Aivazyan T A, Zaitsev V P
Federal state budgetary institution 'Russian Research Center of Medical Rehabilitation and Balneology', Moscow, Russia.
Federal state budgetary institution 'Moscow Research Centre of Medical Rehabilitation, Restorative and Sports Medicine', Moscow, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2016;93(5):4-7. doi: 10.17116/kurort201654-7.
The objective of the present work was to study the influence of the application of the biological feedback (BFB) technique on the dynamics of the psychological and clinical status of the patients presenting with various chronic somatic diseases (CSD) and to identify the predictors of the effectiveness of the treatment by this method.
The study included 337 patients suffering from CSD who were interviewed with the use of the concise standardized multifactorial personality inventory (SMPI), the Spielberger State-Trait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomly distributed into two groups. Group 1 (main) was comprised of 168 patients who underwent psychotherapeutic treatment based on the BFB method, group 2 (control) consisted of 169 patients who did not receive the psychotherapeutic treatment. In order to identify the predictors of the effectiveness of the treatment by the biological feedback technique, the patients of the main group were subdivided into two subgroups at the end of the study period. Subgroup A contained 112 (67%) patients whose health status was normalized under the influence of psychotherapy, subgroup B included 56 (33%) patients who experienced the improvement of the somatic conditions. We undertook the comparative analysis of the background characteristics of the patients belonging to each group.
The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of the parameters estimated based on the scales 1, 2, and 7 and an increase of those evaluated based on the (SMPI) scale 9. Simultaneously, the levels of state and trait anxiety estimated based on the Spielberger и Beck inventory scales decreased. These findings give evidence of the improvement of psychological adaptation of the patients, decrease of the anxiety level and emotional stress under the influence of the treatment with the use of the biological feedback technique; these changes were concomitant with the enhancement of the general activity of the patients, the improvement of their working capacity, mood, and feelings of optimism. The study of the predictors of the effectiveness of the BFB method revealed the significantly higher background values estimated based on the SMPI scales 1, 4, and 6 in the patients with the improvement of the health status compared with those exhibiting normalized conditions (p<0,01). In 12% of the patients in the former subgroup (but in none of the patients of the latter subgroup), the values obtained based on the Beck scale were higher than 20 scores which suggested either the moderate or high level of depression. These data give reason to conclude that the patients that exhibited a relatively weak response to the treatment with the application of the biological feedback technique were initially predisposed to the un-necessary excessive fixation of attention on their sensations in the combination with enhanced impulsivity, rigidity of attitudes, and the presence of depressive disorders.
本研究的目的是探讨生物反馈(BFB)技术的应用对患有各种慢性躯体疾病(CSD)患者心理和临床状态动态变化的影响,并确定该方法治疗效果的预测因素。
该研究纳入了337例患有CSD的患者,使用简明标准化多因素人格量表(SMPI)、斯皮尔伯格状态-特质焦虑量表(STAI)和贝克抑郁量表(BDI)进行访谈。患者被随机分为两组。第1组(主要组)由168例接受基于BFB方法的心理治疗的患者组成,第2组(对照组)由169例未接受心理治疗的患者组成。为了确定生物反馈技术治疗效果的预测因素,在研究期结束时将主要组的患者分为两个亚组。A亚组包含112例(67%)在心理治疗影响下健康状况恢复正常的患者,B亚组包括56例(33%)躯体状况有所改善的患者。我们对每组患者的背景特征进行了比较分析。
研究表明,在观察期结束时,主要组患者基于量表1、2和7评估的参数显著下降(与对照组相比),基于(SMPI)量表9评估的参数有所增加。同时,基于斯皮尔伯格和贝克量表评估的状态和特质焦虑水平下降。这些发现证明了在使用生物反馈技术治疗的影响下,患者心理适应能力得到改善,焦虑水平和情绪压力降低;这些变化伴随着患者总体活动能力的增强、工作能力、情绪和乐观情绪的改善。对BFB方法治疗效果预测因素的研究表明,与健康状况恢复正常的患者相比,健康状况有所改善的患者基于SMPI量表1、4和6评估的背景值显著更高(p<0.01)。在前一个亚组中,12%的患者(但后一个亚组中无一例患者)基于贝克量表获得的值高于20分,这表明存在中度或高度抑郁。这些数据有理由得出结论,即对生物反馈技术治疗反应相对较弱的患者最初易倾向于不必要地过度关注自身感觉,同时伴有冲动性增强、态度僵化和存在抑郁障碍。