极的意义。     

住院进食障碍患者家属心理干预的对照研究

目的:探讨住院进食障碍患者家属心理健康状况及心理干预的效果.方法:将入组的37例患者家属随机分为干预组和对照组(干预组18例,对照组19例).对干预组进行为期6周,每周1次,每次1.5小时的心理干预;对照组仅在患者入院时对家属常规进行入院须知的宣教.使用焦虑自评量表(SAS)、抑郁自评量表(SOS)、症状自评量表(SCL-90)和总体幸福感量表(GWB)在入院时和6周后对两组家属进行评定.结果:进食障碍患者入院时,其家属存在轻至重度抑郁症状群者占56.8%,存在焦虑症状群者占24.3%;干预组家属入院6周后的焦虑、抑郁自评量表得分,症状自评量表总分及各因子分均低于入院时,(如SDS:31.5±6.8/40.8±8.9,P=0.007;SAS:36.3±8.0/45.0±8.2,P=0.006;SCL-90总分:23.4±22.6/53.6±18.1,P=0.002),总体幸福感量表评分高于人院时,差异边缘显著(88.5±15.4/78.7±13.6,P=0.065);对照组家属6周后症状自评量表总分及躯体化、强迫、抑郁、敌对、精神病性因子分均低于人院时(如SCL-90总分:42.4±53.1/59.6±51.6,P=0.001);两组加或减分率比较发现干预组抑郁自评总分、焦虑问卷总分、SCL-90总分和人际敏感因子分大于对照组(0.44±0.28/0.12±0.38,P=0.004;0.16±0.30/0.05±0.19,P=0.025;0.55±0.52/0.35±0.38,P=0.048;0.40±1.03/0.16±0.48,P=0.021).结论:进食障碍患者住院后家属的心理状态随着住院治疗的进程会得到改善,针对家属进行的系统心理干预可更为有效地改善家属的心理状态.     

集体治疗缓解酒依赖患者焦虑抑郁症状的初步评价

目的:初步探讨集体治疗对缓解酒依赖患者焦虑抑郁症状的临床疗效。方法:选取普洱市第二人民医院2014年1月1日-12月31日入院诊断为酒依赖患者,使用焦虑自评量表(SAS)、抑郁自评量表(SDS)及简明精神病量表(BPRS)筛查为伴随焦虑抑郁状态者117例,采用入院先后顺序分为药物联合集体治疗组(干预组,n=89)和单纯药物治疗组(对照组,n=88),两组均给予复方地西泮替代治疗,干预组在此基础上联合集体治疗,观察8周。使用临床疗效总评量表(CGI)评定总体疗效。结果:干预组治疗后SAS、SDS、BPRS、CGI得分均低于治疗前[(21.1±8.3)vs.(65.3±10.2),(35.1±7.5)vs.(73.4±9.2),(20.7±3.5)vs.(51.7±5.6);(4.3±1.0)vs.(5.4±0.6),P0.01或P0.05]。对照组治疗前后各量表得分差异均无统计学意义(均P0.05)。结论:药物治疗基础上的集体治疗在缓解酒依赖患者焦虑抑郁方面优于单纯药物治疗。     

失眠症与抑郁症患者的心理韧性与睡眠不良信念的比较及对睡眠质量的影响

目的:探讨失眠症、抑郁症失眠患者在心理韧性和睡眠信念的差异性及其对睡眠质量的影响。方法:选取符合国际疾病分类第十版(ICD-10)中相应诊断标准的27例非器质性失眠症患者(失眠症组)、40例伴有失眠症状的抑郁症患者(抑郁症失眠组)施测心理韧性量表(RIS)、睡眠个人信念和态度量表(DBAS)及匹兹堡睡眠质量指数量表(PSQI),并以汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评定抑郁、焦虑症状。结果:失眠症组PSQI中的催眠药物分因子得分(t=2.221,P0.05)、心理韧性总分(t=2.048,P0.05)及主体性因子(t=2.169,P0.05)高于抑郁症失眠组,差异具有统计学意义;失眠症组在睡眠个人信念和态度分量表"对药物的认知"得分低于抑郁症失眠组(t=-2.393,P0.05),差异具有统计学意义;PSQI总分与HAMD、HAMA、DBAS总分及"对失眠引起的后果"和"对睡眠的担忧"分量表存在相关关系(P0.05);睡眠不良信念的回归系数β=-0.128(P=0.003);抑郁情绪在心理韧性和睡眠质量间的调节效应显著(P=0.009),引入交互项后新增解释量△R~2=0.095。结论:非器质性失眠患者与伴有失眠症状的抑郁症患者相比,有更好的心理韧性和更多的对药物的不良认知。睡眠不良信念越多,睡眠质量越差,且抑郁情绪对心理韧性和睡眠质量的关系有调节效应。     

