Biofeedback Assisted Stress Management in Patients with Lung Cancer: A Feasibility Study.

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death for men and women in the United States. NSCLC causes a variety of symptoms which result in significant distress and reduced quality of life for patients. Behavioral and other non-pharmacologic treatment interventions for NSCLC have resulted in improved quality of life, reduced emotional distress, and improved longevity. This study investigates the feasibility and effectiveness of biofeedback assisted stress management (BFSM) to reduce stress in patients with NSCLC. Because of patient dropout, this study was terminated prematurely. Despite this, evaluation of data revealed positive trends, with patients learning to reduce their stress, improve their respiration and heart rate variability, and improve coping. These trends suggest that patients with NSCLC can learn to self-regulate physiology and BFSM may be useful for them, although a less ill patient population may be desirable for future investigations.

A systematic review of stress-management interventions for multiple sclerosis patients.

BACKGROUND: The objective of this study was to identify stress-management interventions used for people with multiple sclerosis (MS) and systematically evaluate the efficacy of these interventions. METHODS: Several strategies were used to search for studies reported in articles published up to 2013. RESULTS: Our initial search retrieved 117 publications, of which 8 met our criteria for review. Of the eight studies, one provided Class I evidence, five provided Class III evidence, and two provided Class IV evidence for the efficacy of stress-management interventions according to the evidence classification established by the American Academy of Neurology. Most studies showed positive changes in outcomes assessed; however, the range of methodological quality among the published studies made it difficult to draw conclusions. CONCLUSIONS: The promising findings for stress-management interventions highlight the need for future studies. Additional large, prospective, multicenter studies will help to define the role of stress-management interventions in the treatment and course of MS. Furthermore, including outcome measures based on biological and clinical markers of disease will prove useful in understanding potential underlying mechanisms.

Frequency of depression and anxiety before and after insertion of a continuous flow left ventricular assist device.

Our objective was to investigate the course of depression and anxiety symptoms in patients treated with continuous flow (CF) left ventricular assist devices (LVADs). Depression and anxiety are associated with poor outcomes in patients with heart failure, yet few studies have examined such symptoms in patients with CF-LVADs. Depression and anxiety were measured as part of routine clinical care in patients who received a CF-LVAD at our institution from October 2009 to April 2012. Sixty-six patients completed the Patient Health Questionnaire-9, and 48 of 66 patients also completed the Generalized Anxiety Disorder Questionnaire-7. Nineteen of 66 patients completed measures before implantation. Patients who completed measures before and after implantation demonstrated significant improvements in depression and anxiety scores. All patients showed significant improvements in depression and anxiety scores from implantation to the first time point after implantation. Pairwise mean comparisons between time intervals after implantation were not significant. In conclusion, depression and anxiety scores improve after CF-LVAD implantation and remain stable up to 1 year. The improvement does not depend on baseline psychotropic medication use and may be related to improved physical health.

Heart rate variability as a marker of self-regulation.

Self-regulation is central to many of the most important individual and societal problems today. We sought to determine whether the relationship between self-regulation and heart rate variability (HRV) could be replicated and extended. We hypothesized that baseline HRV would predict persistence on an anagram task, and that under conditions requiring greater self-control, HRV would increase. Two groups were given the same set of difficult and unsolvable anagrams. To induce self-regulatory fatigue, the suppression group was asked to try to not think of a white bear while the expression group was asked to try to think of a white bear. Baseline HRV predicted persistence on the unsolvable anagram. Both groups demonstrated changes in HRV relative to baseline, although we were unable to replicate findings that HRV was elevated during high self-regulatory effort. We were, however, able to replicate findings that the expression group persisted longer on the anagram task compared to the suppression group but only when accounting for physical activity scores. The present study advances our knowledge of the relationship between HRV and self-regulation, so that we can more successfully treat those with seriously impaired self-control.