Predicting differential response to EMG biofeedback and relaxation training: The role of cognitive structure
✍ Scribed by James D. Hart
- Publisher
- John Wiley and Sons
- Year
- 1984
- Tongue
- English
- Weight
- 411 KB
- Volume
- 40
- Category
- Article
- ISSN
- 0021-9762
No coin nor oath required. For personal study only.
✦ Synopsis
Analyzed treatment outcome data for 102 headache patients who had been assigned randomly to receive either EMG biofeedback ( N = 70) or relaxation training ( N = 32). It was hypothesized that a measure of cognitive structure would differentially predict success at the two training tasks and that patients high in cognitive structure would derive more benefit from the more structured relaxation task and less benefit from the biofeedback task. This hypothesis was confirmed (p <.01). The analysis also demonstrated that relaxation training was significantly more effective than biofeedback (p <.05) and that mixed headache patients improved significantly less (p <.05) than either migraine or muscle-contraction headache patients.
In treating headache, the overall improvement rates appear similar for electromyographic (EMG) biofeedback and relaxation training (Blanchard, Andrasik, Ahles, Teders, & O'Keefe, 1980). This does not imply, however, that a given patient will respond equally well regardless of which of these treatments is offered. There may be individual differences that would favor one treatment over another for some subset of patients. Qualls and Sheehan (1981), for example, have argued that more attention should be given to person-treatment interactions, before prematurely concluding that treatments are equivalent on the basis of "central tendency" data. The present study investigates one such interaction: The interaction between the degree of structure in the training task and the individual patient's preference for structure.
Many EMG biofeedback paradigms present the S with a relatively unstructured task. That is, although the goals may be clear and the relationship between the feedback signal and muscular activity made explicit, there are often no clear guidelines or procedures that the patient is asked to follow in order to accomplish the goal of producing lowered EMG levels. In our headache treatment research program, we have noted that some patients seem to find this lack of structure more bothersome than others. Early in the treatment sequence, for example, some patients express concern because they don't know what they are supposed to do to bring about change, or neglect home practice while reporting that they don't see how they are supposed to practice this skill without the machine to help them and without clear guidelines that indicate what they are supposed to do. In contrast, other relaxation procedures (e.g., progressive relaxation) often provide much more explicit guidelines that leave little doubt about what is expected or how it should be practiced.
It was hypothesized that differences in the preference for structure would differentially predict success in response to these alternative treatments. A measure of the "need" or preference for "cognitive structure" (CS) is included in the Personality Research Form (Jackson, 1967). It was hypothesized that patients who scored high on this dimension, in contrast to patients with low CS scores, would derive more benefit (i.e., improvement in headache activity) from the more structured relaxation task and would derive less benefit from the relatively unstructured biofeedback task.