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Autogenic training: A meta-analysis of clinical outcome studies

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Abstract

Autogenic training (AT) is a self-relaxation procedure by which a psychophysiological determined relaxation response is elicited. A meta-analysis was performed to evaluate the clinical effectiveness of AT. Seventy-three controlled outcome studies were found (published 1952-99). Sixty studies (35 randomized controlled trials [RCT]) qualified for inclusion in the meta-analysis. Medium-to-large effect sizes (ES) occurred for pre-post comparisons of disease-specific AT-effects, with the RCTs showing larger ES. When AT was compared to real control conditions, medium ES were found. Comparisons of AT versus other psychological treatment mostly resulted in no effects or small negative ES. This pattern of results was stable at follow-up. Unspecific AT-effects (i.e., effects on mood, cognitive performance, quality of life, and physiological variables) tended to be even larger than main effects. Separate meta-analyses for different disorders revealed a significant reduction of the heterogeneity of ES. Positive effects (medium range) of AT and of AT versus control in the meta-analysis of at least 3 studies were found for tension headache/migraine, mild-to-moderate essential hypertension, coronary heart disease, asthma bronchiale, somatoform pain disorder (unspecified type), Raynaud's disease, anxiety disorders, mild-to-moderate depression/dysthymia, and functional sleep disorders.

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... As an alternative to pharmacological interventions, usage of relaxation techniques turns out to be an effective method of improving the sleep quality in the case of functional sleep disturbances [17]. Literature review indicated that relaxation techniques helped to improve the quality of sleep (less awakenings at night, longer sleep time) and decrease the sense of fatigue after waking up in oncological patients, where sleep problems arise as a consequence of the disease e.g., [18], in older adults [19] and were shown to be an effective, non-pharmacological treatment for insomnia [20]. ...
... When searching for an effective method to improve sleep quality in a group of student-athletes, we chose Schulz autogenic training. Review of studies in groups of students [21] and meta-analysis of clinical outcome studies [17] showed that AT is an effective method to help counteract sleep problems by improving the quality of sleep, sleep latency, the duration of sleep and the energy level after waking up. We assumed that the relaxation training enhances subjective sleep quality and sleep timing parameters also in university athletes. ...
... According to the meta-analysis carried out by Stetter and Kupper [17] in clinical groups, AT should be treated as an add-on support to medical treatment. The outcome presented in this article shows that treatment with AT can be sufficient for healthy people, such as academic athletes for enhancing their subjective quality of sleep. ...
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Despite the growing popularity of relaxation training, the effectiveness of an autogenic training (AT) as a method of dealing with sleep problems in group of student athletes is unknown. Therefore, this study aimed to fill this gap. University athletes with decreased sleep quality (selected from 209 participants) were randomly assigned to the experimental (EG, n = 11) and control (CG, n = 11) groups similar in terms of sleep quality, age, gender, type of sport discipline and sport experience. During the 14 days dedicated to performing relaxation training in the form of an audio recording, electronic daily logs and actigraphy were used to monitor the athletes’ sleep and daily activity. The EG listened to the recording with suggestions based on AT and CG only to the background music. Pre- and post-measurements of sleep quality by means of the Pittsburg Sleep Quality Index (PSQI) and physiological stress reactions by biofeedback device were performed. In EG and CG, the parameters of sleep and daily activity obtained by actigraphy and daily logs as well as physiological indicators of emotional reactivity did not differ. Sleep quality in PSQI significantly increased after AT usage in EG. AT seems to be an effective method for university athletes in improving subjective sleep quality, but further studies are necessary.
... Previous research shows that AMT is a well-established training technique for regulating stress and anxiety (Ernst & Kanji, 2000;Holland et al., 2017;Lim & Kim, 2014;Stetter & Kupper, 2002). However, there is little evidence supporting AMT as an effective method for improving attention, and emotion and behavior regulations in children. ...
... Goldbeck and Schmid (2003) and Klott (2013) concluded that autogenic meditation training could contribute to auto-regulation of internalizing and externalizing symptomatology in children with emotional and behavioral disorders. Although it is generally affirmed that AMT improves concentration performance (Kanji, 1997;Kemmler, 2009;Schultz, 1969;Stetter & Kupper, 2002), only a limited number of studies have examined this effect, especially in child and adolescent populations. Evidence shows improved concentration with a large effect size on different age cohorts (Krampen, 1997), and improved concentration measures, including orthographic error correction (Krampen, 2010); reading performance and dictation in children with dyslexia, which, in turn, decreased anxiety and neuroticism (Frey, 1980); and metacognitive capacity for self-regulated learning (Wagener, 2013). ...
... In the current study, the results showed a significant effect for the AMT group in d2 indexes, selective attention and sustained attention (concentration), supporting the notion that autogenic training favors concentration (Kanji, 1997;Kemmler, 2009;Schultz, 1969;Stetter & Kupper, 2002). Although this effect was previously found in different age cohorts (Krampen, 1997), it had not previously been explicitly studied in children. ...
Article
This study examined the meditative approach of autogenic training in the context of attention state training. The evidence suggests that attention can be improved through attention state training, which includes meditation as a technique to focus and maintain attention. Some studies also indicate that attention state training promotes emotional and behavioral regulation. However, this issue needs further scientific evidence. This study aimed to test the efficacy of autogenic meditation training as a strategy to enhance attention, reduce anxiety, and promote a better mental health profile in children. Seventy Spanish students (M age = 9.77 years; SD age = 1.08 years) were randomly assigned to three conditions: autogenic meditation training, natural reading training (active control), and waiting list (passive control) conducted over a twelve-week period. Pre-post measures were collected for selective and sustained attention employing the d2 test; state and trait anxiety using the State-Trait Anxiety Inventory for Children; and a mental health screening compose of emotional symptoms, behavioral problems, hyperactivity-inattention, peer relationship problems, total difficulties index, and pro-social behavior with the Strengths and Difficulties Questionnaire. The results showed that children randomly assigned to autogenic meditation training experienced improved selective and sustained attention, reduced state and trait anxiety, and better general mental health than children randomized to natural reading training or a waitlist. Findings suggest that autogenic meditation training provides an acceptable approach to improving attention, reducing anxiety, and promoting a better mental health profile in children.
... Within AT, participants are trained in auto-suggestive techniques to influence their physical condition [21][22][23]. In its classic form, AT uses six standard exercises that are trained in individual or group settings over a period of 6 to 8 weeks [24,25]. Participants sit or lie in a quiet, undisturbed setting and focus on different areas of the body, which are addressed using six suggestive formulas aiming at increasing relaxation and balance between sympathetic and parasympathetic control [26]. ...
... AT was associated with mediumsized pre-post effect sizes in migraine and tension headache, but this estimation was based on two or five studies, respectively. Stetter and Kupper [25] updated this review in 2002 examining 60 clinical studies published between 1952 and 1999, including 35 randomized controlled trials. Outcomes were grouped as either 'physiological' or 'behavioral and psychological'. ...
... Altogether, the efficacy of AT in individuals suffering from pain has been investigated in numerous randomized controlled trials. However, a previous meta-analysis is about 20 years old and has so far only summarized the existing evidence without specifically considering pain as outcome [25]. Hence, the aim of this meta-analysis is to investigate the efficacy of AT in individuals with chronic pain on the primary outcome pain in comparison to waiting list control groups, attention control groups, or control groups that received other psychological interventions. ...
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Background: Autogenic training (AT) is frequently used as therapeutic approach in multimodal pain therapy. The aim of this systematic review and meta-analysis is to investigate the efficacy of AT in individuals suffering from chronic pain in comparison to passive and active control groups. Methods: A comprehensive literature search in Medline, Web of Science, PsycInfo, and PubPsych and manual searches (last search April 7, 2021) were conducted to locate randomized controlled trials (RCTs). Treatment guidelines and references of relevant articles and previous reviews were checked. ProQuest Dissertations and Theses Full Text database, DART-Europe E-theses Portal, Networked Digital Library of Theses and Dissertations (NDLTD), and the Theses Database of the German National Library were screened to identify any unpublished material. Results: A total of 13 eligible studies (k = 15 comparisons) including 576 participants were identified. Random-effects meta-analyses revealed a significantly positive, moderate effect of AT on the primary outcome pain compared to passive control groups (g = 0.58, 95% CI [0.36; 0.79], k = 9, I2 = 0%). In comparison with other psychological interventions, no difference was found (g = - 0.05, 95% CI [- 0.30; 0.20], k = 6, I2 = 0%). Sensitivity analyses proved the robustness of findings. Overall risk-of-bias judgment was 'some concerns' in the majority of studies. Conclusions: Beneficial effects of AT on pain reduction were demonstrated, but findings are prone to bias. Furthermore, high methodological quality RCTs are needed to strengthen the promising evidence of AT for individuals with chronic pain.
... Investigaciones previas muestran que el EMA es una técnica de entrenamiento bien establecida para regular el estrés y la ansiedad (Ernst y Kanji, 2000;Holland et al., 2017;Lim y Kim, 2014;Stetter y Kupper, 2002). Goldbeck y Schmid (2003) y Klott (2013) concluyen que el entrenamiento en meditación autógena contribuye a la autorregulación de la sintomatología internalizante y externalizante en niños con trastornos emocionales y conductuales. ...
... Goldbeck y Schmid (2003) y Klott (2013) concluyen que el entrenamiento en meditación autógena contribuye a la autorregulación de la sintomatología internalizante y externalizante en niños con trastornos emocionales y conductuales. En relación con la atención, aunque en general se afirma que el EMA mejora la concentración (Kanji, 1997;Kemmler, 2009;Schultz, 1969;Stetter y Kupper, 2002), sólo un número limitado de estudios ha examinado este efecto, especialmente en la población infantil y adolescente. La evidencia muestra una mejora de la concentración con un tamaño del efecto grande en diferentes cohortes de edad (Krampen, 1997), así como en medidas que requieren concentración, entre ellas la corrección de errores ortográficos (Krampen, 2010), el rendimiento en la lectura y el dictado en niños con dislexia, donde, a su vez, disminuye la ansiedad y el neuroticismo (Frey, 1980) y en la capacidad metacognitiva para el aprendizaje autorregulado (Wagener, 2013). ...
... En el presente estudio, los resultados muestran un efecto significativo para el grupo de EMA en los índices d2, atención selectiva y atención sostenida (concentración), apoyando la noción de que el entrenamiento autógeno favorece la concentración (Kanji, 1997;Kemmler, 2009;Schultz, 1969;Stetter y Kupper, 2002). Aunque este efecto se ha encontrado previamente en diferentes cohortes de edad (Krampen, 1997), no se ha estudiado explícitamente en niños. ...
Article
Resumen Este estudio examina el entrenamiento autógeno meditativo en el contexto del entrenamiento en estado de atención. La evidencia sugiere que la atención puede mejorarse a través del entrenamiento en estado de atención, que incluye la meditación como técnica para enfocar y mantener la atención. Algunos estudios indican también que el entrenamiento en estado de atención promueve la regulación emocional y conductual. Sin embargo, esta cuestión necesita mayor evidencia científica. El objetivo de este estudio es comprobar la eficacia del entrenamiento en meditación autógena como estrategia para mejorar la atención, reducir la ansiedad y promover un mejor perfil de salud mental en los niños. Los participantes de este estudio son setenta estudiantes españoles (M = 9.77, DT = 1.08) asignados aleatoriamente a tres condiciones: entrenamiento en meditación autógena, entrenamiento en lectura natural y lista de espera durante doce semanas. Para evaluar el efecto de entrenamiento se obtienen mediciones previas y posteriores en atención selectiva y sostenida; ansiedad estado y rasgo; y un cribado de salud mental compuesto de síntomas emocionales, problemas de comportamiento, hiperactividad-intención, problemas de relación entre iguales, índice total de dificultades y comportamiento pro-social. Los resultados muestran que los niños asignados al entrenamiento de meditación autógena experimentan una mejora de la atención selectiva y sostenida, una reducción de la ansiedad de estado y de rasgo, y una mejor salud mental general que los niños asignados al entrenamiento de lectura natural o al grupo de control pasivo. Los hallazgos sugieren que el entrenamiento en meditación autógena proporciona un enfoque aceptable para mejorar la atención, reducir la ansiedad y promover un mejor perfil de salud mental en los niños.
