行動療法, バイオフィードバック(心身医学領域における治療の実態)

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In the clinical practice of psychosomatic diseases, behavior therapy is proven to be useful when the therapist adequately selects the therapeutic techniques. However, the behavioral assessment is not so easily made, because psychosomatic diseases are multifactorial.The behavioral approaches to bronchial asthma include relaxation technique, systematic desensitization, hypnotism and so on, and today biofeedback techniques as visceral learning are getting the attention of researchers. Also Kahn, A.U. and his co-workers suggested a hypothesis that the so-called exercise-induced bronchospasm is classically conditioned, and have performed clinical experiments on asthmatic children.Shapiro, A.P. et al examined the results of behavioral approach to hypertension and concluded that the most of them were effective but they remained at the stage of phase 1. Therefore, we expect further researches to be conducted in the future. With regard to anorexia nervosa, the behavior therapists are trying to treat the patients through an instrumental conditioning approach. The target is to increase the patients' body weight in most cases. Halmi, K.A. points out that the gain of body weight makes the patients' behavior psychologically, socioeconomically, and sexually well adjusted.More than ten years have passed since biofeedback techniques appeared in the behavioral practices. There are so many pilot studies of biofeedback therapies on psychosomatic or psychophysiological disorders. Perhaps EMG biofeedback training on tension headache is one of studies where the most unbroken efforts have been made. But Beaty, E.T. and Haynes, S.N. noticed that placebo effect, motivation, practice at home still effected the results of the therapy and therefore we could not literally accept the therapeutic data of EMG biofeedback.The author has the same idea regarding the treatment of tic syndrome in childhood. He tried EMG Biofeedback training and the results were successful. He also believes, however, the therapeutic intervention with their parents should not be neglected.At present behavior therapy and biofeedback are being integrated into behavioral medicine. The relationship between psychosomatic medicine and behavioral medicine is one of controversial matters. Both approaches are comprehensive in medicine. The former is more concerned with the pathogenesis or etiological factors of diseases, whereas the latter with therapeutic techniques and rahabilitation. The author bilieves that their future development will draw a conclusion on this theme.
日本心身医学会の論文
1982-10-01

行動療法, バイオフィードバック(心身医学領域における治療の実態)

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