Neurofeedback?

[psychanon]

I recently heard something about psychologists using neurofeedback as treatment for depression. I've heard that it's had some popularity as a treatment for ADHD, and that some psychologists are expanding its applications. The spin that I heard from an enthusiast was that neurofeedback is a psychiatrist's worst nightmare, because it works as well as meds but can be delivered by psychologists. I'd never heard much about it before, and I'm curious if any of have any opinions on it. Is there evidence for its efficacy? Or is it quackery (something along the lines of EMDR)? Is the biological basis for its claims strong, or are they using specious logic? (i don't specialize in neuro, so i don't feel equipped to evaluate it).

I did a quick PsycINFO search, and there were some articles claiming efficacy for neurofeedback, but they were mostly in journals I haven't heard of, most of which were biofeedback-themed. I'm interested because I'm curious about issues of science vs. pseudoscience in clinical psychology research, and I'm having trouble classifying this one.

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[Psyclops]

A teltale sign of pseudo-science is articles only published in journals that publish only those kind of articles.... you follow?

I don't know anything about neurofeedback though.

There are plenty of things that psychologists do that are = or more effective than medication. CBT for depression for example. It has = response rates, and much better remission rates.

 

[Neuro-Dr]

You are not alone. Most of the debates on the use of qEEG in terms of assessment can be summarized through Loo, Monastra and a couple others who have published widely in this area. The bulk of the data for assessment suggests that with regard to things like ADHD, the beta/theta ratio at PZ and CZ (frontal regios) are slowed under a driving condition in ADHD relative to NC. They don't have NPP or PPP for this, but do have sensitivity and specificity and an overall correct clasification rate around 80-85%. This sounds good, but is certainly misleading with a base rate control model. In addition, it remains unclear whether in times where qEEG differs from clinical diagnosis, who is right. If it is clinical, then you have found a way to be less accurate, if qEEG, then there is a reasonable application. To date, there are no peer-reviewed articles outside of trade journals.

With regard to treatment, I have not found it to generalize well. People can learn to perform the in the procedure, but show no changes in other environments, but this is anecdotal. I have seen no head-to-head of A-B-A trials. The feedback is costly and not always covered by insurance, so I'm still pretty skeptical. Having said that, I wellcome more research in the are.

 

[psychanon]

A teltale sign of pseudo-science is articles only published in journals that publish only those kind of articles.... you follow?

Yeah, that was my suspicion. An advocate for neurofeedback might argue that mainstream journals systematically exclude articles about unfamiliar treatments, but it seems questionable that no well-known journal has published on it (that I could find, anyway). Yet, I've heard several times about psychologists using the technique, which seems shaky given the lack of empirical consensus.

There are plenty of things that psychologists do that are = or more effective than medication. CBT for depression for example. It has = response rates, and much better remission rates.

That's a very good point. 🙂

 

[psychanon]

You are not alone. Most of the debates on the use of qEEG in terms of assessment can be summarized through Loo, Monastra and a couple others who have published widely in this area. The bulk of the data for assessment suggests that with regard to things like ADHD, the beta/theta ratio at PZ and CZ (frontal regios) are slowed under a driving condition in ADHD relative to NC. They don't have NPP or PPP for this, but do have sensitivity and specificity and an overall correct clasification rate around 80-85%. This sounds good, but is certainly misleading with a base rate control model. In addition, it remains unclear whether in times where qEEG differs from clinical diagnosis, who is right. If it is clinical, then you have found a way to be less accurate, if qEEG, then there is a reasonable application. To date, there are no peer-reviewed articles outside of trade journals.

With regard to treatment, I have not found it to generalize well. People can learn to perform the in the procedure, but show no changes in other environments, but this is anecdotal. I have seen no head-to-head of A-B-A trials. The feedback is costly and not always covered by insurance, so I'm still pretty skeptical. Having said that, I wellcome more research in the are.

Thanks for your input! I hadn't heard anything about those assessment issues. It seems like an interesting idea in theory, but the widespread use of it with the lack of strong empirical evidence seems pretty sketchy.

 

[Psyclops]

An advocate for neurofeedback might argue that mainstream journals systematically exclude articles about unfamiliar treatments, but it seems questionable that no well-known journal has published on it (that I could find, anyway). )

Unfortunately, our field has not been imune to ignoring groundbreaking work and not offering an oportunity to publish it. I don't know if you were familiar with Garcia's work on taste aversion. He was systematically ignored for quite awhile.

 

[50960]

Anything with "neuro" in it somehow gets appreciated.....silly. Keep in mind there are many more masters level "therapist" out there than there are licensed psychologists who are skewing the tx data. As a child psych who treats ADHD daily I have never even considered this, the pathophysiology/sx and the tx make no sense put together.......... 😱

 

[lazure]

It's great behaviorally. They have to stay still for long periods 🙂

I still find it hard to believe that they don't fidget or leave the chair....🙂

 

[Logic Prevails]

Anything with "neuro" in it somehow gets appreciated.....silly.

But there are also some valid techniques as well. Like "Neuro-Linguistic Programming." 😉