某高校研究生睡民质量与焦虑状况的相关研究

目的 调查当前研究生的睡眠、焦虑抑郁状况并分析它们之间的相关性.方法 随机抽取177名某医科大学研究生,采用匹兹堡睡眠质量量表(PSQI)、焦虑自评量表(SAS)及抑郁自评量表(SDS)进行调查.结果 调查的研究生中,19人(10.7%)睡眠质量状况差;53人(30.5%)呈焦虑状态;51人(29.1%)呈抑郁状态.PSQI指数与焦虑呈正相关(r=0.313,P=0.000).Logistic回归分析结果显示,睡眠障碍E(x2=4.543,OR=4.366,P=0.033)和日间功能G(χ2=9.388,OR=2.363,P=0.002)是导致焦虑的危险因素.结论 研究生的焦虑抑郁与睡眠质量相关,学生工作者可以通过对睡眠质量的干预,改善研究生的焦虑状况.     

团体心理辅导对大学新生情绪、自尊和学业自我效能感的影响

目的探讨团体心理辅导对大学新生情绪、自尊和学业自我效能感的影响。方法采用症状自评量表(SCL-90)筛选出9名具有抑郁症状的大学新生进行团体心理辅导,对团体辅导前后大学新生的抑郁、焦虑、自尊和学业自我效能感的得分进行对比分析。采用抑郁自评量表(SDS),焦虑自评量表(SAS),自尊量表(SES),大学生学业自我效能感问卷进行评估。结果抑郁得分显著降低(t=2.824,P0.05);自尊得分显著升高(t=-2.341,P0.05);学业自我效能感有显著提高(t=-2.926,P0.05)。结论团体心理辅导对大学新生情绪、自尊和学业自我效能感有明显改善作用。     

老年慢性充血性心力衰竭患者焦虑、抑郁情绪的心理干预

目的: 研究老年慢性充血性心衰(Chronic Heart Failure,GHF)患者焦虑、抑郁发生情况及放松疗法对其焦虑、抑郁情绪的干预效果.方法: 选择2004年9月-2007年9月在我院老年病科住院的老年CHF患者190例,按照其入院日的单双日随机分为实验组(基础心理护理 放松疗法,101例)和对照组(仅基础心理护理,89例);心理干预前及干预结柬1月后均用焦虑自评量表(SAS)、抑郁自评量表(SDS)测定;观察抑郁、焦虑情绪发生率、住院日及干预后两组SAS、SDS分数变化情况;随访出院后6月内再次因CHF住院率.放松疗法包括放松训练和音乐疗法,每日1小时,为期4周.结果: ①实验组及对照组问基线资料如年龄、性别、受教育程度、经济状况、照顾者身份、心功能分级、是否公费医疗、能否自理、CHF病程及心理干预前SAS、SDS分数的差异均无统计学意义;②我院老年CHF患者抑郁、焦虑情绪发生率分别是45.8%和52.6%,高于普通人群(抑郁、焦虑情绪发生率分别是5%～10%和5%);③心理干预后,实验组SAS得分由(42.3±6.8)降低至(32.8±6.1),SDS得分由(41.8±6.1)降低至(32.2±5.4);对照组SAS得分由(41.8±6.5)降低至(37.0±6.3),SDS得分由(41.0±5.9)降低至(36.4±5.9),实验组SAS、SDS得分降低程度均高于对照组(P＜0.05);④实验组平均住院日低于对照组[(29.8±1.4)vs.(32.6±2.6)],而随访结果显示:实验组出院后6月内再次因心衰住院率低于对照组(7.9%/20.2%,x2=6.064,P=0.014).结论: ①我院老年CHF患者抑郁、焦虑情绪发生率较高;②放松疗法对老年CHF患者焦虑、抑郁情绪的干预效果肯定并可改善预后.     

Heart rate and finger pulse amplitude during muscular relaxation with frontalis versus forearm EMG feedback.