... Autogenic training (AT) is a standardized relaxation technique developed by Schultz around 1930 that uses the mental repetition of six systematic exercises (heaviness, warmth, calm and regular heart function, selfregulation of respiration, warmth in the upper abdomen area, and agreeable cooling of the forehead) to decrease sympathetic tone and induce a general disconnection of the organism [21][22][23]. AT is simple to learn and easy to practice following brief training. The repeated practice of the exercises increases the person's capacity to induce ever-deeper relaxation and fosters the accumulation of therapeutic benefits [21]. ...
... The mechanism of action of this relaxation technique lies in the relaxation response, as opposed to the stress response, which involves a complex interplay of the endocrine, immune, neurological, and psychological systems [26]. A systematic review with meta-analysis from 35 randomized controlled trials (RCT) and 25 nonrandomized controlled trials (NRCT) published between 1932 and 1999 [23] found positive effects of AT on disease-specific symptoms and psychological distress in people living with several chronic health problems like tension headaches/migraine, hypertension, asthma, pain, anxiety, mild-to-moderate depression, and sleep disorders. Even though other RCTs have been conducted since 2000 [27,28] to assess the effects of AT, no systematic review has been done on the effectiveness of AT on psychological well-being in people living with a chronic physical health problem. ...
... Even though other RCTs have been conducted since 2000 [27,28] to assess the effects of AT, no systematic review has been done on the effectiveness of AT on psychological well-being in people living with a chronic physical health problem. Furthermore, the review of Stetter and Kupper [23] did not consider AT to be the only therapeutic component of the intervention. Given that there are more RCTs than NRCTs that assess the effectiveness of AT and that including NCRTs would increase the risk of bias [29], we have decided to include only RCTs for this systematic review. ...
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Background: Autogenic training is a relaxation technique that uses systematic exercises to induce a general disconnection of the organism. It is used in conjunction with conventional medical care as part of disease management to relieve symptoms associated with chronic health problems and to improve well-being. The purpose of this systematic review is to evaluate the efficacy of autogenic training on psychological well-being, quality of life, and adverse effects in people living with chronic physical health problems. Methods: The methodology used follows the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Studies, published up to December 31, 2019, will be identified through searches in the following databases: MEDLINE, Web of Science, EMBASE, SCOPUS, PsychINFO, CINAHL, EBM Reviews, Google Scholar, Dissertations & Theses Global, Open Access Theses and Dissertations, OpenGrey, E-Theses Online Service, Grey Literature Report, eScholarship@McGill, Papyrus, and CorpusUL. All studies of randomized controlled trials that assess autogenic training as an intervention to improve psychological well-being and quality of life in adults aged 18 and older living with one or more chronic physical health problem will be considered eligible. The study selection, the data collection, and the evaluation of the risk of bias will be conducted independently and in duplicate by two reviewers. RoB 2 tool will be used to assess the risk of bias. Discrepancies will be resolved through discussion. A tabular and narrative synthesis of data is planned, and a meta-analysis will be done according to the quality of data. The primary outcomes will be general psychological distress, depression, and anxiety, and the secondary outcomes will be quality of life and adverse effects. The present protocol of systematic review is reporting following MECIR standards for the reporting of protocols and the PRISMA-P recommendations. Discussion: Autogenic training appears to be a promising therapy to improve psychological well-being and quality of life in people living with chronic physical health problems, but no recent reports have synthesized the available evidence in this population. The results of this review will examine and synthesize the evidence on the benefits and harms of autogenic training on psychological well-being and quality of life in people living with chronic physical health problems, thus supporting the development of best practices for complementary approaches. Systematic review registration: PROSPERO CRD42018105347.
... A summary of studies specifically reporting on efficacy of psychological treatments for CRPS is presented in Appendix A1 [314][315][316][317][318][319][320][321][322][323][324][325][326][327][328][329]. This reveals few randomized controlled trials (RCTs) specifically testing psychological interventions in CRPS patients. ...
... For example, a meta-analysis of clinical trials testing progressive muscle relaxation techniques found significant effects in various chronic pain conditions, reflecting a moderate effect size (level 1) [327]. Meta-analysis specifically of autogenic training, another relaxation procedure, also indicated a significant and at least moderate effect size in controlled trials for patients with headache and somatoform pain disorder (level 1) [328]. Significant efficacy for biofeedback training is also indicated by meta-analyses in populations including temporomandibular joint pain and migraine headache patients (both level 1) [329,330]. ...
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There have been some modest recent advancements in the research of Complex Regional Pain Syndrome, yet the amount and quality of the work in this complicated multifactorial disease remains low (with some notable exceptions; e.g., the recent work on the dorsal root ganglion stimulation). The semi-systematic (though in some cases narrative) approach to review is necessary so that we might treat our patients while waiting for "better research." This semi-systematic review was conducted by experts in the field, (deliberately) some of whom are promising young researchers supplemented by the experience of "elder statesman" researchers, who all mention the system they have used to examine the literature. What we found is generally low- to medium-quality research with small numbers of subjects; however, there are some recent exceptions to this. The primary reason for this paucity of research is the fact that this is a rare disease, and it is very difficult to acquire a sufficient sample size for statistical significance using traditional statistical approaches. Several larger trials have failed, probably due to using the broad general diagnostic criteria (the "Budapest" criteria) in a multifactorial/multi-mechanism disease. Responsive subsets can often be identified in these larger trials, but not sufficient to achieve statistically significant results in the general diagnostic grouping. This being the case the authors have necessarily included data from less compelling protocols, including trials such as case series and even in some instances case reports/empirical information. In the humanitarian spirit of treating our often desperate patients with this rare syndrome, without great evidence, we must take what data we can find (as in this work) and tailor a treatment regime for each patient.
... Among these practices, autogenic training (AT), developed by Shultz, is a self-guided relaxation technique that aims to foster a state of calm and relaxation in the body and mind, by bringing attention to different bodily sensations [17]. This technique involves inducing a state of calm, performing a sequence of six standardized exercises [17][18][19][20], and finishing with a recovery exercise (Table 1) [17,19]. It is recommended to practice AT three times a day, in sessions lasting between 5 and 15 min. ...
... AT has been shown to have positive effects on pain, anxiety, symptoms of depression, sleep disorders, fatigue, and quality of life [20][21][22][23][24][25] in various populations living with chronic disease. However, according to a systematic scoping review, few studies have evaluated the effects of AT on people living with HIV [26]. ...
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Background Various mind-body practices are used by people living with HIV to promote their general well-being. Among these is autogenic training (AT), a self-guided relaxation technique requiring regular practice for observable benefits. However, little has been written about the process of learning this technique, which is obviously a prerequisite to regular practice. This study therefore aims to describe the process by which people living with HIV learn AT. Methods The study is a descriptive qualitative study using semi-structured interviews and a thematic analysis with a mixed approach. Fourteen participants living with HIV completed sessions to learn autogenic training over a period of 3 months. Results The process of learning AT was approached through three themes: initiating the learning process, taking ownership of the technique, and observing its benefits on wellness. To initiate learning, participants had to express a need to take action on an aspect of their well-being and their openness to complementary approaches to care. Taking ownership of the technique was facilitated by guidance from the nurse researcher, the participants’ personal adaptations to overcome barriers to their practice, regular practice, and rapid observation of its benefits. Finally, the participants reported the observation of benefits on their wellness, including personal development, mainly in terms of the creative self, the essential self, and the coping self. This perception of the technique’s benefits was part of the learning process, as it contributed both to the participants’ ownership of the technique and to reinforcing their AT practice. Conclusions People living with HIV see learning AT as a progressive process, in which wellness is a major outcome and a contributing factor in developing a regular practice.
... Arousal can manifest itself cognitively (e.g., worrisome thoughts), emotionally (distress), and behaviorally (e.g., toss and turn in bed), and occur in the autonomous or central nervous system [4]. In general, relaxation has positive effects on our physical and mental health [5,6]. Different techniques have been found to reduce the level of arousal and enhance sleep in terms of shorter sleep onset latency and subjective sleep quality, including muscle relaxation [5], cognitive techniques [6], newer forms of mindfulness [7], and deep pressure stimulation from weighted blankets [8,9]. ...
... In general, relaxation has positive effects on our physical and mental health [5,6]. Different techniques have been found to reduce the level of arousal and enhance sleep in terms of shorter sleep onset latency and subjective sleep quality, including muscle relaxation [5], cognitive techniques [6], newer forms of mindfulness [7], and deep pressure stimulation from weighted blankets [8,9]. The advances in technology have led to a variety of new products that are advertised as sleep enhancing. ...
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Insomnia is a common sleep disorder characterized by difficulties initiating sleep, maintaining sleep and/or early-morning awakenings. Hyperarousal is a common causal and maintaining factor in insomnia models. Different techniques to decrease arousal have shown to be effective. Calm breathing can be one approach to enhance sleep. The Somnox sleep robot looks like a bean-shaped cushion to hug, and it gives physical and auditive guidance to calm down the users' breathing. There is currently no impartial empirical evidence of the sleep robot's effects on insomnia. This study is a randomized waitlist-controlled trial with a recruitment target of a minimum of 44 adults with insomnia and sleep disturbing arousal. Participants will complete pre-, mid- and post-intervention assessments, in addition to a 1-month follow-up. The primary outcome measure is the Insomnia Severity Index. Secondary sleep outcome measures are the Pre-Sleep Arousal Scale, a sleep diary and actigraphy. A secondary comorbid symptoms outcome measure is the Hospital Anxiety and Depression Scale. The main research question is whether treated participants have greater improvements regarding symptoms of insomnia post-intervention, compared with the waitlist control group. The analytic approach will be mixed-effects models. The current study will increase the knowledge on breath guidance as a way to reduce hyperarousal and enhance sleep. The sleep robot is a novel method and a potential treatment option for people with insomnia, when the recommended first-line treatments of Cognitive Behavioral Therapy and pharmaceuticals are inaccessible or undesirable. The ethics of healthcare robotics is discussed.
... symptoms of anxiety disorders, depression) and patients with physical health problems (e.g. high blood pressure, pain) can benefit from practicing relaxation techniques (for results of metaanalyses see Manzoni et al., 2008;Stetter and Kupper, 2002). Relaxation training can also be useful for healthy people to reduce feelings of stress, and to improve somatic and mental wellbeing (Stetter and Kupper, 2002). ...
... high blood pressure, pain) can benefit from practicing relaxation techniques (for results of metaanalyses see Manzoni et al., 2008;Stetter and Kupper, 2002). Relaxation training can also be useful for healthy people to reduce feelings of stress, and to improve somatic and mental wellbeing (Stetter and Kupper, 2002). ...
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Many people find it difficult to practice progressive muscle relaxation (PMR) regularly. We attempted to improve relaxation quantity (i.e. adherence), and relaxation quality via placebo. A total of 100 women were randomly assigned to a standard group, which practiced PMR at home every day for two weeks, or a placebo group, which practiced PMR for two weeks with additional daily placebo treatment. To monitor adherence to relaxation practice, we used a smartphone app. The placebo group practiced more often than the standard group. Both groups did not differ in their reported relaxation level after the daily exercises.
... Autogenic training (AT) is a desensitization-relaxation technique that induces a relaxation state based on the passive concentration of bodily perceptions (e.g., heaviness and relax of arms and legs) (Stetter and Kupper 2002), it is a common stress management program that consists of systematically relaxing various muscle groups from feet to head, and focusing on muscle relaxation. A meta-analysis and a systematic review showed the clinical effectiveness of AT in patients with tension headache/migraine, essential hypertension, coronary heart disease, anxiety disorders, depression, and functional sleep disorders (Seo et al. 2018;Stetter and Kupper 2002). ...
