Guy C. McCoy

Changes in plasma norepinephrine to combat-related stimuli among Vietnam veterans with posttraumatic stress disorder.

Plasma norepinephrine samples were obtained before and after exposure to auditory stimuli reminiscent of combat from two groups of male Vietnam veterans with combat experience: one with diagnoses of PTSD (N = 15) and one with no mental disorder (N = 6). Results showed a significant 30% rise in plasma norepinephrine for the PTSD group, with no change in the comparison group.

Psychological dimensions of ‘office hypertension’

Abstract The present study examined the psychological and psychophysiological dimensions of ‘office hypertension’. Forty hypertensive Ss were classified as Office Responders (n = 13), Nonresponders (n = 17) or Home Responders (n = 10) based on the observed discrepancies between home and office measures of BP. Psychological tests consisted of the SCL-90, Beck Depression Inventory, Spielberger Self-Analysis Questionnaire, State-Trait Anxiety Inventory, Buss-Durkee Hostility Inventory, Social Readjustment Rating Scale and Jenkins Activity Survey. Psychophysiological assessment consisted of constant monitoring and recording of BP during Baseline, Mental Arithmetic, Cold Pressor and Stressful Imagery conditions. Contrary to expectations, on psychological tests Office Responders did not differ from Nonresponders on measures of anxiety. However, Nonresponders were significantly higher than Office Responders on measures of anger and hostility, characteristics ascribed to the hypertensive personality. On psychophysiological assessment, Office Responders showed significantly greater increases in systolic BP than Nonresponders during a Mental Arithmetic task; however, the groups did not differ during a Cold-pressor task.

Preliminary results from a controlled evaluation of thermal biofeedback as a treatment for essential hypertension

In a controlled trial, thermal biofeedback (n=20) and abbreviated progressive relaxation (n=22) were compared in the treatment of mild to moderate hypertensive patients whose blood pressures (BP) were initially controlled on two medications. For the clinical end point of maintaining control of BP on a single drug after treatment, biofeedback was superior to relaxation training (at 3 months, 47% success for biofeedback versus 23% for relaxation). This same result tended to be true for patient-measured home BPs. BPs from laboratory psychophysiological testing showed no consistent advantage for one treatment over the other.

Three studies on the relation of process to outcome in the treatment of essential hypertension with relaxation and thermal biofeedback

Abstract During the course of a controlled comparison of thermal biofeedback and progressive muscle relaxation as treatments for essential hypertension three studies investigating the relationship of process variables to outcome were conducted. The three variables investigated were expectancies, skill acquisition, and home practice. For patients receiving progressive muscle relaxation, perceptions of deep relaxation during treatment sessions were most strongly related to outcome. For thermal biofeedback patients, expectancies and skill acquisition variables were both related to outcome. Frequency of home practice was related to successful outcome for both treatment groups.

Atropine in the Treatment of Baclofen Overdose

A patient suffering baclofen overdose successfully treated with atropine is reported. Three hours after admission for ingestion of at least 300 mg baclofen as a single dose, the patient became comatose and subsequently bradycardic, hypotensive, and hypothermic. A prompt increase in heart rate and blood pressure followed administration of 1 mg of atropine sulfate. Atropine appears to be useful in treating cases of baclofen overdose complicated by bradycardia and hypotension.

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: III. Psychological changes accompanying treatment

Eighty-seven medicated essential hypertensives received either thermal biofeedback (TBF) or progressive muscle relaxation (PMR) training as a substitute for their second-stage antihypertensive medication. The psychological changes accompanying the treatments were obtained at pretreatment, at post-treatment and at the 3- and 6-month follow-up. Few psychological changes were noted, owing in part to the absence of psychopathological elevations at pretreatment. Short-term psychological changes were greater in patients who were withdrawn from their second-stage antihypertensive medication and then treated compared with those treated and then withdrawn from their medication. This finding may reflect the presence of antihypertensive medication side effects involving psychological factors. In general, TBF patients were more Type B at long-term follow-up compared with PMR patients, who tended toward greater Type A characteristics.

Evaluation of thermal biofeedback treatment of hypertension using 24-hr ambulatory blood pressure monitoring

Ten male hypertensives, whose BPs were controlled on a combination of sympatholytic and diuretic medications, were given 16 sessions of thermal biofeedback prior to attempting withdrawal from the sympatholytic drug. Results were evaluated using 24-hr ambulatory BP monitoring (ABPM) as well as clinic and home BPs, both in multi-baseline-across-subject designs and as a single group. Results showed significant treatment effects on 24-hr ABPM data, both at the individual level (SBPs only) and in the aggregate analyses (SBP and DBP). BPs assessed in the clinic by random zero sphygmomanometer and patient-assessed home BPs were also reduced.

The relationship of expectancies to outcome in stress management treatment of essential hypertension: results from the joint USSR-USA behavioral hypertension project

Outcome expectancy and efficacy expectancy measures were made during the course of a cross-cultural comparison of thermal biofeedback and autogenic training as treatments for mild essential hypertension. There were no differences between groups at either pre- or posttreatment, and expectancy measures were not related to initial success or failure at the completion of treatment. However, both outcome and efficacy expectations were related to relapse over the three months immediately following the completion of treatment. Treatment failures had lower ratings for both outcome and efficacy expectations at the posttreatment assessment in comparison to treatment successes. Implications of these results are discussed.