Twenty-nine volunteers participated in a one-session experiment consisting of 10 min rest followed by a 30 min treatment period. Brief relaxation instructions were given at the beginning of the rest period. The treatment was either frontalis EMG feedback, forearm EMG feedback, or non-contingent stimulation. The two feedback groups showed EMG decreases in their respective target muscles during the no-feedback rest period, with no further decrease during feedback training, indicating that feedback was no more effective than relaxation instructions. Heart rate decreased significantly in both feedback groups. Finger pulse amplitude decreased significantly in the forearm feedback group. It is pointed out that the latter change does not necessarily indicate peripheral vasoconstriction, but may be due to a fall in pulse pressure as a consequence of increased blood flow to the relaxing muscles. The results are unsupportive of the assumption that frontalis relaxation is particularly effective in inducing a generalized relaxation.     

The effects of EMG biofeedback and relaxation training on primary dysmenorrhea

Fifteen dysmenorrhea sufferers received relaxation training with EMG biofeedback, relaxation training with no feedback, or no treatment. Participants who received biofeedback training did not differ from participants who received relaxation training in their ability to maintain a reduced level of EMG activity prior to the onset of menstruation. On the first day of menstruation, those receiving biofeedback training were able to maintain reduced EMG activity, whereas those receiving relaxation training showed an elevated level of EMG activity. Subjective reports indicated that the symptoms of dysmenorrhea improved for the biofeedback group during training but did not improve for the relaxation or control groups. Suggestions for further research are noted.The authors wish to thank Jerry Curtis for his invaluable assistance in setting up and maintaining the laboratory facilities and computer programs used to conduct this study.     

Effect of EMG Biofeedback and Progressive Muscle Relaxation Training on Awareness of Frontalis Muscle Tension

Awareness of muscle tension, as estimated by a modification of the Kinsman et al. (1975) procedure for determining probability of correct estimation (P(c)) of absolute differences in muscle tension between adjacent trials, was examined before and after volunteer subjects underwent 4 sessions of either: 1) EMG biofeedback (BF) training, 2) progressive muscle relaxation (PMR) training, or 3) a placebo-control (MC) procedure which involved listening to music as an alleged guide for relaxation. The subjects were 30 females (mean age = 28.3 yrs) responding to an offering of experimental treatment for anxiety and tension. Measurements of frontalis muscle tension (EMG) and P(c) were made before and after training. The results showed that EMG was significantly reduced by BF and PMR training but not by the MC procedure. Increases in P(c) after training were significantly greater for BF than for PMR or MC training. There were no group differences for subjective report of tension. Correlations between pre- to post-training EMG and P(c) change scores were significant only for the BF group and the combined group of BF and PMR subjects. These results suggest that: 1) both BF and PMR training were effective in producing frontalis EMG reductions, 2) the following relationship may exist among training groups in terms of relative influence upon awareness of tension—BF training > PMR training > MC training, and 3) awareness of tension appears to be related to the ability to reduce EMG although the exact nature of this relationship remains unclear.     

An Experimental Test of Assumptions Relating to the Use of Electromyographic Biofeedbatk as a General Relaxation Training Technique

Twenty-eight normal adults participated in an experimental test of two assumptions underlying the use of electromyographic (EMG) biofeedback as a general relaxation training technique: (1) that trained EMG reduction in one muscle generalizes to untrained muscles; and (2) that subjective feelings of relaxation are related to EMG reduction. An experimental group received 5 sessions, during the middle 3 of which EMG biofeedback training was offered on the frontalis muscle. Throughout all sessions, EMG recordings were also taken from the forearm and lower leg, and ratings of subjective relaxation feelings were obtained at regular intervals. A control group, matched with the experimental group on baseline frontalis EMG, received 5 similar sessions without feedback. Employing a maximum p of .05, the results revealed no evidence of generalization of EMG reduction from the frontalis to the untrained sites, nor any tendency for successful frontalis EMG reduction to result in increased feelings of relaxation beyond what was obtainable from relaxing without the benefit of training. The results were interpreted as suggesting that EMG biofeedback cannot yet be accepted as a viable general relaxation training technique.     

