M.A. / In all communities studied, most people suffer from headaches sometime in their life (Blau, 1991; Selby, 1983). A small portion of this group suffer from both migraine and tension-type headache on a regular basis. Currently the main treatment modality for headache is pharmacological in nature. This type of treatment is limited in as far as it does not address the concomitant psychological variables that often accompany chronic headaches. Furthermore, it seems that most psychophysiological therapies were developed in the USA and Canada over the last 30 years, but thus far research has not been done within the South African context. The aim of this study was to determine the effectiveness of an individualized psychophysiological treatment program for individuals suffering from migraine and tension-type headache. A change in headache activity and mood states such as anxiety and depression was envisaged. Seven subjects suffering from both migraine and tension-type headache were selected to participate in the study. The A-B-A single-subject design was employed allowing three weeks before and after the intervention for baseline recordings. The intervention consisted of seven sessions of cognitive coping training and electromyographic biofeedback. All subjects kept daily records of their headache activity over the eleven week period. They completed the Psychological Assessment of Headache Questionnaire, levels of depression and anxiety were assessed by the Beck Depression Inventory and the State-Trait Anxiety Inventory which were administered three weeks prior to and after the intervention. Results indicated that subjects who exhibited a decrease in headache frequency and intensity and an increase in the number of headache-free days per week, were those who were not habituated to analgesic medication. Subjects who reported no differences at all with regard to headache activity were those who suffered from chronic daily headache. Those subjects were older and consumed analgesic and other medications daily. These findings support those found in literature (Blanchard & Andrasik, 1988). All but one subject reported lower scores at post-assessment on indicators of depression and state-anxiety. Even though there were no significant improvements regarding headache activity, for certain subjects. The overall aim of the study, namely to evaluate the effectiveness of individualized treatment strategies, were addressed and contribute to future intervention studies.

published_or_final_version / abstract / toc / Educational Psychology / Master / Master of Social Sciences

No description available.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

Vita. / Digitized by Kansas State University Libraries

This dissertation investigated the effect of a Doctor Interactive Group Medical Appointment (DIGMA), a unique multidisciplinary medical treatment modality, upon the health behavior of hypertensive patients at the Veterans Health Administration Outpatient Clinic (VA-OPC) in Austin, Texas. Health behavior modification, differences in stress perceptions, blood pressure changes due to the intervention and differences in coping strategies were assessed. Integrated healthcare utilizes a multidisciplinary approach in considering physiological and psychological aspects of health, promoting patients to act on their own behalf in managing health. Increased healthcare costs, decreased patient satisfaction of care received and practitioner satisfaction in care provided currently afflict primary healthcare. Earlier, a “drop-in” shared medical appointment aimed to improve continuity of care, and increase patient and physician satisfaction by allowing patients better access to physicians without taxing more resources. Contrasting the “drop-in” model, this study examined the efficacy of a multi-session DIGMA. Functioning as an adjunct to hypertensive management, participants attended 5 sessions, including one introduction meeting, three consecutive weekly group sessions and an individual telephone session occurring one week following the intervention. The study utilized a pretest/posttest design, with participants acting as their own controls. Self-report measures and blood pressure readings were administered prior to the onset, and again at termination of the DIGMA program. Analyses of variance and hierarchical regression models helped reveal any significant changes in health behaviors, perceptions of stress, and coping styles related to hypertension among 58 participants occurring over time for 7 distinct cohorts participating in the DIGMA. Findings revealed significant differences in both systolic and diastolic blood pressure readings between pre and post intervention. Significant changes in health promoting behaviors among participants who successfully completed all components of the program were also detected. In addition, adaptive coping strategies were found to significantly impact components of health behaviors. Qualitative information supports the quantitative data in determining whether the agent of change is the group process itself, the information imparted in the group, or some other variable. Findings reveal the dynamic of the group, as well as the modality in which information was conveyed positively influenced health behavior changes. Results, implications, and limitations of the study as well as future directions are discussed. / text

The present study was designed to investigate the hypothesis that individuals with the Hyperventilation Syndrome (HVS) are predominantly thoracic breathers. An analogue population was used to examine the breathing patterns of likely (N = 16) as opposed to unlikely (N = 16) hyperventilators. The relative thoracic as opposed to abdominal contribution to total respiratory volume was assessed during periods of quiet breathing and mild stress. Differences in thoracic contribution to total respiratory volume were not found between the likely and unlikely hyperventilators, nor between the quiet and mild stress conditions. A significant effect for sex existed, with females demonstrating a greater thoracic contribution to total respiratory volume than males. A significant group by sex interaction occurred, with likely male hyperventilators displaying a significantly lower thoracic contribution to total respiratory volume than both likely and unlikely females. Results are discussed in terms of application to the HVS, and future avenues of research are suggested.

Note:

A growing literature suggests that training in relaxation or meditation results in significant reductions in blood pressure in hypertensive patients. The present study was designed to assess the efficacy of a combination relaxation and meditation training program structured by the author and previously used in treatment of a broad spectrum of anxiety-related clinical problems of either a medical (somatic) or a psychological (cognitive and emotional) nature. The 20 subjects were a heterogeneous clinical group of veterans with mild hypertension who were seen at the Tucson Veterans Administration Medical Center. Volunteers were randomly assigned to either (I) an education/cognition group, (II) a three-treatment relaxation/meditation group, or (III) a six-treatment relaxation/meditation group. Blood pressure, anxiety, and stress were measured at regular intervals during training and follow up. All groups were trained over a six-week period. Both relaxation/meditation groups were taught the same skills; only the schedules for training were varied. The educational group, conceived as a control for therapist attention, was, in fact, a cognitive treatment group. Statistically significant reductions in both systolic and diastolic blood pressure were found over time in all groups, while no difference in blood pressure reductions was found among the groups. Anxiety scores increased over time, and no correlation was found between subjective anxiety and objective blood pressure measures. Means of both systolic and diastolic blood pressure were lower at times when subjects reported no stress. Results of this study tend to support those of previous studies, finding statistically significant reductions in systolic and diastolic blood pressure over time in two groups of hypertensive subjects trained in relaxation and meditation techniques. No difference was found, moreover, between these groups and an education/cognition group, suggesting that group techniques, in either significant lowering of blood pressure. This finding lends support to a multiprocess theory which suggests that all treatments have multiple effects.

No description available.