Peak Recovery: Substance Use Reset

Long-term follow-up of a clinical replication of the Peniston protocol for chemical dependency

This study is a long-term follow-up of an early replication of the Peniston EEG biofeedback (EEG-BFB) Protocol for chemical dependency (Peniston & Kulkosky, 1989, 1990). Method. This clinical trial included 16 chemically dependent adult participants treated with the Peniston Protocol in a university outpatient clinic between 1993 and 1995. Ten participants were probationers classified as high risk for rearrest. Treatment effects were assessed using pre/posttreatment measures (Beck Depression Inventory, Minnesota Multiphasic Personality Inventory-2) and long-term follow-up of abstinence and rearrest rates. Probationer rearrest rates were compared to an equivalent probation sample (n = 24) that did not receive EEG-BFB. Results. Initial Beck Depression Inventory scores indicated mild/moderate depression but were significantly reduced posttreatment to within normal limits. Substantial differences were noted posttreatment on 7 Minnesota Multiphasic Personality Inventory-2 clinical scales suggesting less psychopathology following treatment. Long-term (74-98 months) follow-up indicated that 81.3% (n = 13) participants were abstinent. Rearrest rates and probation revocations for the probationer subgroup were lower than the comparison group (40% vs. 79.16%). Conclusion. This study provides evidence of the durability of Peniston Protocol results over time but has the usual limitations of a clinical trial with a small sample, nonrandomized, and uncontrolled design. Implications for further research are discussed including the relevance of recent modifications to the Peniston Protocol and qEEG-based protocols in treating substance abuse.

Brainwave Biofeedback for Addictive Disorder

Management of patients with fibromyalgia using biofeedback: A randomized control trial

Objective: Fibromyalgia syndrome (FMS) is a chronic rheumatological condition which could be characterized by generalized pain and fatigue. Cognitive and behavioral therapy has been found to be a suitable technique in the management of FMS. This study intends to evaluate the efficacy of electromyography (EMG) biofeedback to reduce pain in patients with FMS. Materials and Methods: A randomized controlled trial involving two groups of FMS patients, one receiving EMG biofeedback and the other a sham biofeedback, was carried out. The assessment tools included in the study were fibromyalgia impact questionnaire (FIQ), visual analogue scale (VAS), six-minute walk test (SMWT) and number of tender points; and tenderness of each tender point was done for both the groups. Statistics: A Student's 't' test was used to study the test for significance. Results: After using biofeedback, the mean VAS scores and the mean number of tender points were found to be 3 out of 10 and 6 out of 18 respectively. Subjective analysis from both groups showed improvement in physical and psychological realms. Statistical significance (P < 0.001) was observed for decrease in pain and number of tender points. ANOVA analysis revealed a significant decrease in VAS, FIQ and tender points within the groups. Conclusion: Biofeedback as a treatment modality reduces pain in patients with FMS, along with improvements in FIQ, SMWT and the number of tender points.

Applicability of brain wave biofeedback to substance use disorder in adolescents

Neurofeedback treatment for addictions in adults is probably efficacious, and several reported approaches are described with their indications. Neurofeedback is promising as a treatment modality for adolescents, especially those with stimulant abuse and attention and conduct problems. It is attractive as a medication-free, neurophysiologic, and self-actualizing treatment for a substance-based, brain-impaired and self-defeating disorder. More research, beginning with case reporting, is needed to assess use and efficacy in adolescents.

Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population

This study examined whether an EEG biofeedback protocol could improve outcome measures for a mixed substance abusing inpatient population. Method. One hundred twenty-one volunteers undergoing an inpatient substance abuse program were randomly assigned to the EEG biofeedback or control group. EEG biofeedback included training in Beta and SMR to address attentional variables, followed by an alpha-theta protocol. Subjects received a total of 40 to 50 biofeedback sessions. The control group received additional time in treatment equivalent to experimental procedure time. The Test of Variables of Attention (TOVA), and MMPI, were administered with both tester and subject blind as to group placement to obtain unbiased baseline data. Treatment retention and abstinence rates as well as psychometric and cognitive measures were compared. Results. Experimental subjects remained in treatment significantly longer than the control group (p<0.005). Of the experimental subjects completing the protocol, 77% were abstinent at 12 months, compared to 44% for the controls. Experimental subjects demon-strated significant improvement on the TOVA (p<.005) after an average of 13 beta-SMR sessions. Following alpha-theta training, significant differences were noted on 5 of the 10 MMPI-2 scales at the p[removed]

An open clinical trial utilizing real-time EEG operant conditioning as an adjunctive therapy in the treatment of crack cocaine dependence