A Comparison of Auditory and Visual Feedback in Biofeedback Assisted Muscular Relaxation Training

This study compared the efficacy of auditory and visual feedback in electromyographic (EMG) biofeedback assisted relaxation training of the frontalis muscle.Twenty-eight subjects, divided into 4 groups matched on baseline frontalis EMG levels and trait anxiety, received 7 training sessions each under one of the following conditions: (1) auditory feedback-eyes closed; (2) auditory feedback-eyes open; (3) visual feedback; or (4) no feedback-eyes closed. The group who received auditory feedback with the eyes closed manifested significant lowering of EMG over session compared to no significant reduction in EMG for the other three groups. EMG changes failed to correlate significantly with changes in self reports of subjective relaxation derived from pre-to-post session state anxiety test data. The possibility that the ineffectiveness of visual feedback in this study may be specific to the frontalis muscle was discussed and the need for further research in several areas was stressed.     

Training and Transfer of Training Effects in EMG Biofeedback Assisted Muscular Relaxation

Twenty-two normal adults participated in an electromyographic (EMG) biofeedback experiment designed to test if the feedback stimulus is necessary in obtaining EMG reductions during typical laboratory procedures, and if prior training on one muscle facilitates the training of a second muscle. One group of subjects received forearm feedback training followed by frontalis training. A second group received training in the reverse order. Two control groups relaxed first on their own followed by either forearm or frontalis training. Attention was directed toward motivating control subjects to perform maximally during relaxation without feedback. Heart and respiration rates and skin conductance and temperature were also recorded. Both trained and untrained subjects produced significant EMG reductions but did not differ from each other; nor did a transfer of training effect emerge. No differences resulted between feedback and non-feedback conditions for the other physiological measures or for changes in state anxiety. These data compromise somewhat the previous demonstrations of EMG biofeedback “learning,” and are unsupportive of EMG biofeedback as a general relaxation training technique.     

Continuous Biofeedback and Discrete Posttrial Verbal Feedback in Frontalis Muscle Relaxation Training

During training to relax the frontalis muscle, continuous biofeedback (BF) was compared to discrete verbal feedback (VF) delivered immediately after each trial. Both feedback modalities were based on frontalis electromyographic (EMG) activity. Training consisted of 3 consecutive daily session-each comprised of 3 baseline (nonfeedback) trials followed by 10 training trials of 128 see. The presence or absence of the two informationally positive feedback modalities were combined factorially to define four training conditions: BF + VF, NO BF + VF, BF + NO VF, and NO BF + NO VF. Results indicated that while VF alone facilitated muscle relaxation, BF was clearly prepotent ill effecting consistent decreases in EMG activity both across trials and days of training. Additionally, the facilitating effect of BF transferred to nonfeedback trials while VF did not affect performance on nonfeedback trials. Finally, accuracy of self-evaluations of performance on a trial by trial basis was markedly improved by BF, while VF improved accuracy only for trials having a very large absolute difference between levels of EMG activity. Ss receiving no feedback neither reduced muscle tension during training not were able to evaluate their performance accurately even when large absolute differences occurred between trials in frontalis EMG activity.     

Generalized Muscle Changes during EMG Relaxation Training

Tension levels from muscles in the forehead (frontalis) and back of the neck (semispinalis capitis) were simultaneously recorded during short term relaxation training with EMG feedback to assess the efficacy of this technique for producing generalized deep muscle relaxation. The degree of association between the activity of the two muscles was measured both with cross-correlation coefficients and a linear regression technique. The two muscles showed a tendency to covary which did not change during training and was unrelated to which muscle was the source of feedback. These results provide evidence for a moderate degree of association between these muscle groups during relaxation training and suggest that EMG feedback may be more useful in producing general relaxation than was previously thought.     

Sequence effects of relaxation training, EMG, and temperature biofeedback on anxiety, symptom report, and self-concept

Assessed the effects of particular treatment combinations of relaxation training, temperature, and EMG biofeedback on state-trait anxiety, symptom report, and self-concept. The four groups received one of the following sequences: (a) relaxation training, temperature, and EMG biofeedback; (b) temperature, EMG biofeedback, and relaxation; (c) temperature followed by EMG biofeedback; (d) EMG biofeedback followed by temperature. A sample of 37 volunteers participated in 16 20-minute training sessions over an 11-week period, which totaled 800 appointments. Training was found equally effective for decreasing frontalis EMG and increasing finger skin temperature, regardless of sequence. Most substantial improvement occurred after 8 sessions, whereas little improvement was found after 16 sessions. Each group became increasingly homogeneous over time on all measures.