Effectiveness of biofeedback and counter-conditioning in the treatment of bronchial asthma

Khan, Aman U.

doi:10.1016/0022-3999(77)90078-2

Cited by 47 publications

(39 citation statements)

References 14 publications

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“…Consistent with this, Lewis et al (33] found that none of their 30 extrinsic asthmatic subjects showed a criterion response. Horton et al (31), however, found no significant correlation between positive response to skin tests of atopy and bronchoconstriction in response to suggestion, and Khan et al (26,30), found a 50% response rate among 100 extrinsic asthmatics. A replication of the Philipp et al data, with calculation of individual response rate, would thus be required to establish a relationship between atopy and bronchial response to suggestion.…”

Section: Suggestion and Emotion In Asthmamentioning

confidence: 94%

“…Of subjects assessed by FEVT, 87 of 217 (40%) responded to suggestion (23,25,26,28,30,32,34,36,37). For the less effort-dependent measures, 54 of 157 subjects (36.1%) assessed by plethysmography were found to be responders (16,20,21,31,33,35) as were 4 of 13 (30.8%) of subjects assessed by forced oscillation (27).…”

Section: Suggestion and Emotion In Asthmamentioning

confidence: 98%

“…The saline control procedure used in most studies reported after 1974 involves having the subject inhale saline with accurate instructions that the substance is inert (24,25,29,31,(33)(34)(35)(36), and using the level following this intervention as the base from which to measure response to suggested bronchoconstriction. Earlier investigators took baseline readings while the subject was at rest, without saline, before any inhalations (16,20,(26)(27)(28)30). Forty of the 176 asthmatic subjects involved in saline controlled studies (23.3%) were classified as reactors.…”

Section: Relevant Parameters Of the Suggestion Effectmentioning

confidence: 99%

“…In the 20 studies in Table 1 reporting the percentage of changes occurring in individual subjects, 152 of the total group of 427 asthmatic subjects (or 35.6%) were considered "reactors" by at least some criterion (16,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Three studies were not included in these figures because the number of asthmatic subjects reacting to suggestion was not reported (17)(18)(19).…”

Section: Bronchial Response Of Asthmatics To Suggestionmentioning

confidence: 99%

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The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

Isenberg

Lehrer

Hochron

1992

Psychosomatic Medicine

169

118

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This paper reviews the empirical literature on the relation between asthma, suggestion, and emotion, and proposes the hypothesis that these effects are mediated parasympathetically. The literature indicates that, among asthmatics, suggestion can produce both bronchoconstriction and bronchodilation, and that stress can produce bronchoconstriction. The proportion of asthmatic subjects showing bronchoconstriction to both suggestion and stress averages 35%-40% across studies, but, because of methodological considerations, might be conservatively estimated as closer to 20%. The effect is smaller for suggestion of bronchodilation, and is very short-lived among nonasthmatics. No clear connection has been found between these responses and such subject variables as age, gender, asthma severity, atopy, or method of pulmonary assessment, although some nonsignificant tendencies appear. Most studies in this literature used small n's and did not systematically examine various somatic, environmental, and demographic factors that could influence results. A hypothesis is presented regarding vagal mediation of psychological effects on the airways, as well as possible alternative mechanisms, and recommendations for future research to evaluate these hypotheses.

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Section: Suggestion and Emotion In Asthmamentioning

confidence: 94%

Section: Suggestion and Emotion In Asthmamentioning

confidence: 98%

Section: Relevant Parameters Of the Suggestion Effectmentioning

confidence: 99%

Section: Bronchial Response Of Asthmatics To Suggestionmentioning

confidence: 99%

See 2 more Smart Citations

The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

Isenberg

Lehrer

Hochron

1992

Psychosomatic Medicine

169

118

View full text Add to dashboard Cite

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“…The trials used four broad psychological approaches; six studies included an element of relaxation in their intervention [10][11][12][13][14][15][16], two included cognitive behavioural therapy [17,18], and three used biofeedbackassisted relaxation and one behavioural therapy [14,[19][20][21]. Different placebos or controls were used, and rarely was the therapy delivered in its pure form, but, instead, therapists often combined therapies or tailored them to the individual's needs.…”

Section: Psychological Interventions For Children With Asthmamentioning

confidence: 99%

Psychological Interventions in Asthma

Smith

Jones

2015

Curr Treat Options Allergy

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Asthma is a multifactorial chronic respiratory disease characterised by recurrent episodes of airway obstruction. The current management of asthma focuses principally on pharmacological treatments, which have a strong evidence base underlying their use. However, in clinical practice, poor symptom control remains a common problem for patients with asthma. Living with asthma has been linked with psychological co-morbidity including anxiety, depression, panic attacks and behavioural factors such as poor adherence and suboptimal self-management. Psychological disorders have a higher-than-expected prevalence in patients with difficult-to-control asthma. As psychological considerations play an important role in the management of people with asthma, it is not surprising that many psychological therapies have been applied in the management of asthma. There are case reports which support their use as an adjunct to pharmacological therapy in selected individuals, and in some clinical trials, benefit is demonstrated, but the evidence is not consistent. When findings are quantitatively synthesised in meta-analyses, no firm conclusions are able to be drawn and no guidelines recommend psychological interventions. These inconsistencies in findings may in part be due to poor study design, the combining of results of studies using different interventions and the diversity of ways patient benefit is assessed. Despite this weak evidence base, the rationale for psychological therapies is plausible, and this therapeutic modality is appealing to both patients and their clinicians as an adjunct to conventional pharmacological treatments. What are urgently required are rigorous evaluations of psychological therapies in asthma, on a par to the quality of pharmaceutical trials. From this evidence base, we can then determine which interventions are beneficial for our patients with asthma management and more specifically which psychological therapy is best suited for each patient. Key points• Asthma is a condition in which psychological factors play a major role and psychological co-morbidities can co-exist. The rationale for including psychological therapies to improve health outcomes for patients with asthma seems logical.• Because of poor methodological quality and small sample sizes, it is impossible to draw conclusions as to the effectiveness of psychological therapies in the management of adults or children with asthma.• There are some promising results for specific therapies on isolated outcomes, for example, in adults CBT on quality of life, biofeedback on peak flow and relaxation therapies on medication use.• The trials evaluating this clinical area are small, with heterogeneous interventions, poor quality study design and diversity of outcome measures that preclude the provision of guidance for clinical practice.• This potentially important area of patient care needs the development of a rigorous research program where future work is influenced and improves upon existing studies.

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Does Psychotherapy Benefit Neurotic Patients?

Andrews¹

1981

Arch Gen Psychiatry

185

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Effectiveness of biofeedback and counter-conditioning in the treatment of bronchial asthma

Cited by 47 publications

References 14 publications

The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

Psychological Interventions in Asthma

Does Psychotherapy Benefit Neurotic Patients?

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