Effectiveness and Potential Mechanisms of Group Cognitive Behavioral Therapy with Biofeedback-Assisted Program for Patients with Hypertension

• Main Authors: CHANG, HONG-RU, 張弘儒
• Other Authors: WENG, CHIA-YING
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/edy7g6

碩士 === 國立中正大學 === 心理學系臨床心理學研究所 === 106 === Purpose: This study aimed to evaluate the effectiveness and potential mechanisms of the group cognitive behavioral therapy with biofeedback-assisted program (GCBT) for hypertension (HT) patients on emotion regulation function, cardiac autonomic function, peripheral vascular sympathetic function, and blood pressure level. Methods: The database collected by projects supported by the grants from Ministry of Science and Technology (103-2410-H-194-039-MY2) to Chia-Ying Weng. Thirty-five HT subjects were recruited from the cardiology clinics of a regional hospital and assigned to an intervention group (IG) or a wait-list control (WLC). The IG (n = 10; female, 60.0%; mean age = 57.20 ± 6.73 years) received eight two-hour weekly sessions group program, which incorporated cognitive behavioral therapy and biofeedback-assistant breathing training component. The WLC (n = 13; female, 61.5%; mean age = 58.98 ± 8.73 years) received regular medical care and went through the group program after the post-waiting measurement. After the WLC had the program, the IG and WLC were combined and all were followed up six months post-intervention (n = 12; female, 50.0%; mean age = 56.50 ± 8.05 years). The emotion regulation function (Perceived Stress Scale, Beck Depression Inventory - II, Trait Anxiety Inventory, Type D Scale-14 Taiwan version, Chinese Hostility Inventory: Short form, and Chinese Happiness Inventory), cardiac autonomic function (heart rate variability), peripheral vascular sympathetic function (blood volume amplitude), and blood pressure were assessed pre- (T1) and post- (T2) intervention,3 (T3) and 6-month of follow-up (T4). The main outcomes analyzed were the changes in measures from T1 to T2 between the two groups, and the changes in measures from T1 to T4 among all the participants who attended intervention program. Results: From T1 to T2, there was a significant reduction in respiration rate (F(1, 21) = 16.46, p< .001) and a significant elevation in cardiac baroreflex regulation, as indicated by log-transformed low-frequency power (F(1, 16) = 5.99, p< .05), in the IG relative to the WLC. The participants who attended intervention program had better emotion regulation, which decreased anxiety trait(F(3, 33) = 6.14, p< .01), perceived stress (F(3, 33) = 4.03, p< .05), negative affectivity (F(3, 33) = 3.01, p< .05), depression (F(3, 33) = 3.45, p< .05), and increased happiness(F(3, 33) = 4.74, p< .01), during follow-up period. In addition, the participants had lower systolic blood pressure at T3 and T4 compared to T1(F(3, 33) = 4.56, p< .01), and higher blood volume amplitude at T4 compared to T1(F(3, 33) = 5.08, p< .01). Conclusions: The findings indicated that GCBT might lower systolic BP levels for HT patients through potential mechanisms, including improving emotional regulation function, immediately promoting cardiac autonomic regulation, and subsequently reducing peripheral vascular sympathetic activity.