... Autogenic training (AT) is a desensitization-relaxation technique that induces a relaxation state based on the passive concentration of bodily perceptions (e.g., heaviness and relax of arms and legs) (Stetter and Kupper 2002), it is a common stress management program that consists of systematically relaxing various muscle groups from feet to head, and focusing on muscle relaxation. A meta-analysis and a systematic review showed the clinical effectiveness of AT in patients with tension headache/migraine, essential hypertension, coronary heart disease, anxiety disorders, depression, and functional sleep disorders (Seo et al. 2018;Stetter and Kupper 2002). A recent study found that AT was an effective technique to decrease anxiety and depression in healthy adults (Seo and Kim 2019); as well as increase selfefficacy and performance, and decrease anxiety among 53 nursing students during nursing simulations (Holland et al. 2017). ...
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Heart rate variability biofeedback (HRV-BF) has been confirmed to increase heart rate variability (HRV) and cardiac outflows by baroreflex in healthy populations and clinical patients. Autogenic training (AT) is common used in the psychological intervention. This study integrates a single-session of HRV-BF and AT into a high-technology mobile application (app), and examines the effects on HRV indices, breathing rates, and subjective relaxation scores. Healthy college students were recruited and assigned to the single-session HRV-BF group or AT group. Participants in the HRV-BF group received HRV-BF combined with paced breathing training, which gradually stepped down their breathing rates from 12, to 8, to 6 breaths/per min; and received feedback of HRV indices from the app. Participants in the AT group received autogenic training and feedback of heart rate from the app. A chest belt Zephyr BioHarness was connected through Bluetooth to a Zenfone5 mobile phone, it collected the signals of interbeat intervals and breathing rates at pre-training, mid-training, and post-training stages. The Kubios HRV software was used to analyze HRV indices. The results reveal higher HRV indices and lower breathing rates during mid-training and post-training in the HRV-BF group compared to the AT group. There were higher high-frequency of HRV at post-training than pre-training in the AT group. Participants of both groups increased their subjective relaxation scores after training. The HRV-BF protocol increased cardiac outflows by baroreflex and decreased breathing rates, and the AT protocol increased high-frequency of HRV. These high-technology wearable devices combined with psychological interventions will apply to various populations in the future.
... According to these authors, relaxation, which is an easy-to-learn and self-applied intervention, has proved to be a simple first-line therapy that is capable of reducing depressive symptoms. Two relaxation techniques, namely, progressive muscular relaxation (PMR) and autogenic training (AT), are effective in reducing depressive symptoms in various populations [15,16]. The effect of PMR on depression has been studied more extensively than that of AT [15]. ...
... These formulas are organized into six exercises: 1) heaviness; 2) warmth; 3) calm and regular heart function; 4) self-regulation of respiration; 5) warmth in the upper abdominal area; and 6) pleasant cooling of the forehead. The practice always ends with three consecutive steps: flexing and extending the arms, taking a deep breath, and opening the eyes [16,28]. An exercise was taught at each session, and the practice included all the exercises learned until that time. ...
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Background Progressive muscle relaxation (PMR) and autogenic training (AT) are effective relaxation techniques to reduce depressive symptoms. However, no studies on their effectiveness have been conducted among people living with HIV and depressive symptoms. The primary aim of this pilot study was to assess the feasibility and acceptability of PMR and AT interventions among people living with HIV who have depressive symptoms. A secondary aim was to assess the potential effectiveness of these interventions on depressive symptoms and quality of life. Methods This study was a three-arm pilot randomized control trial with mixed methods. Participants were randomized to PMR, AT, or a control group (CG), with four assessments (baseline, and at one, three, and six months). The PMR and AT interventions consisted of six 1 h sessions of individual training over 12 weeks, plus home practice. Recruitment, attrition, and completion rates were calculated. Depressive symptoms and quality of life were assessed at all times. Participants' perceptions of the interventions were collected in semi-structured interviews. Results Following the screening, 54/63 people met the inclusion criteria, and 42/54 were randomly allocated to the PMR group (n=14), AT group (n=14), and CG (n=14). Six participants (43%; 95% CI 18–71%) in the PMR group and 10 (71%; 95% CI 42–92%) in the AT group completed the intervention. Participants reported better emotion management and improvements in depressive symptoms and quality of life. Conclusions The pilot study suggests that a randomized trial to test the effectiveness of these interventions is feasible. Trial registration ClinicalTrials.gov NCT01901016
... Várias fontes da literatura sustentam que dificuldades em perceber conscientemente a actividade fisiológica num dado sistema biológico se associam a problemas nesse mesmo sistema (Costa, Oliveira, Pestana, Costa, & Oliveira, 2019;Gannon, 1984), o que torna o estudo da consciência interoceptiva cada vez pertinente para a investigação e prática clínica. O desenvolvimento da capacidade de perceber conscientemente as sensações interoceptivas poderá tratar várias perturbações, tais como depressão e ansiedade ( Potes et al., 2018;Price & Hooven, 2018;Silverstein, Brown, Roth, & Britton, 2011;Stetter & Kupper, 2002), perturbações do sono (Hubbling, Reilly-Spong, Kreitzer, & Gross, 2014;Stetter & Kupper, 2002) perturbações sexuais ( Bossio et al., 2018;Johnson, Johnson, Barton, & Elkins, 2016;Paterson, Handy, & Brotto, 2017;Silverstein et al., 2011;Vilarinho, 2017) e dependência de substâncias Price, Thompson, Crowell, Pike, Cheng, et al., 2019). Assim, é importante validar medidas de consciência interoceptiva que possam ser usadas em investigação não só sobre efeitos de tratamentos e correlações com medidas de saúde de bem-estar, mas também na avaliação clínica de forma a melhor compreender se os pacientes têm défices de consciência interoceptiva que possam ser supridos. ...
... Várias fontes da literatura sustentam que dificuldades em perceber conscientemente a actividade fisiológica num dado sistema biológico se associam a problemas nesse mesmo sistema (Costa, Oliveira, Pestana, Costa, & Oliveira, 2019;Gannon, 1984), o que torna o estudo da consciência interoceptiva cada vez pertinente para a investigação e prática clínica. O desenvolvimento da capacidade de perceber conscientemente as sensações interoceptivas poderá tratar várias perturbações, tais como depressão e ansiedade ( Potes et al., 2018;Price & Hooven, 2018;Silverstein, Brown, Roth, & Britton, 2011;Stetter & Kupper, 2002), perturbações do sono (Hubbling, Reilly-Spong, Kreitzer, & Gross, 2014;Stetter & Kupper, 2002) perturbações sexuais ( Bossio et al., 2018;Johnson, Johnson, Barton, & Elkins, 2016;Paterson, Handy, & Brotto, 2017;Silverstein et al., 2011;Vilarinho, 2017) e dependência de substâncias Price, Thompson, Crowell, Pike, Cheng, et al., 2019). Assim, é importante validar medidas de consciência interoceptiva que possam ser usadas em investigação não só sobre efeitos de tratamentos e correlações com medidas de saúde de bem-estar, mas também na avaliação clínica de forma a melhor compreender se os pacientes têm défices de consciência interoceptiva que possam ser supridos. ...
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Objectivo Consciência interoceptiva refere-se à percepção consciente dos estados internos do organismo. O presente trabalho pretendeu a validação do Multidimensional Assessment of Interoceptive Awareness (MAIA) recolhida a partir de uma amostra não probabilística de 755 indivíduos. Método O MAIA é originalmente constituído por 32 itens (divididos em oito dimensões) que assumem como possibilidade de resposta uma escala de Likert de 6 pontos. O estudo das qualidades métricas deste instrumento realizou-se com recurso a análise factorial exploratória ( N = 376) e, numa amostra diferente, a análise factorial confirmatória ( N = 379). Resultados Verificou-se uma estrutura diferente da original, mantendo-se o seu significado psicológico e características de validade, sensibilidade e fiabilidade adequadas. Conclusão Obtiveram-se quatro dimensões (Regulação Atencional; Consciência Emocional; Escuta Corporal e Confiança), as quais correspondem a dimensões da medida original.
... To prevent anxiety and depression, we often use relaxation techniques (Stetter & Kupper, 2002) and put lifestyle factors (such as the daily amount of sleep and general health status) in the focus of counseling. These techniques significantly influence the development of depression and anxiety (Cheung & Yip, 2015;Hoying et al., 2020). ...
... Based on other integrated treatment studies, this model provides the best opportunity to sustain recovery from OUD in the context of chronic pain [29,30]. For instance, self-regulation is an effective tool to reduce pain reactivity as well as de-escalate pain-related emotional states and has been called many different things (i.e., relaxation [30], biofeedback [31], autogenic training [32], and imagery [33]). Meta-analyses indicate that self-regulation matches medication in pain reduction [34]. ...
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Background It is critical to develop empirically based, community-treatment friendly, psychotherapy interventions to improve treatment for patients with comorbid chronic pain and Opioid Use Disorder. Understanding factors that increase patient adherence and attendance is important, along with strategies targeted to address those issues. Methods Based on initial psychophysiology research on adults with OUD and chronic pain, we created an integrated cognitive-behavioral, 12-week outpatient group therapy called STOP (Self-regulation Therapy for Opioid addiction and Pain). In this study, we pilot tested STOP in a Stage 1a feasibility and acceptability study to identify unique treatment needs and factors that increased session attendance, adherence to treatment, and improved outcomes. Fourteen individuals on medication for OUD with co-occurring chronic pain participated. Results STOP had high attendance rates (80%; and active patient engagement). Urine toxicology showed no illicit drug use after week 8. Data analysis from pre-intervention to a 3-month follow-up showed significant functional improvement ( F (1,12) = 45.82; p < 0.001) and decreased pain severity levels ( F (1,12) = 37.62; p < 0.01). Participants reported appreciation of the unique tools to counteract physiological activation during a pain flare or craving. Participants also reported benefit from in-session visual aids, applicable pain psychology information, take-home worksheets, tools for relaxation practice, learning to apply the therapy tools. Discussion STOP is a 90-min 12-week rolling-entry group therapy based on previous research identifying psychophysiological needs of pain and OUD patients that can be seamlessly incorporated into community addiction treatment clinics. Conclusion Preliminary results of STOP are promising with high patient engagement and adherence and significant reductions in drug use and pain. Trial registration ClinicalTrials.Gov NCT03363243 , Registered Dec 6, 2017.
... Hypnosis strategies are described in Table 2 but included both hetero-hypnosis and selfhypnosis. One study used autogenic training [21], a selfinduced state of focused relaxation with suggestion [33] that is considered by some to be a form of self-hypnosis and by others to not be hypnosis [32,34]. Given the divergence in opinion, this study was included, but we clearly note the use of autogenic training throughout to avoid misrepresenting the literature. ...
Article
Objective Neuropathic pain is complex and often refractory. Clinical hypnosis has emerged as a viable treatment for pain. This scoping review is the first comprehensive review of hypnosis for chronic neuropathic pain. It critically assesses available evidence noting practice implications, literature gaps, and future research opportunities. Subjects Individuals with chronic neuropathic pain treated with hypnosis. Methods Following PRISMA guidelines, we searched PubMed, CINAHL, Embase, and PsycInfo for studies for which the intervention and primary outcome(s) were associated with hypnosis and neuropathic pain, respectively. Included studies were empirical, in English, and published from January 1996—August 2021. Results Nine articles with 301 total participants were reviewed. Neuropathic pain included, for example, complex regional pain syndrome (CRPS), brachial neuralgia, and spinal cord injury. Hypnosis dose varied with administration and format. Six studies used comparators. Every trial demonstrated pain and quality-of-life benefits, with several controlled trials indicating hypnosis as superior to active comparator or standard of care. CRPS-specific studies showed notable improvements but had significant study limitations. Methodological weaknesses involved trial design, endpoints, and recruitment strategies. Conclusions The evidence is weak because of poor study design, yet encouraging both for analgesia and functional restoration in hard-to-treat chronic neuropathic pain conditions. We highlight and discuss key knowledge gaps and identify particular diagnoses with promising outcomes after hypnosis treatment. This review illustrates the need for further empirical controlled research regarding hypnosis for chronic neuropathic pain and provides suggestions for future studies.
