Paroxysmal dyskinesia and electrodermal volatility: The role of mindfulness, self-compassion and psychophysiological interventions.

To date, there are no behavioral or psychophysiological treatment studies on paroxysmal dyskinesia (PD). PD is a group of debilitating movement disorders that present with severe episodes of dystonia, chorea, and/or ballistic like movements. This is a first case report of a 50-year-old male who received behavioral interventions (e.g., mindfulness, CBT, and biofeedback interventions) to manage his PD episodes in tandem with multidisciplinary treatments (e.g., neurology, psychiatry, etc.). The paper primarily discusses the serendipitous observation of galvanic skin response (GSR) elevations and spikes immediately before and after the onset of PD episodes. GSR volatility was noted in wave amplitude and wave morphology. Graphs are presented to illustrate GSR volatility associate with PD episodes and the reduction of GSR volatility in response to behavioral approaches. The discussion highlights the feasibility of using GSR biofeedback as an adjunct to mindfulness and CBT to manage PD as part of a multidisciplinary treatment approach. Peripherally, issues that related to misclassification of somatic symptoms and related disorders (e.g., psychogenic non-epileptic seizures) and aspects of neurocognitive disorders are discussed. The paper reviews neurological findings, MRI, neuropsychological data, and psychiatric assessment to highlight the dilemma clinician's face and clarify behavioral practices to further the management of PD.

The P3-model of perioperative psychological preparation: Pre-surgical and pre-medical procedural psychological preparation and psychophysiological interventions.

Applied psychophysiological and psychological interventions can support successful post-surgical outcomes among patients who undergo surgical or medical procedures. However, more translational research is needed to extend the current understandings and practices of evidence-based and evidence-informed behavioral interventions to improve the outcomes of surgical and medical procedures. As healthcare becomes increasingly integrative, biopsychosocial oriented practitioners (e.g., health psychologists, neuropsychologists, pain psychologists, psychiatrists, nurses) will play an integral role with surgical and interventional professionals (e.g., neurosurgeons, bariatric surgeons, anesthesiologist, transplant surgeons, interventionalist, radiologist). These roles include pre-surgical evaluations, identifying pre-emptive concerns and implementing behavioral interventions, which ultimately act to improve the outcome of the surgery or medical procedure. In this paper, the authors 1) review the status of the broader practice of perioperative behavioral interventions; 2) review the pre-surgical and pre-procedural behavioral risk factors and translate psychophysiological and behavioral interventions to optimize post-surgical and post-procedural outcomes; and 3) provide a general framework (P3-Model) that can be used in a perioperative practice to carry out pre-surgical and pre-procedural behavioral interventions. Specifically, the role of behavioral and biofeedback interventions in the preparation of patients who are undergoing surgeries and medical procedures will be detailed. Psychological preparation that addresses pre-surgical and pre-medical procedure behavioral risk factors help perioperative healthcare providers and patients to have maximal post-operative success.

Case study of an Iranian-American neuropsychological assessment in the surgical setting: role of language and tests.

There is a growing need to conduct a neuropsychological assessment with bilingual Middle Eastern populations, particularly those who speak the Persian language (Farsi). Although validated neuropsychological and language tests have emerged in Iran, there remains a shortage of appropriate psychometric tests in the U.S. that have been validated for use with the Iranian-American population. This often leads to an assortment of using U.S. tests in English, U.S. tests translated into Farsi, and Iranian tests in Farsi, which can complicate the clinical assessment. To better understand common testing issues when working with bilingual Iranian-American patients, we review the first report of a 62-year-old, bilingual (English-Farsi) Iranian-American male with 18-years of education who was tested using U.S.-developed and Iranian-developed tests in both English and Farsi language. Pre-surgical, 6 months post-surgical, and 1.5 years of post-surgical assessment data are discussed. We highlight the strengths and limitations of naming tests, test used in the native country versus U.S. language tests, the importance of baseline testing, general bilingual Persian-English assessment considerations, and case-based learning points.