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Clinical Outcomes in Addiction: A Neurofeedback Case Series

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Abstract

This case series (N = 30) shows the impact of an addiction treatment approach that uses phenotype-basedneurofeedback in an integrated clinical treatment (Crossroads Institute), which combines targeted brain recovery exercises and neurotherapy. We present pre- and post-neurocognitive testing and electroencephalography/quantitative electro- encephalography measures of the phenotype findings in this polysubstance-based addict population. The electroencephalography phenotypes identify two separate drive systems underlying individual addiction: central nervous system overactivation and obsessive/compulsive drives. In addition to sobriety and abstinence, the neurocognitive improvements documented are particularly impressive. Background According to a survey by the National Institute on Drug Abuse (NIDA), addiction is characterized by compulsive cravings, drug seeking, and drug use, which persist in the face of consequences (Substance Abuse and Mental Health Services (SAMHSA), 2006). For many, addiction is a chronic condition, with relapses occurring even after long periods of abstinence. Relapse rates are quite strikingly similar to rates for other chronic medical illnesses such as asthma. Like any chronic illness, addiction treatment generally requires repeated and persistent intervention to extend the time between relapse as well as to diminish the relapse severity and duration. Through treatment, people with drug addiction can lead productive lives. The U.S. Substance Abuse and Mental Health Services Administration states that chemical dependency, along with associated mental health disorders, has become one of the most severe health and social problems facing the United States. In the United States, 12.5% of the population has a significant problem with alcohol or drugs, with 40% of these individuals having a concurrent mental/nervous disorder (the so-called dual diagnosis). The medical costs are approximately 300% higher for an untreated alcoholic than for a treated alcoholic. About 70% of addicts are employed, with their addiction contributing substantially to absenteeism, turnover costs, accidents/injuries, decreased productivity, increased insurance expenses, and even workplace violence. Costs related to addiction include those related to violence and property crimes, prison expenses, court and criminal costs, emergency room visits, health care utilization, child abuse and neglect, lost child support, foster care and welfare costs, reduced productivity, and unemployment. Of Americans aged 12 years or older, 22.5 million need treatment, but only 3.8 million people receive it (SAMHSA,
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Clinical Outcomes in Addiction: A Neurofeedback Case Series
Gunkelman, Jay;Cripe, Curtis, PhD
Biofeedback; Winter 2008; 36, 4; ProQuest Psychology Journals
pg. 152
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
... Advances in basic and computational neuroscience, brain mapping, neural engineering and brain machine interfaces are exponentially transforming our ability to maintain astronaut cognitive performance and mental health. The function of large-scale brain networks offers a powerful paradigm for modeling and explaining cognitive and affective operations that support task performance and mental health, while neural decoding algorithms have enabled the development of brain machine interfaces, robust neuroprosthetics, and adaptive countermeasures to overcome deficits in attention, depression, and other mental health challenges [1][2][3][4][5][6][7][8][9][10][11]. Non-invasive imaging (e.g. ...
... Presently, in clinical practice, Cripe [8][9][10][11] has successfully applied neural functional connectivity measures of cognitive resilience to both pediatric and adult Earth based analog populations. These methods have consistently and quantifiably aided these populations in both identifying dysfunctional neural networks, and in ameliorating learning and brain development issues, TBI, and substance abuse [8][9][10][11]. ...
... Presently, in clinical practice, Cripe [8][9][10][11] has successfully applied neural functional connectivity measures of cognitive resilience to both pediatric and adult Earth based analog populations. These methods have consistently and quantifiably aided these populations in both identifying dysfunctional neural networks, and in ameliorating learning and brain development issues, TBI, and substance abuse [8][9][10][11]. This occurred by strengthening performance within dysfunctional brain networks, which resulted in more robust cognitive resilience and ego-strength. ...
... Furthermore, evidence suggests that ego depletion detrimentally affects not only selfcontrol and executive function, but also our general cognitive resilience as well, thus affecting performance on many tasks. From resiliency and coping studies in earth based analog populations that include learning challenged children, adults with Traumatic Brain Injury (TBI), and those in substance abuse recovery, the author has found this concept to be not only true, but also a key ingredient in the treatment remediation plan for individuals with brain-based challenges [22,23,24]. ...
... Presently, in clinical practice the author has successfully applied measures of cognitive resilience, based upon specific brain measurements as real time neuro responses, to both child and adult earth based analog populations. These methods have consistently and quantifiably aided these earth analog populations in identifying and in recovery from learning and brain development issues, TBI, and substance abuse [22,23,24]. If similar objective brain response measures were obtained during a mission, this added data will give mission control teams a window into how to assist structuring onboard crew mission activities as well as assigning similar brain based exercises as used in earth based analog populations to help ensure mission success. ...
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Full-text available
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Preprint
Full-text available
Neurofeedback brain-training has a significant presence in the literature for its efficacy in alleviating the symptoms and behavioral manifestations of ADHD, with no enduring negative side-effects. It is considered a behavioral intervention in that it teaches the brain to better manage its own brainwave activity, leading to reduction of 80-85% of symptoms in the first 30-40 training sessions. Brain-training has shown efficacy in treating autism spectrum disorder, anxiety, depression, learning disabilities, and many more brain-imbalances that prevent children from full academic and social capacity. Barriers to broad-based implementation in both clinical and subclinical settings include cost of equipment, lengthy, in-depth training requirements, and a lack of clear guidance in developing and implementing brain-training protocols specific to each individual's brain-phenotype. Automated Psychophysiological assessment and EEG Biofeedback training systems demonstrate equal efficacy as clinician-guided EEG Systems. We propose that Automated EEG Biofeedback systems have evolved to differentiate and train a multiplicity of brain-phenotypes related to symptoms of ADHD and other childhood developmental disorders. Further, these systems decrease the cost of brain-training significantly, reduce the training requirements for brain-trainers, and significantly increase the effectiveness of all other behavioral and academic school/district level interventions. We propose that automated brain-training can be implemented at a school/district level, by a licensed school social worker, counselor, nurse or other person qualified by their understanding of behavioral training.
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Full-text available
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During the 40-plus-year history of EEG biofeedback, now also called neurofeedback (NF), the approach has been used clinically to address attentional problems in attention deficit-hyperactivity disorder (ADHD). Initially, NF was based on the theta/beta ratio, which was measured with eyes open, at the vertex, or the Cz electrode in the International 10–20 Electrode placement system. Generally, the early NF work was based on enhancing beta and reducing the slower theta content (Monastra et al. 1999).
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