This study investigated the treatment outcome of males dependent on crack cocaine participating in an inpatient treatment facility in which electroencephalographic operant conditioning training (EEG-OC) was added to the treatment protocol. Eighty-seven men were assessed twelve months after completion of the EEG portion of the program. Follow-up procedures of urinalyses, self-report measures, length of residence, and scores on a measure of depression were obtained and showed significant changes after treatment. The addition of EEG-OC to crack cocaine treatment regimens may promise to be an efficfive intervention for treating crack cocaine abuse and increasing treatment retention

Biofeedback treatment in patients with refractory epilepsy: Changes in depression and control orientation

Depression is a common and serious interictal problem in patients with epilepsy. The genesis of depressive disorders is multifactorial. One aetiological aspect focuses on psychosocial factors. It was hypothesized that uncontrollable, unpredictable chronic aversive events (i.e. epileptic seizures) result in cognitive deficits ofexternal control orientation. If this is true, biofeedback training could represent a possible treatment strategy to lower depression, because biofeedback is known to mediate success experiences and control. Measures of depression and locus of control were administered to 20 patients with refractory partial epilepsy before and after biofeedback treatment. The biofeedback consisted of slow cortical potentials or breathing parameters in 10 patients each. A clear relationship occurred between depression and locus of control in the subjects. After biofeedback training control orientation moved towards a more internal locus of control. Also, depression scores were significantly reduced six months after training. Results show that in patients with refractory epilepsy depression is highly correlated with locus of control, in a way that external control orientation relates to high depression scores. Biofeedback is able to improve internal control orientation through personal success mediation.

The Treatment of Addictive Disorders by Brain Wave Biofeedback: A Review and Suggestions for Future Research

“Native Americans, Neurofeedback, and Substance Abuse Theory”. Three Year Outcome of Alpha/theta Neurofeedback Training in the Treatment of Problem Drinking among Dine' (Navajo) People

This three year follow-up study presents the treatment outcomes of 19 Dine' (Navajo) clients who completed a culturally sensitive, alpha/theta neurofeedback training program. In an attempt to both replicate the earlier positive studies of Peniston (1989) and to determine if neurofeedback skills would significantly decrease both alcohol consumption and other behavioral indicators of substance abuse, these participants received an average of 40 culturally modified neurofeedback training sessions. This training was adjunctive to their normal 33 day residential treatment. According to DSM-IV criteria for substance abuse, 4 (21%) participants now meet criteria for “sustained full remission”, 12 (63%) for “sustained partial remission”, and 3 (16%) still remain “dependent” (American Psychiatric Association, 1994). The majority of participants also showed a significant increase in “level of functioning” as measured by the DSM-IV Axis V GAF. Subjective reports from participants indicated that their original neurofeedback training had been both enjoyable and self-empowering; an experience generally different from their usual treatment routine of talk-therapy and education. This internal training also appeared to naturally stimulate significant, but subtle, spiritual experiences and to be naturally compatible with traditional Navajo cultural and medicine-ways. At the three-year follow-up interview, participants typically voiced that these experiences, and their corresponding insights, had been helpful both in their ability to cope and in their sobriety. From an outside perspective, experienced nurses also reported unexpected behavioral improvements during the participant's initial training. Additionally, administrators and physicians generally found the objective feedback and verification quality of neurofeedback protocols compatible with their own beliefs. An attempt has also been made to conceptualize the outcome analysis of this study within both a culturally specific and universal socio/bio/ environmental context.

Alpha-theta brainwave neurofeedback training: An effective treatment for male and female alcoholics with depressive symptoms

This was an experimental study of 14 alcoholic outpatients using the Peniston and Kulkosky (1989, 1991) brainwave treatment protocol for alcohol abuse. After temperature biofeedback pretraining, experimental subjects completed 20 40-minute sessions of alpha-theta brainwave neurofeedback training (BWNT). Experimentally treated alcoholics with depressive syndrome showed sharp reductions in self-assessed depression (Beck's Depression Inventory). On the Millon Clinical Multiaxial Inventory-I, the experimental subjects showed significant decreases on the BR scores: schizoid, avoidant, dependent, histrionic, passive-aggression, schizotypal, borderline, anxiety, somatoform, hypomanic, dysthmic, alcohol abuse, drug abuse, psychotic thinking, and psychotic depression. Twenty-one-month follow-up data indicated sustained prevention of relapse in alcoholics who completed BWNT.

