Electrodermal Activity and Stress Assessment.

Stress, as a kind of emotion, is inevitable in everyday life. In psychosomatic medicine stress represents a powerful link in the pathophysiological chain of disorder. Having evidence about the power of stress on the body, the interest in medicine was how to measure it in appropriate, fast way and with minimal cost. Electrodermal activity seems to be available for this purpose. The galvanic skin response (GSR) is an objective, transient indication of autonomic nervous system arousal in response to a stimulus. It refers to changes in sweat gland activity that are reflective of the intensity of our emotional arousal. In this article we discuss physiological specifics of skin conductance/resistance and how it is measured in practice. The most used application of GSR is in biofeedback methodology. Biofeedback assessment and training exactly uses skin reaction to different stimuli and aims to gain voluntary control over this autonomic response. The aim of this article is to show effectiveness of this method in paediatric practice.

Neurofeedback - A Method Which Trains the Brain to Obtain Changes in Behaviour.

EEG can determine changes in brain activity that might be useful in diagnosing different brain disorders as well as some mental states. Many advantages of this record have been the reason for resurrect the EEG in current clinical practice and research. More sophisticated form, the Q-EEG comprises a procedure that processes the recorded EEG activity from a multi-electrode recording using a computer, where data is processed with various algorithms, such as the Fourier or Wavelet analysis. Q-EEG data are important as a marker for many psychophysiological disorders. Neurofeedback (NF) is a form of behavioural training aimed at developing skills for self-regulation of brain activity. It is a treatment method for altering brain functioning by the use of signals provided to a patient that reflect the moment-to-moment changes in the patient's electroencephalogram. This article summarizes some of our large experience with neurofeedback training in different groups of disorders in children and adolescents. Positive outcome is promising for more expansive use of this non-pharmacological, cost-benefit methodology in paediatric and general population.

On Psychosomatic Problems in Dentistry.

In their daily practice dentists frequently have patients showing signs of stress-related oral manifestations in different forms. Stress-related aetiology of oral changes are still not investigated enough, and present a subgroup of psychosomatic diseases which had been recognized in medicine a long time ago. Recognition of such psychological or emotional disturbance needs deep evaluation "per exclusionem", and is beneficial for both the patient and clinician. Psychological management should be taken into consideration when treating patients with these psychosomatic disorders. Therapeutic approach comprises different forms of psychotherapy and medication as well.

Anorexia: Anormal Phobia of Normal Weight.

Anorexia nervosa is a disorder of feeding behavior associated with distortion of body image, mood disturbance and a wide variety of hormonal and metabolic abnormalities. It is supposed that the disease could be the consequence of a combination of cultural-social, psychological and biological factors. Our study confirmed that anorexia mentalis is a serious, life threatening disorder which in our country appears earlier than it was expected and that is strongly related to environmental factors (family, school, fashion, society). We showed that specific personality traits are characteristic for both, young patients and mothers. Sublimation of emotional stress by exceptional performances, accompanied by food restrictive consumption together with hypersensitivity, oppositional behavior and aggression are specific for this disorder. High levels of self-imposed standards increase the risk for psychological distress, especially for eating disorder symptomatology. Both genders could be involved as patients. Boys must be especially followed for possible psychiatric manifestation. We confirmed that the biofeedback as additional therapeutic modality is very useful.

The Use of Smartphone in Medical Practice.

In this review we present some data about the use of mobile phones in medical practice. The results of over hundred studies cited in PubMed during the last few years have been discussed. The article gives background connected with a project in the Macedonian Academy of Sciences and Arts referring to a personal mobile phone application named "Neurogame" which is currently constructed to evaluate motor skills related to attention and concentration in different samples of people.

Emotional health in children and adolescents with cystic fibrosis.

Although modern therapeutic procedures have considerably improved the survival and the quality of life of children with cystic fibrosis, the relevant psychological aspects have been still insufficiently considered similarly to the other chronic diseases. The aim of this research was to evaluate the emotional health: psychological characteristics and adjustment of CF children and their family coping. The study comprises 25 CF children, mean age 13.13 ± 2.29 years (23 boys and only 2 girls), selected from total 60 actually treated children for CF. Children were examined in the period of improved health conditions (without superinfection, wheezing or gastrointestinal problems). Obtained results are compared with a control group of 25 healthy children of the same age, selected by random from primary schools. The psychometric instruments used were: Kohs Design Test, Child Behavior Checklist, Eysenck Personality Questionnaire, General Anxiety Scale, Emotional Profile Index, MMPI-201 and Human Values Test, together with two projective tests of drawing (Machover and Corman). The unexpected good psychological results obtained from psychometric instruments could be explained by the fact that CF children accept the real situation and express vivacity. However, their deep feelings of fear impose on them high level of self-control and resistance. The results obtained for CBCL presented CF children as immature, with accentuated aggressiveness in interpersonal relations. The most important problem is related to the delay of puberty changes, leading to low self-esteem. Generally, family members cope relatively well with the disease in children, in spite to discrepancies in mother/child reports for child psychopathology. Divorces also occurred in some families. Psychological support for both, children and family members are necessary. The need for a holistic approach in the assessment and treatment, including biofeedback techniques was pointed out.