... In most cases, relaxation training is taught by the provider to the patient in a session, demonstrating a relaxed physical position, quieting the mind and body in a space free from distractions or interruptions, and is then practiced at home between sessions. For example, autogenic training, a standardized relaxation technique 103 that can be taught to the patient for home practice by physicians and allied health providers, is widely used for psychosomatic conditions 104 and has shown some evidence of effectiveness in IBS. 105 See Shah et al 106 for an excellent overview of relaxation training in IBS. ...
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Background and Aims This Rome Foundation Working Team Report reflects the consensus of an international, interdisciplinary team of experts regarding the use of behavioral interventions in patients with disorders of gut-brain interaction (DGBI), specifically Brain-Gut Behavior Therapies (BGBT). Methods The committee members reviewed the extant scientific literature and whenever possible, addressed gaps in this literature through the lens of their clinical and scientific expertise. Delphi method was used to create consensus on the goals, structure and framework before writing the report. The report is broken into five parts: 1) Definition and evidence for Brain-Gut Behavior Therapies (BGBT); 2) The Gut-Brain Axis as the mechanistic basis for BGBT; 3) Targets of Brain-Gut Behavior Therapies; 4) Common and Unique Therapeutic techniques seen in BGBT; and 5) Who and How to Refer for BGBT Conclusions We chose to not only review for the reader the 5 existing classes of BGBT and their evidence, but to connect DGBI-specific behavioral targets and techniques as they relate directly, or in some cases indirectly, to the Gut-Brain-Axis. In doing so, we expect to increase GI providers’ confidence in identifying and referring appropriate candidates for BGBT and also support clinical decision making for mental health professionals providing BGBT. Both gastrointestinal medical providers and behavioral health providers have an opportunity to optimize care for DGBI through a collaborative, integrated approach that begins with an effective patient-provider relationship, thoughtful communication about the brain-gut-axis and, when appropriate, a well-communicated referral to BGBT.
... As previously, this perception correlates with the usual frequency of practice and is concordant with research showing that AT practice increases the body's homeostatic functions and the resilience to illness (Luthe and Schultz, 1970a). Furthermore, a meta-analysis of clinical outcome studies has shown positive effects of AT for tension headache, migraine, mild-to-moderate essential hypertension, coronary heart disease, bronchial asthma, unspecified somatoform pain disorder, Raynaud's disease, anxiety disorders, dysthymia, mild-tomoderate depression, and functional sleep disorders (Stetter and Kupper, 2002). ...
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Currently, humanity is facing one of the most critical situations of this century, the COVID-19. The adverse effects of the pandemic on the mental health of the population are well known. Fear of illness, confinement, lack of financial resources, or poor social support can influence people’s mental state. Despite these risks, several psychological resources may help address this situation. The present study investigated the effectiveness of a self-relaxation techniques known as autogenic training. Autogenic training is a well-known method in Europe for the treatment of anxiety and stress disorders. The practice of autogenic training is also reported to improve neurovegetative and immune regulation. This study focuses on describing how autogenic training is helping its practitioners to cope with the pandemic. Specifically, they report strong beneficial effects on their physical, psychological, and relational health. In total, 75 autogenic training practitioners (41 women), age 22–71, participated in the survey. An ad-hoc questionnaire was developed to collect information on sociodemographic variables, health status during the pandemic, characteristics of their AT practice, and response to the pandemic as outcome variables. The questionnaire was distributed through Google Forms in the first week of September 2020. The results show that there was an increase in the practice of autogenic therapy during the pandemic, especially among women. In addition, the majority of participants (88%) remained healthy during the pandemic. Furthermore, the results show that autogenic training is very useful for physical and psychological health and for a better understanding of others. Therefore, the practice of autogenic training is recommended to people who live moments of anxiety, are afraid of illness, or feel that they have to improve the quality of relationships with others.
... Perubahan yang terjadi selama maupun setelah relaksasi Menurut penelitian Stetter F pada tahun 2002 dimana dari 60 pelajar dari 35 negara, ditemukan efek besar pada perbandingan untuk pre dan post intervensi teknik relaksasi autogenik, efek menengah terhadap kelompok kontrol, dan tidak ada efek bila dibandingkan dengan terapi psikologis yang lain. 18 Relaksasi autogenik efektif dilakukan selama 20 menit dan relaksasi autogenik dapat dijadikan sebagai sumber ketenangan selama sehari. 16 Berdasarkan penelitian yang dilakukan oleh Setyawati A relaksasi autogenik yang dilakukan sebanyak 3 kali juga memiliki pengaruh yang signifikan terhadap penurunan tekanan darah dan kadar gula darah pada klien diabetes melitus tipe 2 dengan hipertensi. ...
... Practices based on mindfulness improve the quality of sleep [55] and of life [56]. Similarly, different relaxation techniques affect psychological outcomes by decreasing anxiety and depression symptoms [57,58]. ...
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Social distancing plays a leading role in controlling the spread of coronavirus. However, prolonged lockdown can lead to negative consequences in terms of mental health. The goal of the research is to examine the relationship between anxiety and general psychosomatic functioning during the COVID-19 pandemic; the impact of psychological flexibility and mindfulness is also considered. Variables were measured with self-report questionnaires and symptom checklists. The sample included 170 people (M = 27.79, SD = 8.16). Pearson's correlation, stepwise regression, and path analysis were conducted. The results showed a significant positive relationship between state anxiety and somatic and psychological responses to the pandemic. Path analysis revealed that mindfulness had a direct negative impact on and decreased the level of state anxiety (b = −0.22, p = 0.002), whereas psychological flexibility influenced the variable indirectly (b = 0.23, p = 0.002) by enhancing psychosomatic functioning (b = −0.64, p < 0.001). Psychological flexibility and mindfulness may mediate the development of mental disorders and facilitate achieving overall wellbeing. The study points to the usefulness of mindfulness practice as a form of self-help with anxiety symptoms; this is crucial during the pandemic because contact with clients is restricted.
... Physiologically speaking, the generated warmth and muscular relaxation can be associated with a decrease of psychological arousal and an advanced blood flow leading to a better oxygen supply (Payne, 2005). Collectively, these processes have been scientifically proven to promote better healing, while assuaging fears and worries (Kanji & Ernst, 2000;Stetter & Kupper, 2002). Interestingly, in a study about anxiety patients, AT was found to be even more effective to relax than PR (Takaishi, 2000). ...
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Throughout the last decades, research has increasingly acknowledged the psychological aspects entailed in sports injury occurrence and rehabilitation processes. More current studies have also focussed on the impact of psychological issues of the return to sport. Collectively, the existing body of research highlights that physical readiness alone is an incomplete rehabilitation outcome and an insufficient indication of a successful return to sport. The binarity of physiological and psychological outcomes and their intertwined relationship to one another is a paramount feature of existing conceptual models concerned with the topic of the rehabilitation process following serious sports injuries. This examination aims at giving an overview of the multitude of psychological responses to athletic injuries.
... The physical category includes for example pure behavioral relaxation training, progressive muscle relaxation, deep breathing, the Alexander technique and Feldenkrais method (education techniques aiming at establishing a heightened awareness of movements), and Mitchell's simple physiological relaxation [94][95][96]. Cognitive or nonphysical approaches include, among others, autogenic training-first described already in 1932 [97]-and Benson's method [98,99] which are more focused on accomplishing the relaxation state by a person following the specially crafted instructions, rather than physical work with the body. ...
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Background: The aim of this article is to present a short review of noninvasive, nonpharmacological treatment methods used in somatic illnesses that fall under the umbrella of approach called behavioral medicine. Methods: The narrative review method was applied in the study. Science paper databases, including PubMed, had been used to retrieve papers on therapeutic methods used in clinical setting that meet the broad criteria of behavioral medicine definition as stated in the Charter of International Behavioral Medicine Society. Results: Main groups of methods, disorders in which they are being employed and their effectiveness, have been identified. Conclusions: Behavioral medicine is grouping treatment methods and interventions that hold large potential for clinical setting. Two groups of methods can be distinguished by the scrutiny and level of evidence gathered in their effectiveness assessment; for biofeedback, guided imagery, and hypnosis techniques, comprehensive evidence reports in the framework of U.S. Evidence Synthesis Program exist. Meditation techniques, disclosure therapies, and relaxation methods are less well assessed. Broader employment of behavioral medicine therapies in clinical setting is possible after addressing two major problems in the field, which are deficiencies in quality evidence of effectiveness for many of the methods and their insufficiencies in underlying therapeutic mechanism knowledge.
... Performing this challenging test twice might have overloaded the patients and may explain the accumulation of fatigue on day 2. The resulting feeling of severe fatigue might have been too high for being influenced by the two biofeedback interventions: only patients with weak to moderate fatigue were able to increase parasympathetic activation as consequence of the PMR training. In this respect, it should be mentioned that fatigue of the total group was rather severe with a mean FSMC total score of 72.1 ± 16.6, and a former review on the efficacy of autogenic training indicated that relaxation methods are not effective as stand-alone therapies, especially not in severe forms of the psychological disorders (Stetter & Kupper, 2002). ...
Article
MS related fatigue might be related to autonomous nervous system (ANS) dysfunctions or to inflammation related vagal (hyper-) activation. Consequently, influencing ANS status may lead to relieve of fatigue. We used two opposite biofeedback interventions to either increase sympathetic (“self-alert training”, SAT) or parasympathetic activation (“progressive muscle relaxation”, PMR). We recorded fatigue status of patients before and after a challenging vigilance task, their behavioural performance on this task, their skin conductance response (SCR), and parameters indicating parasympathetic activity concerning heart rate variability (HRV). We repeated these recordings after the biofeedback training sessions. Patients of the SAT group were able to learn to increase their SCR voluntarily. Patients of the PMR group showed increasing parameters indicating parasympathetic modulation of the HRV. The vigilance task increased their feeling of fatigue. However, there was no effect of biofeedback training on either fatigue status or performance on the vigilance task. Our results show that MS patients can learn to change voluntarily their ANS activity using biofeedback instructions based on SCR and this can be used in future studies to test the postulated link between ANS and fatigue. However, in this experimental intervention we were unable to document a relation between ANS activity and fatigue. Trial registration: ClinicalTrials.gov identifier: NCT03268187.
... Referring to Yoshie, Kudo, and Ohtsuki [19], Brugués [8] states that the connection between arm stiffness and performance anxiety in musicians could be related to dysfunctional physical reactions, such as excessive muscle tension accompanying great anxiety. The eclectic approach of DRMT incorporates aspects of body-oriented procedures like hypnotherapy and autogenic training (autogenic training is defined as a technique of self-hypnosis or a self-relaxation procedure facilitating psychophysiological relaxation, see [20]), which are recommended for the treatment of MPA [17]. ...
Article
This article presents the results of a study which focused on the application of combined Depth Relaxation Music Therapy (DRMT) and silence in preventing music performance anxiety (MPA) in music students. Participants (n=12) were divided into two groups. Each group received either 16 minutes of DRMT followed by 6:30 minutes of silence or a 16-minute seminar consisting of a moderated group discussion on silence followed by 6:30 minutes of silence. Each of the two groups experienced the alternative condition (within-subject design) with one week in between. Focus groups were held for data gathering after each session. Qualitative content analysis according to Mayring was applied to analyze the data. Silence following DRMT was perceived as more relaxing and longer lasting than silence following the seminar. Participants reported that their distracting or depressing thoughts decreased and their auditive perception of silence changed during the combined silence and DRMT. The results indicate that the procedure can help prevent MPA.
... In the present study, we found an association between relaxation therapy and decreased BZD use in patients with MUS. AT is an effective relaxation therapy for sleep disorders, anxiety disorders, and MUS, such as tension-type headaches, migraine headaches, and [30,31]. In addition, the use of these approaches has demonstrated improved quality of life in cases of multiple sclerosis [32] and reduced anxiety and stress in healthy students [33], with one meta-analysis reporting relief from anxiety [34]. ...
