A Contemplative Biofeedback Intervention for Adults with Autism Spectrum Disorder: Feasibility of a Community-Based Treatment.

As the number of diagnosed adults living with autism spectrum disorder (ASD) continues to grow, a lack of resources and lack of available interventions exacerbate their low quality of life, including low levels of education and employment, and high levels of co-morbid anxiety and depression. Here we build upon existing research showing the effectiveness of contemplative interventions on individuals with ASD, to provide a low-cost biofeedback-enhanced training which can be implemented by non-professional staff, and may help autistic individuals grasp abstract contemplative techniques. We hypothesize that the intervention will decrease participants' anxiety and autism symptoms, and increase their self-awareness, self-determination, and empathy. Fourteen adults with ASD, residing in assisted living, were provided with 16 weekly half-hour contemplative-biofeedback sessions with non-professional trainers, in which they learned to reduce their arousal levels through combined biofeedback and contemplative techniques, and apply those to everyday life. Quantitative and qualitative data was collected pre- and post-intervention, to determine changes in participants' self-awareness, self-determination, anxiety, autism symptoms, and empathy. Participants were capable of successfully improving their physiological arousal levels on the biofeedback setup, indicating feasibility of the technique. Further, we found initial indications for reduction in autism symptoms and increased self-determination. Qualitative reports by participants and counselors revealed that participants applied the techniques in many real-life situations, and these had far-ranging effects on their emotional regulation, work and social motivation, and self-determination. The study provides proof-of-concept for a low-cost, community-based intervention which can ameliorate the lives of adults with ASD.

Obsessive-compulsive tendencies may be associated with attenuated access to internal states: evidence from a biofeedback-aided muscle tensing task.

The present study was motivated by the hypothesis that inputs from internal states in obsessive-compulsive (OC) individuals are attenuated, which could be one source of the pervasive doubting and checking in OCD. Participants who were high or low in OC tendencies were asked to produce specific levels of muscle tension with and without biofeedback, and their accuracy in producing the required muscle tension levels was assessed. As predicted, high OC participants performed more poorly than low OC participants on this task when biofeedback was not available. When biofeedback was provided, the difference between the groups was eliminated, and withdrawing the monitor again reversed this effect. Finally, when given the opportunity, high OC participants were more likely than low OC participants to request biofeedback. These results suggest that doubt in OCD may be grounded in a real and general deficiency in accessing internal states.

Obsessive-compulsive tendencies and undermined confidence are related to reliance on proxies for internal states in a false feedback paradigm.

BACKGROUND AND OBJECTIVES: We have previously hypothesized that obsessive-compulsive (OC) tendencies are associated with a general lack of subjective conviction regarding internal states, which leads to compensatory seeking of and reliance on more discernible substitutes (proxies) for these states (Lazarov, A., Dar, R., Oded, Y., & Liberman, N. (2010). Behaviour Research and Therapy, 48, 516-523). This article presents two studies designed to provide further support to this hypothesis by using false biofeedback as a proxy for internal states. METHODS: In Study 1 we presented high and low OC participants with pre-programmed false feedback showing either increasing or decreasing levels of muscle tension. In Study 2 we presented similar false feedback on level of relaxation to non-selected participants, half of which received instructions that undermined their confidence in their ability to assess their own level of relaxation. RESULTS: In Study 1, high OC participants were more affected by false biofeedback when judging their own level of muscle tension than were low OC participants. In Study 2, undermined confidence participants were more affected by false biofeedback when judging their own level of relaxation as compared to control participants. LIMITATIONS: Our findings are based on a non-clinical, highly functioning, largely female student sample and their generalization to OCD requires replication with a sample of OCD patients. CONCLUSIONS: These results provide converging evidence for our hypothesis by replicating and extending our previous findings. We discuss the implication of our hypothesis for the understanding and treatment of OCD and outline directions for future research.

Are obsessive-compulsive tendencies related to reliance on external proxies for internal states? Evidence from biofeedback-aided relaxation studies.

This article presents two studies that examine the hypothesis that obsessive-compulsive (OC) tendencies are associated with a general deficiency in subjective conviction, which leads to seeking and reliance on external proxies to compensate for that deficiency. We examined this hypothesis using a biofeedback-aided relaxation procedure. In Study 1 low OC participants performed better on a relaxation task than high OC participants. More importantly, viewing the biofeedback monitor (an external proxy for the internal state of relaxation) had a different effect on the two groups: Whereas high OC participants performed better, low OC participants did not. In addition, when given the opportunity, high OC participants requested the biofeedback monitor more than did the low OC participants. In Study 2 high OC participants were more affected by false biofeedback when judging their level of relaxation compared to low OC participants. Real relaxation level differences between the two false biofeedback phases among the two groups were not found. These results provide preliminary support for the hypothesis that obsessive-compulsive disorder is associated with deficient subjective conviction in internal states and increased reliance on external proxies. Implications for the understanding of OCD-related rules and rituals as well as for cognitive therapy for OCD are discussed.

Comparison between three memory tests: cued recall, priming and saving closed-head injured patients and controls.

Twenty closed-head injured (CHI) patients and 20 matched controls were tested with three different memory tasks: cued recall, word stem completion (WSC), and saving. Saving is defined as the advantage of relearning of a list of word pairs, in terms of the number of learning trials to the criterion of one errorless trial, over the original learning of the same list. It was predicted that CHI patients' explicit memory (i.e., cued recall), but not implicit memory (i.e., WSC), would be impaired. The question addressed in this study is whether the memory of CHI patients will be impaired when memory is tested with a saving task, with 2 weeks delay between original learning and relearning. The findings confirm impairment of CHI patients in explicit memory, although the learning rate is preserved. Implicit memory is preserved in CHI patients only when based on reactivation of preexisting knowledge, but not when dependent on forming new associations. Finally, the CHI patients, even after 2 weeks delay, demonstrated a significant saving in relearning old, as compared to new, pairs of words. The clinical contribution of this study is the delineation of those aspects of memory that are impaired and those that are preserved in CHI patients. The theoretical implications of the finding that memory could be preserved in CHI patients when measured by saving, are discussed in terms of the relationship between implicit memory and saving.