Game-based peripheral biofeedback for stress assessment in children.

BACKGROUND: Peripheral biofeedback is considered to be an efficient method for assessment and stress mitigation in children. The aim of the present study was to assess the levels of stress and stress mitigation in healthy school children (HSC), in children with cystic fibrosis (CF), general anxiety (GA) and attention-deficit-hyperactivity disorder (ADHD). METHODS: Each investigated group (HSC, CF, GA, ADHD) consisted of 30 school-aged children from both sexes. Psychological characteristics were evaluated on Eysenck Personality Questionnaire (EPQ). The lie scale was used to determine participant honesty. Four biofeedback games using a pulls detector were applied for assessment of the stress levels as well as to evaluate ability to relax. RESULTS: EPQ found more psychopathological traits (P < 0.001) and less extroversion (P < 0.001) in children with GA and ADHD. In addition, high neurotic tendencies were found in children with CF (P < 0.01) and GA (P < 0.01). Unexpectedly, the lie scale was lower in ADHD children (P < 0.01) than in all other groups (HSC, CF, GA). The Magic blocks score was significantly different in relaxation levels between control and CF children (P < 0.05). Speed in the game Canal was significantly different in relaxation levels between healthy controls and all other groups, but no changes in pulls, as a relaxation measure, were found during the game. The CF group had much more commissions stemming from impulsivity (t= 5.71, P < 0.01), while the GA and ADHD children had more inattention omissions (P < 0.05). Strong negative correlation between age and pulls (r= 0.49, P= 0.003) and strong negative correlation between age and omissions (r=-0.86, P= 0.029) were found among all groups analyzed. CONCLUSIONS: The ability to learn stress mediation is correlated with age. All three groups of children had significantly lower relaxation levels when compared to healthy controls. Relaxation was more difficult for children with GA or ADHD, and easier for children with CF.

Simultaneous EEG and EMG biofeedback for peak performance in musicians.

The aim of this study was to determine the effects of alpha neurofeedback and EMG biofeedback protocols for improvement of musical performance in violinists. The sample consisted of 12 music students (10 violinists and 2 viola players) from the Faculty of Music, Skopje (3 males, mean age of 20 +/- 0 and 9 females, mean age = 20.89 +/- 2.98). Six of them had a low alpha peak frequency (APF) (< 10 Hz), and six a high APF (> 10 Hz). The sample was randomized in two groups. The students from the experimental group participated in 20 sessions of biofeedback (alpha/EMG), combined with music practice, while the students from the control group did only music practice. Average absolute power, interhemispheric coherence in the alpha band, alpha peak frequency (APF), individual alpha band width (IABW), amount of alpha suppression (AAS) and surface forehead integrated EMG power (IEMG), as well as a score on musical performance and inventories measuring anxiety, were assessed. Alpha-EEG/EMG-biofeedback was associated with a significant increase in average alpha power, APF and IABW in all the participants and with decreases in IEMG only in high-APF musicians. The biofeedback training success was positively correlated with the alpha power, IcoH, APF, IABW and baseline level of APF and IABW. Alpha-EEG/EMG biofeedback is capable of increasing voluntary self-regulation and the quality of musical performance. The efficiency of biofeedback training depends on the baseline EEG alpha activity status, in particular the APF.

Spectrum-weighted EEG frequency ("brain-rate") as a quantitative indicator of mental arousal.

A concept of brain-rate is introduced, defining it as the weighted mean frequency of the EEG spectrum. In analogue to the blood pressure, heart-rate and temperature, used as standard preliminary indicators of corresponding general bodily activations, it is proposed to use the brain-rate as a preliminary indicator of general mental activation (mental arousal) level. In addition, along with the more specific few-band biofeedback parameters (theta-beta ratio, relative beta ratio, etc.), the brain-rate could be effectively used as a general multiband biofeedback parameter.