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Background: The change in the benzodiazepine (BZD) use of patients with medically unexplained symptoms (MUS) following the application of relaxation therapy were examined. Methods: Of the 221 outpatients with MUS using BZD, 42 received relaxation therapy. Change in BZD use was compared using a relaxation group (n = 42) and a control group that had 84 MUS patients whose baseline was matched by optimal matching algorithms. Logistic regression analysis was done to evaluate the effect of BZD-dependent factors on the BZD dose of the relaxation group. Results: Compared with the control group, the number of patients who decreased the amount of BZD and the number of patients whose subjective symptoms of MUS improved were significantly higher in the relaxation group (p < 0.05). In addition, a factor that made it difficult to reduce the BZD of MUS patients who had undergone relaxation was a long history of BZD use, for more than 6 months (odds ratio, 0.06, 95% confidence interval, 0.01-0.36). Conclusions: Relaxation therapy for patients with MUS may help reduce BZD use; however, early intervention is important to prevent BZD dependence.
... Underarousal, which is, for example, associated with externalizing behavior (Baker et al., 2018), may be tackled by increased sensory stimulation or enhanced disciplinary consequences (Beauchaine et al., 2015). Over-arousal problems may be overcome by autogenic training, which includes systematic exercises for learning to perceive relaxation of body parts and autonomic activity (Stetter & Kupper, 2002). ...
... Hence, there has been a wide consensus that, besides antihypertensive medications and lifestyle changes, hypertensive patients should be provided also with psychosocial interventions that aim at increasing stress management and relaxation [74][75][76]. Importantly, however, several intervention studies and meta-analyses have concluded that the current relaxation techniques, stress reduction programs, or cognitive-behavioral therapies seem not to be effective treatment methods for raised blood pressure [77][78][79]. Hence, there is an acute need for the development of novel psychosocial treatments. ...
Article
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Background This study investigated (i) whether compassion is associated with blood pressure or hypertension in adulthood and (ii) whether familial risk for hypertension modifies these associations.Method The participants (N = 1112–1293) came from the prospective Young Finns Study. Parental hypertension was assessed in 1983–2007; participants’ blood pressure in 2001, 2007, and 2011; hypertension in 2007 and 2011 (participants were aged 30–49 years in 2007–2011); and compassion in 2001.ResultsHigh compassion predicted lower levels of diastolic and systolic blood pressure in adulthood. Additionally, high compassion was related to lower risk for hypertension in adulthood among individuals with no familial risk for hypertension (independently of age, sex, participants’ and their parents’ socioeconomic factors, and participants’ health behaviors). Compassion was not related to hypertension in adulthood among individuals with familial risk for hypertension.Conclusion High compassion predicts lower diastolic and systolic blood pressure in adulthood. Moreover, high compassion may protect against hypertension among individuals without familial risk for hypertension. As our sample consisted of comparatively young participants, our findings provide novel implications for especially early-onset hypertension.
... Underarousal, which is, for example, associated with externalizing behavior (Baker et al., 2018), may be tackled by increased sensory stimulation or enhanced disciplinary consequences (Beauchaine et al., 2015). Over-arousal problems may be overcome by autogenic training, which includes systematic exercises for learning to perceive relaxation of body parts and autonomic activity (Stetter & Kupper, 2002). ...
Chapter
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In this chapter, we present the theory of Personality Systems Interactions (PSI) as a meta framework for analyzing the functional architecture of human motivation and personality functioning. Section 1 delineates how PSI theory integrates various traditional motivation theories into seven distinct levels of human motivation and individual differences thereof. Section 2 covers principles of PSI theory that determine how motivational systems, located at the same level or at different levels, interact with each other. Sections 3 and 4 show how these principles can explain two major paradoxes in motivation psychology, namely a) people’s frequent failure to act upon their best intentions, and b) people’s tendency to adopt goals that run counter to their personal preferences and needs. Section 5 discusses how PSI theory conceives of implicit motives as “switch boards” that connect motivational systems at different levels. Section 6 reports neuroscientific evidence supporting PSI theory. Finally, Section 7 reflects more broadly on PSI theory’s key contributions to motivation science and its applications.
... A recent meta-analysis examining autogenic training and self-relaxation demonstrated that each technique had positive effects in patients with tension headaches, coronary artery disease, asthma, pain, Raynaud syndrome, anxiety, depression, or sleeplessness. 24 Early studies suggest genomic changes may be induced by the relaxation response. 25 This pilot randomized clinical study examined the willingness of men undergoing radiotherapy for prostate cancer to participate in a study of CAM therapies and tested the effects of Reiki and RRT on psychosocial and physiological outcomes. ...
Article
15638 Background: Prostate-cancer patients suffer from substantial distress with both their diagnosis and treatment. Several studies have looked at the use of complementary and alternative medicine (CAM) in patients with prostate cancer to alleviate their stress and effects of therapy. We elected to study Reiki and Relaxation Response Therapy (RRT) in prostate-cancer patients. Methods: Patients receiving an eight-week course of radiation for prostate cancer were eligible. Consented participants were randomly assigned to RRT, to Reiki, or to no CAM therapy during radiotherapy. Reiki was given twice weekly, RRT once weekly. The feasibility of enrolling 60 patients, their compliance with physiologic and psychological testing, and preliminary assessment of the effect of CAM are the study endpoints. Statistical analysis of feasibility is based on the assumption that at least 80% of patients would complete 14/16 Reiki sessions or 7/8 RRT sessions. Patients were tested for outcome measures at baseline, at randomization, halfway through radiation, at completion of radiation and 2 months later. The psychosocial outcome measures used were the STAI, CES-D, FACT-G, FACIT: Fatigue Scale, and EPIC: Hormone Section. Physiological assessment included salivary cortisol, blood samples for interleukin-6, tumor necrosis factor alpha, CD8, natural killer cells, heat shock protein 70 and a validated bowel-and-bladder-symptom questionnaire. Results: We have enrolled 62 of 108 eligible patients (60%) within 18 months. The number of enrollment has been increased to 62 as two patients changed their treatment location. To date five patients dropped out short of completion, 1 became ineligible, 32 have completed the study, 20 are still receiving CAM therapy or are in active follow-up and 2 are awaiting randomization and radiotherapy. Conclusions: Complementary therapy appears to be of much interest to prostate-cancer patients. At the completion of the trial, we will have more data on feasibility, compliance and preliminary results on the effect of CAM intervention in this population. No significant financial relationships to disclose.
... Cheung and Yip [11] found an influence of lifestyle factors on depression with physical activity being a key factor in mental health. Using relaxation techniques can influence various mental health problems like anxiety or depression [12,13]. Pekmezovic and colleagues [14] showed that health-related quality of life (including mental health) increases with the frequency of physical activity in a sample of college students. ...
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Objectives Up to 90% of medical students experience stress. Studies have observed a relationship between stress and depression. Coping strategies to deal with stress and depression are of great interest. This study aimed to evaluate the prevalence of stress and depression and the efficacy of coping strategies in undergraduate medical students.Methods This survey was conducted with 589 second-year and sixth-year students in 2017 at the Medical University of Vienna. The questionnaire included a stress and coping questionnaire, depression screening, substance use questionnaire, and questionnaire concerning leisure time activities.ResultsThe coping strategies were included in a regression model to assess their predictive value for stress and depression screening scores. The most common stressor was performance pressure overload (92.1%). Overall, 52.4% of the participating students reached critical scores in the depression screening. Positive thinking and active coping were associated with lower stress scores. Positive thinking also was a protective factor against depressive symptoms. Less than 2% of all students reached high-risk values for substance use.Conclusion Accessible counseling for students in need of psychological care should be provided. Different interventions of positive psychology showed a positive impact on depression screening scores.
... Within the therapeutic sessions the task of the psychologists includes i) to evaluate disease models of the participants and to introduce the psychophysiological model of the effects of AT (or relaxation in general), ii) to reinforce positive relaxation responses reported by the participants after the exercises, iii) to deal with possible negative initial relaxation responses, and iv) to enhance motivation for training. 15 The AT consisted of supervised training session twice a monthsfor 16 weeks. The course of the AT was progressive. ...
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Emergency room have particularly stressful work situations. Emergency room personnel cope with stressors on a daily basis. These stressors can be risks factor for burn out and for reduced quality of life and work motivation. Emergency room staff of one of ASP 3 CT urban hospital in Acireale, Italy participated to stress management program by autogenic training twice a month for 16 weeks. This program were prepared based on existing research and studies, and were conducted by clinical psychologists. We found that the mean value in pre-test is significantly different from mean value in post-test for: Perceived Stress Scale PPS (t=7.72 with 27 df and P<0.001); Euro Quality for life (t=-14,13 with 27 df and P<0.001); Work motivation assessed by Visual Analogue scale VAS (t=-4.52 with 27 df and P<0.001) . In the Maslach Burnout Inventory, the mean value is significantly different for emotional exhaustion sub-scale (t=5.64 with 27 with 27 df and P<0.001) and for depersonalization subscale (t=6.67 with 27 df and P<0.001). No significant difference was observed for the personal accomplishment sub-scale. This research suggests that psychological interventions with emergency room staff are effective. Our study showed effectiveness of an auto-genic and stress management training in improvement of quality of life, work motivation, burn-out and stress perceptions for emergency department team.
... Die Wirksamkeit der Grundstufe des AT wurde durch metaanalytisch gewonnene Befunde [30] [34]. Die Durchführung von AT in der Migräneattacke ist sorgfältig abzuwägen, da die kardiovaskuläre Entspannungsreaktion mit einer peripheren Gefäßerweiterung einhergehen kann. ...
Article
ZUSAMMENFASSUNG In diesem Beitrag wird beschrieben, welche psychologischen Behandlungsverfahren in der Therapie von Kopfschmerzerkrankungen eingesetzt werden können. Technologische Entwicklungen in den letzten Jahrzehnten habe neue Möglichkeiten eröffnet, deren Potenzial es allerdings noch genauer auszuloten gilt. Die Idee moderner Kopfschmerztherapie ist nicht der isolierte Einsatz einzelner Verfahren, sondern eine möglichst gute, individuell auf den Patienten zugeschnittene Kombination verschiedener psychologischer Behandlungsverfahren mit anderen medikamentösen und nicht medikamentösen Verfahren. Um für jeden Kopfschmerzpatienten eine maßgeschneiderte Therapie zu ermöglichen, sollte ein interdisziplinäres Vorgehen das Ziel sein.
Article
The study objective was to assess if a 3‐week intervention with the Somnox sleep robot had effects on symptoms of insomnia, somatic arousal, and/or concurrent symptoms of depression and anxiety in adults with insomnia, compared with a waitlist‐control group. The participants (n = 44) were randomized to a 3‐week intervention with the sleep robot (n = 22), or to a waitlist‐control group (n = 22). The primary outcome measure was the Insomnia Severity Index administered at baseline, mid‐intervention, post‐intervention and at 1‐month follow‐up. Secondary outcome measures were the Pre‐Sleep Arousal Scale, and the Hospital Anxiety and Depression Scale. Additionally, sleep‐onset latency, wake time after sleep onset, total sleep time and sleep efficiency were measured the week prior to and the last week of the intervention, both subjectively with the Consensus Sleep Diary and objectively with wrist actigraphy. Mixed‐effects models were used to analyse data. The effect of the sleep robot on the participants' insomnia severity was not statistically significant. The differences between the intervention group and the control group on the measures of arousal, anxiety and depression were also not statistically significant, and neither were the sleep diary and actigraphy variables. In conclusion, a 3‐week intervention with daily at‐home use of the robot was not found to be an effective method to relieve the symptom burden in adults with insomnia.
Article
The physiotherapeutic and rehabilitative treatment of patients suffering from primary arthrofibrosis following total joint replacement or joint reconstruction is challenging for both patients and therapists. It can be successful if basic principles are applied. The necessary treatment techniques are presented in detail immediately postoperatively and in the subsequent rehabilitation process.
