Abstract
Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers. The training comprised exercises promoting acquisition of control over sympathetic arousal under resting conditions and during exposure to visual, acoustic and cognitive stressors resembling situations related to crisis management. In a randomized controlled design, 36 crisis managers were assigned to either a biofeedback training group or waiting list control group. Subjective stress was assessed using the Perceived Stress Scale. In the training group, stress level markedly decreased; the decrease remained stable at follow-up 2 months after the training. The results indicate that biofeedback training in crisis management is an effective method for stress management that may help to reduce vulnerability to stress-related performance decline and stress-related disease.
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References
Alexander, D. A., & Klein, S. (2001). Ambulance personnel and critical incidents: Impact of accident and emergency work on mental health and emotional well-being. British Journal of Psychiatry, 178(1), 76–81.
Association for Applied Psychophysiology and Biofeedback (2003). Standards for performing biofeedback. http://www.aapb.org/i4a/pages/index.cfm?pageid=3678#VI.
Berger, W., Coutinho, E. S. F., Figueira, I., Marques-Portella, C., Luz, M. P., Neylan, T. C., Marmar, C. R., & Mendlowicz, M. V. (2012). Rescuers at risk: A systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Journal of Social Psychiatry and Psychiatric Epidemiology, 47(6), 1001–1011.
Berntson, G. G., Quigley, K. S., & Lozano, D. (2007). Cardiovascular psychophysiology. In J. T. Cacioppo, L. G. Tassinary & G. G. Berntson (Eds.), Handbook of psychophysiology (pp. 182–210). New York, NY: Cambridge University Press.
Berry, M. E., Chapple, I. T., Ginsberg, J. P., Gleichauf, K. J., Meyer, J. A., & Nagpal, M. L. (2014). Non-pharmacological intervention for chronic pain in veterans: A pilot study of heart rate variability biofeedback. Global Advances in Health and Medicine, 3(2), 28–33.
Bonanno, G. A., Papa, A., O’Neil, K., Westphal, M., & Coifman, K. (2004). The importance of being flexible: The ability to enhance and suppress emotional expression predicts long-term adjustment. Psychological Science, 15, 482–487.
Bouchard, S., Bernier, F., Boivin, É., Morin, B., & Robillard, G. (2012). Using biofeedback while immersed in a stressful videogame increases the effectiveness of stress management skills in soldiers. PLoS ONE, 7(4), 1–11.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.
Critical response in security and safety emergencies (2011). Retrieved from November 30, 2015, http://cordis.europa.eu/project/rcn/98623_en.html.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396.
Cowings, P. S., Kellar, M. A., Folen, R. A., Toscano, W. B., & Burge, J. D. (2001). Autogenic feedback training exercise and pilot performance: Enhanced functioning under search-and-rescue flying condition. International Journal of Aviation Psychology, 11(3), 303–315.
Cutshall, S. M., Wentworth, L. J., Wahner-Roedler, D. L., Vincent, A., Schmidt, J. E., Loehrer, L. L., Cha, S. S., & Bauer, B. A. (2011). Evaluation of a biofeedback-assisted meditation program as a stress management tool for hospital nurses: A pilot study. Explore, 7(2), 110–112.
Dawson, M. E., Schell, A. M., & Filion, D. L. (2007). The electrodermal system. In J. T. Cacioppo, L. G. Tassinary & G. G. Berntson (Eds.), Handbook of psychophysiology (pp. 159–181). New York, NY: Cambridge University Press.
Garcia-Vera, M. P., Sanz, J., & Labrador, F. J. (1998). Psychological changes accompanying and mediating stress-management training for essential hypertension. Applied Psychophysiology and Biofeedback, 23(3), 159–178.
Ginsberg, J. P., Berry, M. E., & Powell, D. A. (2010). Cardiac coherence and posttraumatic stress disorder in combat veterans. Alternative Therapies, 16(4), 52–60.
Janka, A., Adler, C., Fischer, L., Perakakis, P., Guerra, P., & Duschek, S. (2015). Stress in crisis managers: Evidence from self-report and psychological assessments. Journal of Behavioral Medicine, 38(6), 970–983.
Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878.
Kellar, M. A., Folen, R. A., Cowings, P. S., Toscano, W. B., & Hisert, G. L. (1993). Autogenic-feedback training improves pilot performance during emergency flying conditions. NASA Technical Memorandum, 104005, 1–14.
Kotozaki, Y., Takeuchi, H., Sekiguchi, A., Yamamoto, Y., Shinada, T., Araki, T., Takahashi, K., Taki, Y., Ogino, T., Kiguchi, M., & Kawashima, R. (2014). Biofeedback-based training for stress management in daily hassles: An intervention study. Brain and Behavior, 4(4), 566–579.
