Derek W. Johnston

Type A behaviour in British men: Reliability and intercorrelation of two measures

Two questionnaire measures of the Type A behaviour pattern, the Jenkins Activity Survey and the Bortner Questionnaire were completed by a sample of 151 middle-aged male civil servants on three occasions, up to 34 weeks apart. The reliability of both measures was satisfactory. The reliability coefficient of the JAS Type A measure did not fall below 0.79 while the Bortner achieved a reliability of 0.71 over the longest time interval studied. The intercorrelation of the two tests on two occasions was approximately 0.7. In addition it was shown that both tests were largely independent of a number of standard cardiovascular risk factors. It was concluded that in the population studied both tests had satisfactory psychometric properties and that they were measuring a very similar behavioural characteristic.

The control of blood pressure using pulse-wave velocity feedback

Abstract Ten volunteer subjects each attended four training sessions of 1 hr, during which they were instructed to raise or lower blood pressure. They were provided with immediate analogue feedback of pulse wave velocity from a PDP-12 computer, and successful performance was rewarded with money. Significant differences in PWV between Increase and Decrease conditions were produced, the mean divergence in the final trial being equivalent to 11 mm Hg. These changes were accompanied by adjustments in heart rate and respiration rate, and did not improve with repeated sessions—indeed on some measures deterioration in performance was observed. Neither analysis from the initial baseline nor from the pre-trial level, appears to reflect the precise effects of feedback. Different methods of assessment are discussed, together with the use of PWV as a measure of blood pressure in such experiments.

The learned control of differential temperature in the human earlobes: preliminary study.

Abstract Eight subjects were given six training periods during which they were provided with visual and auditory feedback of the temperature difference between their ears. By the end of the training, mean temperature changes of 0.3 °C were produced. Muscle activity was controlled and measured, and is not thought to have mediated the effect.

Biofeedback, Verbal Instructions and the Motor Skills Analogy

Biofeedback has been largely atheoretical in its orientation; there does, however, seem to be a sizeable body of opinion that regards learning to voluntarily control a visceral response as analogous to learning a conventional motor skill. This view has been most clearly proposed by Lang, e.g., “the acquisition of voluntary control over a viscus is a skill ... it requires an organised sequence of activities, movements and symbolic information such as those required to play darts or hit a tennis ball accurately.” (Lang, 1975). Brener (1974), Engel (1972), and Schwartz (1974) take a similar position.

The behavioral control of high blood pressure

Stress management and relaxation training lower the blood pressure of many mild hypertensives substantially through mechanisms that are as yet unclear but may include behavioral and cognitive change. It is almost certain that the reduction of weight in the obese, drinking in heavy drinkers, and increased exercise in the sedentary also reduces pressure usefully in hypertensives, and opportunites exist for the application of behavioral principles to improve the effectiveness of programs to alter these behavioral risk factors. It is fortunate that behavioral methods for the control of hypertension exist and are making progress since there are increasing doubts about the effectiveness of pharmacological solutions for mild hypertension.

The Effects of Cardiovascular Feedback and Relaxation on Angina Pectoris

Seven patients with angina pectoris were treated with relaxation training, electromyographic feedback and feedback of heart rate, pulse transit time or the product of these measures. Six showed a decreased frequency of anginal attacks, of trinitrin usage and an increased exercise tolerance.

Clinical applications of cardiovascular assessment.

Cardiovascular measures are central to clinical psychophysiology. This article briefly describes the range of measures typically recorded in the laboratory and field. Laboratory testing procedures are outlined, and the theoretical bases for the selection of mental stress tests and the reliability of responses are discussed. New developments in the analysis of laboratory and ambulatory cardiovascular measures are described, including autoregressive modeling, power spectrum analysis, and other measures of variability. Applications of cardiovascular measures to the investigation, assessment, and management of essential hypertension, coronary heart disease, Raynauds phenomenon, anxiety, fear, and panic are reviewed. Major contributions have already been made by psychophysiologists, and the incorporation of these methods into clinical practice is recommended. The scope of clinical cardiovascular psychophysiology may be expanded considerably over the next decade if investigators are able to capitalize on innovations in measurement and analysis technologies. The measurement of cardiovascular activity and reactivity plays a major role in much of clinical psychophysiology. The relevance of such measures is obvious in the assessment of risk factors for cardiovascular disease such as raised blood pressure, in testing and developing etiological models for these risks, and in the investigation of risk factors of a more behavioral nature such as Type A behavior (Harbin, 1989). Cardiovascular reactions also play a descriptive and, some maintain, causal role in the development and maintenance of fear and anxiety (Clark, 1986; Lang, 1985), pain (Elbert et al, 1988), and in information processing (Lacey, 1967). In this article we shall outline the main forms of cardiovascular measurement used in the laboratory and in real life settings and describe methodological issues in their application. We shall then present selected instances of their use in three areas of cardiovascular disease—essential hypertension, coronary heart disease, and Reynauds phenomenon. Finally, the applications of cardiovascular measurement to anxiety, fear, and panic are discussed.

The control of pulse transit time independently of interbeat interval by providing feedback from both

Sixteen subjects took part in a two-stage cardiovascular biofeedback experiment. For five sessions all subjects attempted to control their pulse wave transit time(TT), using TT feedback. The eight subjects who achieved control were given a further five sessions, during which they attempted to control their transit time without altering their interbeat interval(IBI) when provided with TT and IBI feedback. No evidence was found for complete dissociation of TT and IBI. When the single TT contingency was in operation, all subjects who had significant control of TT also showed significant changes in IBI in the same direction. When the dual contingency was introduced, subjects either controlled TT but failed to keep IBI stable or kept IBI stable but failed to control TT.

Behavioural Medicine: The Application of Behaviour Therapy to Physical Health

Three typical areas of application of behavioural medicine are described: biofeedback, relaxation training, and various cognitive behavioural procedures. It is argued that biofeedback has led to few useful clinical treatments but both relaxation and more complex procedures and methods of analysis can contribute to the prevention and treatment of disease. This is illustrated with examples from the literature on headache and the prevention and treatment of coronary heart disease and cancer.

Feedback and incentive effects on the decrease of interbeat interval

Johnston and Lethem (1981) have hypothesized that when subjects attempt to decrease their interbeat interval (i.e., increase their heart rate) maximally, then interbeat interval feedback has a purely motivational role, but when they attempt to decrease their interbeat interval by a precise amount, such feedback has a primarily informational role. This was tested by comparing the performance of 16 subjects on both types of task. It was predicted that additional monetary incentives would reduce the difference between feedback and no-feedback conditions when subjects were attempting to reduce interbeat interval maximally but not when attempting to reduce it by a specific amount. This prediction was not supported. Incentive was found to aid performance on the maximal interbeat interval decrease task, but this was independent of the effects of feedback. Only feedback effects were detected on the specific interbeat interval decrease task.