In this video we will describe one method of assessing person’s psychophysiological reaction to stress using biofeedback. We will also present general guidelines for treatment planning.
Part 1: Setting up and preparing the skin
Part 2: Recording
Part 3: Debriefing and treatment planning
Appendix I
Stress assessment interpretation guidelines
(all “bold” answers indicate areas to be addressed)
EMG (normal reading <3 microvolts) | ||
1. Is EMG elevated at baseline? | yes _ | no _ |
2. Is EMG elevated past the baseline at any of the 3 stressors? | yes _ | no _ |
3. Is there recovery of EMG to baseline level during rest periods? | yes _ | no _ |
Heart rate (normal range 60-80 beats per minute) | ||
1. Is heart rate elevated at baseline? | yes _ | no _ |
2. Is heart rate elevated past the baseline at any of the 3 stressors? | yes _ | no _ |
3. Is there recovery of heart rate to baseline level during rest periods? | yes _ | no _ |
Breathing rate (normal rate <12 breaths per minute) | ||
1. Is breathing rate elevated at baseline? | yes _ | no _ |
2. Is breathing rate elevated past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of breathing rate to baseline during rest periods? | yes _ | no _ |
Skin conductance | ||
1. Is skin conductance elevated at baseline? | yes _ | no _ |
2. Is skin conductance elevated past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of skin conductance to baseline during rest periods? | yes _ | no _ |
Finger temperature (normal reading >90F) | ||
1. Is finger temperature low at baseline? | yes _ | no _ |
2. Does finger temperature decrease past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of finger temperature to baseline during rest periods? | yes _ | no _ |
Heart rate variability (norms vary by age) | ||
1. Is heart rate variability low at baseline? | yes _ | no _ |
2. Does heart rate variability decrease past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of heart rate variability during rest periods? | yes _ | no _ |
Appendix I
Stress assessment interpretation:
EMG (normal reading <3 microvolts) | ||
1. Is EMG elevated at baseline? | yes _ | no _ |
2. Is EMG elevated past the baseline at any of the 3 stressors? | yes _ | no _ |
3. Is there recovery of EMG to baseline level during rest periods? | yes _ | no _ |
Heart rate (normal range 60-80 beats per minute) | ||
1. Is heart rate elevated at baseline? | yes _ | no _ |
2. Is heart rate elevated past the baseline at any of the 3 stressors? | yes _ | no _ |
3. Is there recovery of heart rate to baseline level during rest periods? | yes _ | no _ |
Breathing rate (normal rate <12 breaths per minute) | ||
1. Is breathing rate elevated at baseline? | yes _ | no _ |
2. Is breathing rate elevated past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of breathing rate to baseline during rest periods? | yes _ | no _ |
Skin conductance (normal reading <5 micro ohms) | ||
1. Is skin conductance elevated at baseline? | yes _ | no _ |
2. Is skin conductance elevated past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of skin conductance to baseline during rest periods? | yes _ | no _ |
Finger temperature (normal reading >90F) | ||
1. Is finger temperature low at baseline? | yes _ | no _ |
2. Does finger temperature decrease past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of finger temperature to baseline during rest periods? | yes _ | no _ |
Heart rate variability (norms vary by age) | ||
1. Is heart rate variability low at baseline? | yes _ | no _ |
2. Does heart rate variability decrease past the baseline for any stressor? | yes _ | no _ |
3. Is there recovery of heart rate variability during rest periods? | yes _ | no _ |
Treatment planning:
If a reading is higher or lower than normal at baseline, goal of treatment is to help client bring that physiological parameter to normal in all circumstances
If a reading is higher or lower than normal during the stressor, goal of treatment is to help client identify stressors and be able to maintain normal level of physiological functioning under stress
If a reading indicates lack of recovery during down time, goal of treatment is to help client bring that physiological parameter to normal level quickly following a stressor.
Completed psychophysiological in the appendi stress assessment provides a biofeedback practitioner with information necessary for formulating a treatment plan. This assessment provides information about both the individual’s response stereotypy, or uniformity of certain physiological responses to all stressors, and stimulus-response specificity, or individual’s unique physiological responses to different kinds of stressors. With this information, the client is then able to learn to predict what kind of physiological response to expect in which situation and be able to modify his/her response accordingly.
Following the assessment, it is important for the practitioner to inquire about the client’s subjective experience of the stressors in order to catch any mismatch between client’s subjective experience and physiological readings. Such mismatch would then need to be addressed during treatment.
It is also important to keep in mind that effects of the stressor presented first may impact client’s response to subsequent stressors. One possible solution to this problem is to present stressors to the same client in different order on several occasions. However, this is time consuming and may not be feasible in a clinical, non-research, setting.
The protocol presented here is a general guideline, with many possible modifications depending on each client’s individual needs and on the equipment available to the practitioner. Placement of EMG sensors may vary depending on the presenting problem (eg., massester and/or sternocleidomastoid muscle for TMJD, upper trapezius and/or frontalis muscle for tension headaches). Particular stressors presented may vary according to what the client is likely to encounter in real life. With different equipment used, particular settings/programs used would vary accordingly.
Biofeedback practitioners should use their training to tailor the treatment to each individual client, with appropriate use of complementary psychotherapy to facilitate biofeedback treatment.
The authors have nothing to disclose.
Material Name | Type | Company | Catalogue Number | Comment |
---|---|---|---|---|
Physiolab I-330-C2 | J&J | |||
PLUS 12 ch |