LeBlanc, V. R. (2009). The effects of acute stress on performance: Implications for health professions education. Academic Medicine, 84(10 Suppl), S25–S33.
LeBlanc, V. R., Regehr, C., Tavares, W., Scott, A. K., MacDonald, R., & King, K. (2012). The impact of stress on paramedic performance during simulated critical events. Prehospital and Disaster Medicine, 27(4), 369–374.
Lehrer, P. M., Can, R., Sargunaraj, D., & Woolfolk, R. L. (1994). Stress management techniques: Are they all equivalent, or do they have specific effects? Biofeedback and Self-regulation, 19(3), 353–401.
Lemaire, J. B., Wallace, J. E., Lewin, A. M., de Grood, J., & Schaefer, J. P. (2011). The effect of a biofeedback-based stress management tool on physician stress: a randomized controlled clinical trial. Open Medicine, 5(4), 154–163.
Linden, W. L. E. T., Earle, T. L., Gerin, W., & Christenfeld, N. (1997). Physiological stress reactivity and recovery: conceptual siblings separated at birth? Journal of Psychosomatic Research, 42(2), 117–135.
McClelland, D. (2000). Human Motivation. Cambridge: University Press.
McGaugh, J. L. (2000). Memory—A century of consolidation. Science, 287(5451), 248–251.
Moravec, C. S. (2008). Biofeedback therapy in cardiovascular disease: Rationale and research overview. Cleveland Clinic Journal of Medicine, 75(2), 35–38.
Nash, J. M., & Thebarge, R. W. (2006). Understanding psychological stress, its biological processes, and impact on primary headache. Head and Face Pain, 46(9), 1377–1386.
Ratanasiripong, P., Ratanasiripong, N., & Kathalae, D. (2012). Biofeedback intervention for stress and anxiety among nursing students: A randomized controlled trial. International Scholarly Research Network Nursing, 1–5.
Reyes, F. J. (2014). Implementing heart rate variability biofeedback groups for veterans with posttraumatic stress disorder. Biofeedback, 42, 137–142.
Ritchie, E. C., Watson, P. J., & Friedmann, M. J. (2006). Interventions following mass violence and disasters. Strategies for mental health practice. New York: Guilford Press.
Rozanski, A., & Kubzansky, L. D. (2005). Psychologic functioning and physical health: A paradigm of flexibility. Psychosomatic Medicine, 67(1), S47–S53.
Saynaeve, G.J.R. (2001). Psycho-social support in situations of mass emergency: A european policy paper concerning different aspects of psychosocial support and social accompaniment for people involved in major accidents and disasters. Brussels: Ministry of Public Health.
Schwartz, M. S., & Andrasik, F. (2005). Biofeedback: A practitioner´s guide. New York, NY: Guilford Press.
Svensson, E., Angelborg-Thanderz, M., & Sjöberg, L. (1993). Mission challenge, mental workload and performance in military aviation. Aviation Space and Environmental Medicine, 64(11), 985–991.
Tan, G., Dao, T. K., Farmer, L., Sutherland, R. J., & Gervitz, R. (2011). Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): A pilot study. Applied Psychophysiology and Biofeedback, 36(1), 27–35.
van der Zwan, J. E., de Vente, W., Huizink, A. C., Bögels, S. M., & de Bruin, E. I. (2015). Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: a randomized controlled trial. Applied Psychophysiology and Biofeedback, 40(4), 257–268.
Walker, M. P., & Stickgold, R. (2004). Sleep-dependent learning and memory consolidation. Neuron, 44(1), 121–133.
Weltman, G., Lamon, J., Freedy, E., & Chartand, D. (2014). Police department personnel stress resilience training: An institutional case study. Global Advances in Health and Medicine, 3(2), 72–79.
Zucker, T., Samuelson, K. W., Muench, F., Greenberg, M. A., & Gevritz, R. N. (2009). The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: A pilot study. Applied Psychophysiology and Biofeedback, 34(2), 135–143.
Acknowledgements
The study was supported by the European Commission (Project PsyCris, FP7-SEC-2012-1).
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All procedures performed in the study were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments. The study was approved by the ethics committee of UMIT - University of Health Sciences, Medical Informatics and Technology; all participants provided written informed consent.
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Janka, A., Adler, C., Brunner, B. et al. Biofeedback Training in Crisis Managers: A Randomized Controlled Trial. Appl Psychophysiol Biofeedback 42, 117–125 (2017). https://doi.org/10.1007/s10484-017-9360-6
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DOI: https://doi.org/10.1007/s10484-017-9360-6