Chapter
Relaxation is at the core of managing our stress. Sleep is our natural form of relaxation, conserving and restoring energy. Physiologically, sleep is composed of two phases: nonrapid eye movement sleep and rapid eye movement sleep. Oftentimes, stress disrupts our sleep patterns. Relaxation techniques provide us with excellent methods that can be practiced with awareness anytime at our discretion. These techniques include yogic breathing, progressive muscle relaxation, autogenic training, and visual imagery. Biofeedback, self-hypnosis, humor (laughter), music, and massage can also contribute to a relaxed state. Optimism and introspective meditations help in achieving happiness and relaxation. The chapter includes Thoughts for Reflection about relaxing. Important terms are defined along with five websites to explore. Worksheets provide practice of relaxation techniques for yogic breathing, progressive muscle relaxation, autogenic training, imagery, meditation, and readiness for determining change toward developing relaxation behavior in daily life.
Chapter
This chapter outlines an interdisciplinary approach for the rehabilitation of complex regional pain syndrome (CRPS). Complex regional pain syndrome is often complicated by marked physical disability and psychosocial factors. Published guidelines recommend interdisciplinary care when early response to treatment has not been adequate. Integrated pain rehabilitation has been recognized as superior to single specialty pain treatment for complicated chronic pain patients. Rehabilitation focuses on functional restoration and quality-of-life improvement versus pain elimination and this approach has shown efficacy for several pain conditions. This chapter presents knowledge gained based primarily on clinical experience through Mary Free Bed Rehabilitation Hospital’s interdisciplinary pain management program. This program includes medical care, physical therapy, occupational therapy, and psychology intervention. Key components of CRPS treatment for each discipline are presented in addition to a discussion of the role of interdisciplinary care in the treatment of CRPS.
Chapter
Die Anwendung von Entspannungsverfahren in der Prävention, Psychotherapie und Rehabilitation ist als eine Standardtechnik zu betrachten. Es stehen eine Reihe von Entspannungsverfahren zur Verfügung (z. B. PMR, AT) deren Evidenz in den verschiedenen Aufgabenfeldern der Klinischen Psychologie und Psychotherapie belegt ist. Gemeinsam ist allen Entspannungsverfahren die „Entspannungsreaktion“, welche als zentraler Wirkmechanismus angesehen werden kann. Trotz der Vielfältigkeit der Anwendungen, Evidenznachweise und Verfahren lässt sich eine Vernachlässigung in der Klinischen Psychologie beobachten. In der Klinik werden Entspannungsverfahren häufig nicht von Psychologischen Psychotherapeuten oder Psychologen angewandt, auch in der ambulanten Psychotherapie wird die Anwendung vernachlässigt. Es ist zu wünschen, dass die basalen Techniken der Entspannungsverfahren wieder als grundlegendes „Handwerkzeug“ von Psychologen und Psychologinnen verstanden und angewandt werden.
Chapter
Entspannungsverfahren gelten als basale Interventionsstrategie im medizinischen, klinisch-psychologischen und psychotherapeutischen Kontext. In der medizinischen Rehabilitation sind sie standardmäßig integriert in ein indikationsspezifisches übergeordnetes Behandlungskonzept. Zunächst werden in diesem Kapitel grundlegende Überlegungen zu Entspannung und ihrem Wert für Individuum und Gesellschaft dargestellt, mit einem Kurzportrait ausgewählter Entspannungstechniken. Danach wird die wissenschaftliche Erforschung der Wirkung von Entspannung beschrieben, unter Bezug auf konkrete Anwendungsfelder und die aktuelle Evidenzlage. Im letzten Abschnitt geht es um pragmatische Aspekte von Entspannungstherapie in der Rehabilitation.
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The goal of this research is to integrate Virtual Reality (VR) with the bilateral stimulation used in EMDR as a tool to relieve stress. We created a 15 minutes relaxation training program for adults in a virtual, relaxing environment in form of a walk in the woods. The target platform for the tool is HTC Vive, however it can be easily ported to other VR platforms. An integral part of this tool is a set of sensors, which serves as physiological measures to evaluate the effectiveness of such system. What is more, the system integrate visual (passing sphere), auditory (surround sound) and tactile signals (vibration of controllers). A pilot treatment programme, incorporating the above mentioned VR system, was carried out. Experimental group consisting of 28 healthy adult volunteers (office workers), participated in three different sessions of relaxation training. Before starting, baseline features such as subjectively perceived stress, mood, heart rate, galvanic skin response and muscle response were registered. The monitoring of physiological indicators is continued during the training session and one minute after its completion. Before and after the session, volunteers were asked to re-fill questionnaires regarding the current stress level and mood. The obtained results were analyzed in terms of variability over time: before, during and after the session.
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Objectives: Autogenic training (AT) is one of the effective relaxation methods. Recent studies reported that some patients feel much anxious during AT exercises, and elevated anxiety sensitivity (fear of anxiety-related sensations) that increases the risk of anxiety disorders is the factor which influences relaxation effects by AT. However, influences of reducing anxiety sensitivity on relaxation effects by AT has not been clarified. The purpose of this study was to examine the influences of reducing anxiety sensitivity on relaxation effects by AT. Methods and subjects: Subjects were 55 healthy undergraduate students who were divided into three groups: subjects with high anxiety sensitivity who participated in a cognitive behavioral program designed to reduce anxiety sensitivity before AT exercise (TREATMENT group: n=10), subjects with high anxiety sensitivity who did not participate in a cognitive behavioral program designed to reduce anxiety sensitivity before AT exercise (H-CONTROL group: n=5), and subjects with low anxiety sensitivity who did not participate in a cognitive behavioral program designed to reduce anxiety sensitivity before AT exercise (L-CONTROL group: n=40). AT exercises were composed of group sessions and homework sessions. Relaxation effects were measured during AT exercises at the last group session. Results: Comparison of relaxation effects by AT among three groups revealed that scores of the H-CONTROL group were lower than those of TREATMENT group and L-CONTROL group (H-CONTROL vs. TREATMENT: p <0.05; H-CONTROL vs. L-CONTROL: p<0.05). Discussion: The results of this study indicate that individuals with high anxiety sensitivity before AT exercise were not provided relaxation effects by AT exercise. Additionally, individuals with high anxiety sensitivity were provided relaxation effects by AT, if elevated anxiety sensitivity is reduced before AT exercise. From this result, it is clarified that reducing anxiety sensitivity, which means anxiety related-sensations, would promote relaxation effects by AT. Therefore, before AT exercise, it is suggested that reducing anxiety sensitivity is important for the psychosomatic intervention which includes AT exercises for anxiety disorders. Furthermore, the intervention may be effective to improve the anxiety disorders.
Article
Evidence-based medicine (EBM) is the integration of best external evidence with clinical expertise and patient values. The full-blown practice of EBM comprises the following 5 steps; converting the need for information (e.g. diagnosis, prognosis, therapy, and prevention) into an answerable question (step 1), tracking down the best evidence with which to answer that question (step 2), critically appraising that evidence for its validity, impact, and applicability (step 3), integrating the critical appraisal with our clinical expertise and with the patient's unique biology, values and circumstances (step 4), and evaluating our effectiveness and efficiency in executing steps 1 to 4 and seeking ways to improve them both for next time (step 5). Concerning the step 1, it is often difficult to define "exposure" and "outcome" clearly in the field of psychosomatic medicine. For my clinical and research experience under Herbert Benson, M.D at Mind/Body Medicine, Harvard Medical School (1998-2001), definitions of stress and relaxation were quite elaborate tasks to assess the effects of stress management program in the treatment of patients with mind/body distress (Nakao M, Fricchione G, Benson H, et al. Psychother Psychosom 70: 50-57, 2001). He used the word of "relaxation response" instead of "relaxation", and defined it as follows; "the relaxation response is the psychological and physiological opposite of the arousal or stress response, characterized by decreased metabolism, blood pressure, rate of breathing and heart rate in association with feelings of calmness and control." Although general interest in relaxation therapies is on the rise, research in this area does not seem to be growing at the same pace. The working group of the Cochrane library has just begun their work to accumulate literature concerning relaxation therapies for the management of essential hypertension in adults (Nicolson DJ, et al. The Cochrane Database of Systematic Reviews, Volume 1, 2006 [Protocol]). According to this recent report, relaxation therapies include autogenic training, cognitive therapy, behavioral therapy, meditation, guided imagery, biofeedback, progressive muscle relaxation, breathing exercises, and yoga. They identified five systematic reviews, one of which was published by us (Nakao M, Yano E, Nomura S, et al. Hypertens Res 26: 37-46, 2003). In our systematic review, 388 articles were initially selected for review of biofeedback treatment for essential hypertension, but only 22 articles met inclusion criteria for further review and meta-analysis, meaning that the remaining 366 articles did not have enough information based on the standardized quality assessment. Although psychosomatic medicine is comprised of different approaches including internal medicine, psychiatry, psychology, sociology, and behavioral medicine, it should be recognized and applied in the mainstream of medicine, and many researchers and practitioners are needed to be involved in establishing the EBM of psychosomatic medicine.
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Stress could be explained as non-specific outcomes of the body to any exterior event that evokes the specific functional reactions of the body’s ability to regulate the equilibrium of inner biological mechanisms. 121 million people worldwide are affected by stress which is the common psychological disorder. Stress and anxiety are interrelated. Stress-induced eating is one of the ways to make oneself feel better in stressful condition, thereby increasing the physiologic demands which lead to obesity and further comorbidities as cardiovascular diseases, hypertension and diabetes. Psychological feeding incorporated with stress can be managed by implying healthy eating practices as compared to opting for convenience foods. Strategic approaches as muscles relaxing techniques, transcendental meditation, autogenic training, guided imagery and cognitive behavior therapy should be intervened in managing level of stress in individuals. Stress is inevitable but it can be managed by lifestyle modification such as physical activity, healthy eating and meditation. Keywords: stress, disability adjusted life years, glucocorticosteroids, HPA axis, deep muscle relaxation, transcendental meditation, autogenic training, guided imagery, cognitivebehavioral therapy
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Chronischer psychosozialer und traumatischer Stress sind zentrale Risikofaktoren für die Entwicklung psychosomatischer Erkrankungen. Eine Schlüsselrolle in der gemeinsamen Ätiologie psychischer und komorbide-auftretender körperlicher Erkrankungen wird dabei Veränderungen in der Regulation der neuroendokrinen Stressantwort, erhöhten Entzündungsprozessen und oxidativem Stress, dem schädlichen Überschuss an freien Sauerstoffradikalen, zugeschrieben. Angesichts der hohen Prävalenz von psychosozialem und traumatischem Stress über alle Gesellschaftsschichten hinweg ist es für die psychotherapeutische Praxis von großer Bedeutung, auch dessen molekulartoxische Folgen besser zu verstehen und in moderne Behandlungskonzepte zu integrieren. Es gilt, Interventionsmöglichkeiten auf psychobiologischer Ebene zu identifizieren, die stressassoziierte ­biomolekulare Veränderung im Körper rückgängig machen können. In diesem Beitrag soll deshalb insbesondere die Rolle von entspannungs- und achtsamkeitsbasierter Verfahren wie Entspannungstechniken, z.B. Hypnose, Mediation oder Yoga, betrachtet werden, die neben der Symptomreduktion auf klinischer Ebene auch die biomolekularen Veränderungen nach psychosozialem und traumatischem Stress reduzieren und so der gesundheitlichen Belastung entgegenwirken können. Obwohl entspannungs- und achtsamkeitsbasierte Verfahren im psychotherapeutischen Setting schon seit langem in unterschiedlichem Umfang eingesetzt werden, zeigt die aktuelle Studienlage, dass regelmäßig praktizierte entspannungs- und achtsamkeitsbasierte Verfahren eine bislang unterschätzte Interventionsmöglichkeit in der Psychotherapie sein könnten, die es zukünftig häufiger und gezielter in die gesamtkörperliche Behandlung stress- und traumaassoziierter Erkrankungen zu integrieren gilt.