Alterations in EEG Amplitude, Personality Factors, and Brain Electrical Mapping after Alpha-Theta Brainwave Training: A Controlled Case Study of an Alcoholic in Recovery

A controlled case study was conducted of effects of EEG alpha and theta brainwave training with a recovering alcoholic patient who experienced craving and fear of relapse after 18 months of abstinence. Training consisted of six sessions of thermal biofeedback to increase central nervous system (CNS) relaxation. Effects were documented with pretreatment and post-treatment personality testing, 20-channel digitized EEG evaluations both under relaxed conditions and under stress, minute-by-minute physiologic recordings of autonomic and EEG data during each training session, blood pressure, and heart rate indications taken both during relaxation and under stress, and by clinical observation. Results replicated those of a previous controlled study with chronic alcoholic patients not abstinent prior to treatment. New findings include post-treatment indications of more relaxed CNS functioning under stress, and of reduced autonomic activation both during relaxation and under stress. Brain-mapping indications of anxiety associated with painful cold-pressor stimulation were seen only in the pretest readings; at post-test the brain map indicated pain-associated EEG activity in the contralateral somatosensory area, but no apparent anxiety-associated EEG activity. At 4 months post-treatment the patient's wife and colleagues report the patient appears to function in a more relaxed way under the impact of stress, and he reports no longer experiencing craving for alcohol. Overall, support is provided for the possibility that alpha and theta brainwave training may be a useful intervention for the abstinent alcoholic experiencing stress-related craving and fear of relapse.

Alpha wave biofeedback training therapy in alcoholics

This investigation evaluated the therapeutic efficacy of alpha-wave biofeedback treatment for alcoholics. Twenty-five Ss were compared to a matched control group before and after administration of a 3-week alpha-wave biofeedback regimen on a wide variety of criteria that included State-Trait Anxiety, the MMPI, Multiple Affect Adjective Check List, Zuckerman's Sensation Seeking Scale, Watson's Anhedonia Scale, the Brief Psychiatric Rating Scale, and baseline alpha. The experimental Ss received 10 hour-long alpha training sessions. The experimentals showed more improvement than did controls on alpha production and two anxiety measures. Contradictory results appeared on two suspicion/paranoia measures. Alpha training appeared useful in the treatment of anxiety, but not other problems. However, the absence of significant correlations between amount of change on alpha and the anxiety measures suggests that the improvement may be due to a placebo effect.

Alpha Conditioning as an Adjunct Treatment for Drug Dependence: Part II

The use of alpha biofeedback in a multimodal client-centered program is seen to have certain unique advantages for treating an opiate-abusing population. It employs immediate reinforcement for success in a task which virtually all subjects can accomplish. Subjects are seen to be responding to intrinsically important motives, including the desire to reduce transient, situational anxiety or to seek a state of euphoria. The concreteness and nonverbal nature of the alpha techniques appear to be favorably contrasted to the word therapy techniques which client populations have often found unsuccessful and/or rewarding. The shift of responsibility for health onto the client, combined with the achievement of self-produced success experiences, appears to offer a useful method for therapeutic generalization and treatment.Reservations in such use of alpha biofeedback include the fact that little or no controlled study of alpha as a therapeutic modality has been published. Also, there are data suggesting that anxiety reduction and increase in alpha are not intrinsically tied together. Finally, alpha use is suggested only as one link in a total program focusing on the unique history and motives of the client. The maladaptive motives and habits of the clients make alpha control useful at an early stage, but the therapeutic program must lead to the development of styles of thought and behavior fostering autonomy from such existential crutches. Research is needed to clarify both the short -and long-term functions that alpha can serve in a therapeutic program and the types of substance abusers that can most profit from its use. More clarification is also needed in the exact techniques of alpha training to allow comparison and criticism.

Alpha Conditioning as an Adjunct Treatment for Drug Dependence: Part I

The effects of alpha conditioning on the habits of four methadone maintained patients were assessed. All four learned some control over alpha acitivity in the 5-week, 10-session training period. The most striking results, however, related to the subjects’ substitution of self-initiated mental states associated with alpha for previously used drug-seeking or self-medicating methods of coping with everyday problem situations. All four subjects reported a decrease in illicit drug usage and an increased feeling of self-control. Verification of improvement in adjustment and drug abuse was shown by counseling reports and narcotic screens from the maintenance program.

Physiological and Psychological Effects of Alpha and Emg Feedback Training with College Drug Users a Pilot Study*

Twenty four volunteer college students who were regular drug users were randomly allocated to three training groups of equal size: alpha feedback, EMG feedback and a joked control group. The subjects were unaware of which feedback condition they received and were asked to practise at home during a six month follow up period in order to achieve a relaxed state similar to that experienced during training. No group was successful in retaining gains made in their alpha levels during each session, but the EMG group significantly reduced their muscular activity during training and retained the improvement during follow up. The alpha and joked groups did not greatly improve their EMG during training but at follow up achieved the same levels as the EMG group. There was evidence to suggest that a reduction in drug use among light and medium users was maintained during follow up. Significant and lasting improvements were made by each group in the duration and quality of their sleep and anxiety levels were reduced.