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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that includes attention deficit, hyperactivity, and impulsivity as the core symptoms. Studies have reported that secondary symptoms of ADHD people include high trait anxiety, low self-esteem, and low self-acceptance. This two-part study investigated the efficacy of autogenic training (AT) for ADHD people. AT is considered to be effective for relieving anxiety, improving self-esteem, and self-acceptance. In Study 1, college students and ADHD people were compared to identify the psychological characteristics of ADHD people. In Study 2, ADHD people were randomly divided into an intervention and control group, and ADHD participants in the intervention group experienced an eight-week AT intervention. Results indicated that trait anxiety decreased significantly in the AT group. Moreover, there were improvements in self-esteem, and attention control, as well as a remarkable improvement in unconditional self-acceptance in the AT group (ηp²=.55) compared to the control. These results indicate that AT is effective for relieving anxiety, improving self-esteem and attention control, as well as promoting unconditional self-acceptance in ADHD people.
Chapter
Dargestellt werden die Möglichkeiten der Arbeit mit dem autogenen Training nach I. H. Schultz, einem physiologisch und tiefenpsychologisch fundierten Verfahren, das eine eigene Form der Psychotherapie darstellt. Hypnose wird in der Medizin als Ergänzung zu traditionellen Therapien (Unterstützung der Abwehr, Aktivierung der eigenen Ressourcen) und zur Bewältigung von Angst sowie zur Kontrolle/Bekämpfung von Schmerzen eingesetzt. Biofeedback ist eine apparative Methode zur Erlangung und Verbesserung der Selbstkontrolle über Vorgänge im Körper. Signale von Körperfunktionen werden erfasst und in Echtzeit rückgemeldet. Meditation ist ein Sammelbegriff für sehr unterschiedliche geistige Techniken und Übungen. Grundlegende Meditationsprinzipien sind konzentrative Aufmerksamkeitstechniken, Kontemplations- und Achtsamkeitsübungen und automatisches Selbsttranszendieren. In der Psychoneuroimmunologie wird untersucht, wie wechselseitige psychoneuroimmunologische Verbindungswege genutzt werden können, um die Gesundheit positiv zu beeinflussen.
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Twenty-one female patients suffering from diagnosed idiopathic Raynaud's Disease were trained to raise digital skin temperature using either autogenic training, progressive muscle relaxation, or a combination of autogenic training and skin temperature feedback. Patients were instructed in the treatment procedures in three one-hour group sessions spaced one week apart. All patients were instructed to practice what they had learned twice a day at home. Patients kept records of the frequency of vasospastic attacks occurring over a four-week baseline period, and during the first four weeks and the ninth week of training. In addition, patients underwent four laboratory cold stress tests during which they were instructed to maintain digital temperature as the ambient temperature was slowly dropped from 26 degrees to 17 degrees C. Cold stress tests were given during week 1 of baseline and during weeks 1, 3, and 5 of training. No significant differences between the three behavioral treatment procedures were obtained. In addition, the ability of patients to maintain digital temperature during the cold stress challenge showed significant improvement from the first to the last tests. Symptomatic improvement was maintained by all patients nine weeks after the start of training. The implications of these findings for the behavioral treatment of Raynaud's Disease are discussed.
Article
90 adult patients (aged 20–50 yrs) with essential hypertension were followed for 5 yrs. Initially the Ss were randomized into 2 groups: (1) an experimental group consisting of 44 Ss who received autogenic training and (b) a control group of 46 Ss who did not receive any behavioral intervention. By the end of the follow-up period, the experimental group was significantly different from the control group, with reduced blood pressure, a small increase in left-ventricular myocardial mass, improved psychological indices, and a decrease in the number of sick days of leave. Autogenic training appeared to be more effective in patients with mild hypertension than in those with moderate hypertension, and the results were comparable with those obtained with regular medication.
Article
Four groups of 25 healthy men and women undertook two-month courses of either mental training, with a specific method known as autogenic training, or physical training. The programmes were found to be safe and highly acceptable with a low drop-out rate. There were improvements in the psychological ratings in several groups, particularly with autogenic training. These measurements were supported by a generally improved sense of well-being reported by subjects in all groups, and accompanied by a decrease in symptoms of physical tension and improved ability to sleep. There were highly significant reductions in a wide variety of stress-related variables and cardiovascular risk factors in all training groups. It is suggested that training in such mental and physical skills is likely to be more effective than health education alone in preventing illness and in the promotion of what has been termed Positive Health.
Article
Autogenic training is a relaxation technique based on autosuggestions and practice in the perception of 'natural' relaxating processes of the body with an increasing calm basic attitude. The psycho-physiological changes that occur after periodical exercises can be explained by a plausible model which has been empirically proved in many of its aspects. With regard to methodological aspects the present study deals with the qualitative meta-analysis of 64 controlled clinical studies from 1952 to 1997. The clinical effect of autogenic training on the main symptoms as exclusive or at least central psychotherapeutic intervention (partly in combination with a somatic basic therapy) was evaluated. It was proved that autogenic training has positive effects on psychosomatic disorders (hypertension, asthma, intestinal diseases, 'vegetative dystonia', glaucoma, atopic eczema), on preparation for childbirth, sleep disorders and anxiety disorders. A positive effect can also be expected in case of headaches and Raynaud's disease, however, other relaxation techniques seem to be superior in these cases. Moreover, positive effects on the mood (e. g. depressive symptoms) and the general subjective condition (e. g. 'quality of life') have been proved by many studies. Hence indications can be derived according to the basic rules of evidence-based medicine. Nevertheless there are contraindications, for instance regarding exogenous, acute schizophrenic or affective psychosis. Beyond that the preparedness to therapy of many patients can be improved if the therapeutic offers are enlarged by autogenic training as a 'low level' offer. Autogenic training is an effective and useful component of preventive, rehabilitative or therapeutic interventions and can last but not least be part of therapeutic interventions which include naturopathy.
Article
This paper presents the results of a 3-year follow-up study on the effectiveness of additional autogenic training (AT; a psychophysiological self-control method using self-inductions of physical and mental relaxation) in the psychotherapy of outpatients with depressive disorders. Subjects were 55 patients (aged 22–69 years) with depressive disorders diagnosed according to ICD-10. Subjects were randomized to one of three groups: Group A participated in 40 single psychotherapy sessions over a period of 20 weeks; Group B learned AT in the first 10 weeks and had 20 single psychotherapy sessions as well as AT practice in the second 10 weeks; Group C was the waiting-list control group in the first 10 weeks and had 20 single psychotherapy sessions as well as AT learning in the second 10 weeks. Tests for depressive symptoms (BDI) and psychosomatic complaints (AT-SYM) were given before the start of treatment, after 10 weeks, after 20 weeks, as well as 8 months and 3 years after the end of treatment. In addition, at both follow-ups information were gathered on disease course, relapses, psychotherapy and medical treatments, as well as AT practice. Long-term follow-up shows that controlled and supervised use of AT before or in combination with psychotherapy has more positive effects than psychotherapy alone. Compared to psychotherapy without AT (Group A), combined psychotherapy and AT (Groups B and C) resulted in significantly lower rates of relapse and treatment reentry as well as in significantly more stable positive treatment effects in the reduction of depression and psychosomatic symptoms at the second follow-up.
Examined the effectiveness of autogenic training on patients with depressive disorders. Human Ss: 55 German male and female adults (depressive) (aged 22–69 yrs) (mean age 41.3 yrs). Autogenic therapy was applied to Ss in 3 groups: with vs without pre-experience in autogenic training, a waiting list control group without any treatment, and a group under integrated psychotherapy. The effectiveness of the autogenic training was assessed after 10 wks and after 29 wks. Autogenic therapy was correlated with psychotherapy. The indications and relative contraindications of autogenic training in Ss were discussed. Tests used: Beck's Depression Inventory and ICD-10. (English abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Four relaxation techniques, autogenic phrases, frontalis muscle biofeedback, unaided self-relaxation, and a noncontingent tone, were compaired for their ability to help hospitalized psychiatric patients to relax. The four treatment groups were assessed before and during four daily 20-min training periods, in a 4×4 independent groups by repeated measures anlysis of variance design. Frontalis muscle tension, heart rate, skin resistance, hand and forehead temperature, and the Nowlis Mood Adjective Check List (MACL) were used to measure baseline and within-session treatment effects. Heart rate, and MACL “anxiety” and “egotism” scores decreased significantly with the noncontingent tone treatment. However, except for a decrease in MACL “anxiety” during the autogenic phrases, the other three treatments did not significantly affect any of the measures.
Article
M-mode echocardiograms were obtained on unmedicated males with mild hypertension before and after treatment with thermal biofeedback, autogenic training, or self-relaxation. Although patients for whom diastolic blood pressure (DBP) was successfully reduced showed trends toward reduction in left ventricular parameters while unsuccessful patients showed no changes, the results were not significant. For the four patients with borderline left ventricular hypertrophy, there was a strong trend (p=.06) for successful treatment to lead to a reduction in left ventricular mass. Moreover, across the whole sample, reduction in left ventricular mass was related (r=.30) to decrease in DBP.
Article
Two methods of relaxation therapy, electromyograph biofeedback and autogenic training, were compared to a nonrelaxation treatment, electrosleep therapy, in reducing sleep latency among 22 chronic, sleep-onset insomniacs. While none of the electrosleep patients improved on all-night laboratory electroencephalographic sleep records or daily home sleep logs, approximately one-half of the relaxation-treated patients showed marked improvement, which was sustained over a 1-month follow-up period. Although some sleep and treatment variables differentiated relaxation therapy responders from nonresponders, external stress appeared to be the most salient factor. Successful and unsuccessful patients could not be differentiated on any of the psychological variables studied.
Article
In order to assess the effectiveness of verbal relaxation instructions and EMG relaxation training on the relief of tension headaches, 18 medically documented tension-headache sufferers were randomly assigned to one of three conditions:(1) Jacobson-Wolpe autogenic-relaxation training,(2) EMG relaxation training, or(3) EMG relaxation training combined with Jacobson-Wolpe autogenic instructions. The two EMG-assisted groups showed significantly better results, compared to the verbal group, in terms of reduction of headache activity and the rate at which reduction took place. Thus, EMG-assisted relaxation procedures seem the treatment method of choice for relief of tension headaches.
Article
In order to assess the efficacy of a behavioral intervention in the treatment of idiopathic Raynaud''s disease, 30 female patients were trained to control their digital skin temperature using autogenic training or a combination of autogenic training and skin temperature feedback either in the laboratory or at home. All trained subjects demonstrated a significant ability to maintain digital skin temperature in the presence of a cold stress challenge and reported significant reductions in both frequency and intensity of vasospastic attacks. The addition of skin temperature feedback to autogenic training did not provide additional clinical benefit.
Article
The effects of the Respiratory Autogenic Training (RAT) for childbirth preparation on relaxation and anxiety during the course and on pain and behaviour during delivery were compared with those of the traditional psychoprophylactic course (TPP) in primipara. Women were assigned randomly to one of the two courses and double blind conditions were maintained where possible. Of the 53 selected primipara only 34 completed the study (14 of the RAT and 20 of the TPP courses). Both courses had similar outcomes but, having eliminated by means of covariance analyses the effects of the initial anxiety level, the RAT participants reported less anxiety before entering the labour ward and less pain during labour. The expulsion time, corrected for ‘anxiety before labour’ (covariate) was shorter in the RAT group. In none of the RAT participants but in 4 women of the TPP group the vacuum extractor had to be used.
Article
In order to assess the effectiveness of verbal relaxation instructions and EMG relaxation training on the relief of tension headaches, 18 medically documented tension-headache sufferers were randomly assigned to one of three conditions: (1) Jacobson-Wolpe autogenic-relaxation training, (2) EMG relaxation training, or (3) EMG relaxation training combined with Jacobson-Wolpe autogenic instructions. The two EMG-assisted groups showed significantly better results, compared to the verbal group, in terms of reduction of headache activity and the rate at which reduction took place. Thus, EMG-assisted relaxation procedures seem the treatment method of choice for relief of tension headaches.
Article
Thirty-four patients having chronic idiopathic headaches participated in a long-term study comparing autogenic relaxation training alone (REL) with combinations of relaxation and electromyographic biofeedback (REL + EMG) or relaxation and temperature biofeedback (REL + TEMP). Assignment to treatment conditions was balanced on demographics and clinical characteristics, as well as headache classification according to muscle contraction or vascular headache symptomatology. The results indicate that REL + TEMP produced no additional improvements over REL following the 8-week treatment program, or at 6-month, or 12-month follow-up. However, REL + EMG produced significantly greater reductions in headache activity measures than the REL and REL + TEMP conditions at all post-treatment time points. Headache activity continued to improve over the follow-up period independent of treatment condition. These data indicate that EMG biofeedback augments long-term clinical improvements in headache patients who undergo autogenic relaxation training.
Article
The research investigated the autogenic training (AT) effects, analyzing the emotional and somatic distress symptoms of patients during their learning of the AT standard exercises (N = 79). An improvement was observed even before the beginning of the course, thus demonstrating the Balint effect of the drug-doctor phenomenon. The control subjects, entered in a waiting list, showed no further improvements from this phase of the study; the experimental ones, who had begun their AT exercises, continued to show significant improvement.
Article
The aim of the present study was (a) to investigate the relative efficacy of autogenic training and future oriented hypnotic imagery in the treatment of tension headache and (b) to explore the extent to which therapy factors such as relaxation, imagery skills, and hypnotizability mediate therapy outcome. Patients were randomly assigned to the 2 therapy conditions and therapists. 55 patients (28 in the autogenic therapy condition and 27 in the future oriented hypnotic imagery condition) completed the 4 therapy sessions and 2 assessment sessions. No significant main effect or interaction effects for treatment condition or therapist was revealed. A significant effect for time in analyzing scores for headache pain, pain medication usage, depression, and state anxiety was found. In the self-hypnosis condition, pain reduction proved to be associated with depth of relaxation during home practice (as assessed with diaries) and capacity to involve in imagery (as assessed with the Dutch version [van der Velden & Spinhoven, 1984] of the Creative Imagination Scale [Barber & Wilson, 1978/79; Wilson & Barber, 1978]). After statistically controlling for relaxation and imagery, hypnotizability scores (as assessed with the Dutch version [Oyen & Spinhoven, 1983] of the Stanford Hypnotic Clinical Scale [Morgan & J.R. Hilgard, 1975, 1978/79]) were significantly correlated with ratings of pain reduction. Results are discussed in the context of the neo-dissociation and social-cognitive model of hypnoanalgesia. The clinical relevance and the methodological shortcomings of the present study are also critically assessed.
Article
SYNOPSIS The purpose of this investigation was to evaluate the long-term course of non-invasively treated chronic headache. A total of 1015 adult patients with primary diagnosis of vascular/ migraine or muscle contraction headache participated in the study investigating symptom frequency and severity over a 36 month period after receiving treatment. Treatment consisted of either: relaxation training (stepwise relaxation/hypnosis/ autogenic training/cognitive behavior therapy); biofeedback (thermal/photoplethysmograph/EMG); micro-electrical therapy (TENS/Neurotransmitter Modulation) or multimodal treatment (combination of any of the above two treatments). Seven hundred and ninety-three patients returned sufficient data to be included in the analysis. Patients were randomly assigned to treatment groups and received either short term intervention (15 or less treatments) or long term intervention (greater than 15 treatments). Results indicate that all treatment conditions significantly reduced frequency and intensity of cephalalgia. Repeated measure analysis of variance indicated that grouping variables of Biofeedback treatment, symptoms being evidenced less than 2 years and receiving over 15 treatment sessions best predicted successful intervention.
Article
A detailed 402 patient survey explored the psychological concomitants of arterial hypertension. Non-linear correlation analysis was used to uncover the strong association of psychic and somatic aspects in patients with arterial hypertension and to suggest new methods for their ambulatory rehabilitation. Aspects of patient compliance were considered, taking into account the patients' psychic status. Particulars of doctor--patient relationship were discussed and strong emphasis was placed on close psychological affinities between the two as the prerequisite for fostering patient compliance. A multi-dimensional study, is was concerned with assessing the efficiency of both drug therapy (hypotensive and psychotropic drugs and an association of the two) and other types of therapy (autogenous training, therapeutic relaxation exercise) for the rehabilitation of patients with arterial hypertension by means of polyclinic-based ambulatory care.
Article
Quantitative measurements of finger blood flow have not been performed during temperature biofeedback or other treatments for Raynaud's disease. In the present investigation, finger blood flow was determined with venous occlusion plethysmography, in addition to measurements of finger temperature, heart rate, blood pressure, and skin conductance level. After a maximum vasodilation test, subjects received 10 sessions of finger temperature biofeedback or autogenic training. There were no group differences during the maximum vasodilation test. During training, temperature feedback subjects showed significant elevations in finger blood flow, finger temperature, and skin conductance level, whereas those who received autogenic training did not. These findings could not be explained by group differences in other cardiovascular measures and are consistent with previous studies suggesting the involvement of an active vasodilating mechanism in temperature feedback.
Article
Ninety patients with essential hypertension were followed for 5 years. Initially the patients were randomized into two groups: (a) an experimental group consisting of 44 patients who received autogenic training and (b) a control group of 46 patients who did not receive any behavioral intervention. By the end of the follow-up period, the experimental group was significantly different from the control group, with reduced blood pressure (by 5.8 mm Hg systolic and 3.2 mm Hg diastolic vs. 4.3 mm Hg systolic and 2.0 mm Hg diastolic), a smaller increase in left-ventricular myocardial mass (14.6 g vs. 38.2 g), improved psychological indices, and a decrease in the number of sick days of leave. Autogenic training appeared to be more effective in patients with mild hypertension than in those with moderate hypertension and the results were comparable with those obtained with regular medication.
Article
We examined 117 outpatients (20- to 45-year-old men) with mild essential hypertension before treatment, after the main treatment course (6 weeks), and at 12-month follow-up. The patients were randomized into two major groups: (a) a treatment group that received autogenic training (23 patients), biofeedback (24 patients), or breathing-relaxation training (23 patients) and (b) a control group that consisted of 24 patients who did not receive any intervention and 23 patients who were treated with a "psychological placebo." Clinical, psychological, and psychophysiological data from all patients who were offered relaxation therapy were analyzed. By the end of follow-up, and compared to the control group, the treatment group demonstrated a significant reduction in systolic and diastolic blood pressures, peripheral vascular resistance, and hypertensive response to emotional stress, and an improvement in psychological adaptation, quality of life, and capacity for work. Comparative analysis of the efficacy of different relaxation methods revealed that biofeedback and breathing-relaxation training resulted in the greatest reduction in blood pressure. The antihypertensive effect of relaxation therapy correlated positively with pretreatment blood pressure levels and negatively with the duration of illness and certain psychological features.
Article
We have conducted a cross-cultural (USA and USSR) comparison of thermal biofeedback (TBF) and autogenic training (AT) to a self-relaxation control condition in 59 unmedicated males with mild hypertension. Identical assessment and treatment protocols were carried out in both settings (Albany, New York, and Moscow). Treatments were delivered in small groups on an outpatient basis twice per week for 10 weeks. Results showed comparable, significant (p less than .05), short-term decreases (M = 8.5 mm Hg) in diastolic blood pressure (DBP) for both treatments at both sites. However, the Soviet patients, starting with significantly (p less than .01) higher systolic blood pressures (SBPs), showed significant decreases (M = 12.8 mm Hg) in SBP, whereas the American patients did not change appreciably (M = 4.6 mm Hg). During follow-up, the treated Soviet patients showed significantly (p less than .05) better maintenance of treatment effects, from 3 months to 1 year, than did the American patients. At 1 year, 75% of the treated Soviet patients had DBPs less than 90 mm Hg, whereas only 24% of the American patients had comparable DBPs.
Article
Patients with labile hypertension received various kinds of nonmedicinal therapy: psychological intervention (40 patients), acupuncture (25 patients), physical training (11 patients). Chemotherapy was provided to 38 patients. A significant antihypertensive effect was achieved with the use of the nonmedicinal therapeutic methods. Their efficacy was comparable with that of chemotherapy.
Article
A comparative study of the use of GSR feedback (n = 16) and Schultz relaxation (n = 15) with patients presenting tension headaches showed that there was no significant improvement in the group treated by relaxation at the end of the treatment whereas the group treated by GSR feedback showed significant improvements with respect to frequency and intensity of headaches and to anxiety as measured by subjects' self-evaluation (P less than 0.05). Intergroup comparison demonstrated a greater improvement in headache intensity for the GSR feedback group than for the relaxation group (P less than 0.05) at the post-treatment stage. Likewise, the percentage of patients showing at least 50% improvement as to headache frequency was significantly higher (P less than 0.05) in the GSR feedback than in the relaxation group. High pre-treatment EMG and high pre-treatment weekly pain level indicate a good prognosis of improvement with respect to post-treatment headache frequency and intensity respectively in the case of the GSR feedback group. We found no prognostic factor for post-treatment clinical improvement in the relaxation group.
Article
Headache variables were examined for 136 subjects who participated for 36 weeks in one of four groups--No Treatment, Autogenic Phrases, Electromyographic (EMG) Biofeedback, and Thermal Biofeedback. All subjects kept daily records of headache activity and medication usage and participated in 22 laboratory sessions during which frontalis electromyographic and hand-temperature measurements were taken; those in the three treatment groups practiced at home. There was a substantial reduction in headache variables in all groups. The No-Treatment Group differed significantly from the treatment groups combined, with the least reduction in headache variables. The Thermal Biofeedback Group vs. EMG Biofeedback and Autogenic Phrases Groups showed a suggestive trend toward improvement in the frequency and intensity of total headache.
Article
Forty-one headache patients were classified into tension-headache, migraine or combinedheadache groups. After a 2-week baseline period they were assigned to either autogenic training (AT) or progressive relaxation (PR). Treatment was conducted in small groups over 12 sessions. Three months after treatment, the patients returned for a follow-up session. Patients charted their headache every 4 hr throughout the baseline and treatment periods and again 2 weeks prior to the follow-up session. PR was more successful in the treatment of tension headache, whereas for migraine cases, both treatments seemed equally effective. For combined headaches, PR lagged behind AT. Among headache Subparameters, the duration and frequency of pain periods were mainly affected, with the exception of the tension-headache PR condition, in which decreases in duration and intensity of pain occurred jointly.
Article
16 patients with an irritable colon were examined psychologically and independent of the result of the diagnostics of neuroses additionally distributed to two groups of treatment. One group was treated symptomatically, the other additionally psychotherapeutically (above all with autogenous training). Two thirds of the patients showed a neurosis. Psychotherapy was very useful only in those patients with a neurosis, measured as the result of the treatment one year after the beginning of the therapy. When an obstinate irritable colon is present, a diagnostics of neuroses is indicated. If a neurosis is proved, an individual psychotherapy is indicated, in which case the autogenous training as basis therapy apparently stood the test.
Article
To evaluate the role of active and passive instructions to Ss given abbreviated training with Schultz and Luthe's six exercises, 18 Ss completed the test anxiety questionnaire and the Wonderlic Personnel Test. Analyses of repeated (two) measures showed treatment decreased test anxiety scores somewhat more for active Ss; 78% of Ss reported high relaxation was achieved and improved performance.
Following investigation of 500 juvenile hypertensives (first degree of severity) which uncovered characteristic maladaptive behavior patterns, a complex psychotherapy was developed which foccused upon the achievement of changes in these conflict intensifying maladaptive behavior patterns. The effectiveness of the complex psychotherapeutic approach was determined in a group of 46 hypertensives on the basis of a systolic and diastolic drop in blood pressure (in per cent of initial value) over a short period and over a more extended time (discharge from the clinic, followup after 1 and 2 yr). In comparison to 5 other therapy groups (treated with antihypertensive, psychopharmaca, and combined methods) the effectiveness of this complex psychotherapy was shown. (10 references.)
Article
In this preliminary pilot study a technique similar to Schultzs autogenic training method was presented to 10 college students individually and to 23 comparable students in a group. Self-ratings of individually-trained Ss showed slight but systematic superiorit