Combined Neurofeedback and Heart Rate Variability Training for Individuals with Symptoms of Anxiety and Depression: A Retrospective Study

Abstract

Introduction.Neurofeedback (NFB) and heart rate variability (HRV) training present promising, nonpharmaceutical intervention strategies for anxiety and depression. This report is the first to address whether concurrent NFB and HRV (NFB+HRV) provides a viable intervention for symptoms of anxiety and depression, measured by the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire. Methods. 183 children and adults with symptoms of anxiety and/or depression underwent NFB+HRV training. Psychological symptom rating, EEG, blood pressure, breathing pattern, and HRV were measured before and after treatment. Results. After NFB+HRV training, symptoms of anxiety (p < .001, d z = 1.42) and depression (p < .001, d z = 1.34) were reduced in children and adults. The majority of individuals with pretreatment symptoms of anxiety (82.8%) or depression (81.1%) experienced ASEBA improvements of clinical importance. There were also significant changes in EEG, breathing rate, and HRV. For the 16 individuals copresenting with hypertension, systolic and diastolic blood pressure were significantly reduced. Conclusion. We present evidence that NFB+HRV training may provide an effective, nonpharmaceutical intervention to reduce symptoms of anxiety and depression in children and adults. Additionally, NFB+HRV training may improve EEG, blood pressure, resting breathing rate, and HRV.

Z-Score Neurofeedback and Heart Rate Variability Training for Adults and Children with Symptoms of Attention-Deficit/Hyperactivity Disorder: A Retrospective Study

“…This initial group of individuals excluded employees and family members of employees, due to potential conflict of interest. Further exclusion criteria for this study were: total time to complete the program was fewer than six weeks or more than 24 weeks (our center recommends that clients complete the 30-session program in 12 weeks (White et al 2017)), IVA results consistent with a potential neurodevelopmental or neurocognitve disorder (as identified by the IVA + Plus Interpretive Flowchart for ADHD, version 2014.2), and ASEBA scores that indicated the client was denying or exaggerating the existence of problems (as defined by the ASEBA, for children: a Total Problems raw score less than 3 or more than 133; for ages 18-35: less than 9 or more than 142; for ages 36–59: less than 7 or more than 100). After exclusion criteria were applied, 139 clients remained in the current analysis.…”

Predictors of Neurofeedback Outcomes Following qEEG Individualized Protocols for Anxiety

“…Neurofeedback is also a form of biofeedback that is showing promising effects in correcting negative symptoms including depression (Cheon et al, 2015), sleep disorders (Cheon et al, 2015), attention-deficit/hyperactivity disorder (Van Doren et al, 2019), and anxiety (Cheon et al, 2015;Kerson, Sherman, & Kozlowski, 2009;Scheinost et al, 2013;Wang et al, 2019;Zhao et al, 2018). In addition, combinations of neurofeedback and biofeedback (e.g., HRV) have produced promising outcomes for reducing anxiety symptoms (White et al, 2017).…”

Evaluating Deep Learning EEG-Based Anxiety Classification in Adolescents with Autism for Breathing Entrainment BCI

“…In conjunction with breath control, neurofeedback training has been shown to be a promising mitigatory tool for anxiety. For example, White et al [43] demonstrated that breathing-based visual neurofeedback reduces symptoms in patients with anxiety and depression, while acoustically-mediated deep breathing neurofeedback was shown by Crivelli et al [44] to diminish long-term stress and anxiety levels in young adults. The first step towards an EEG-based BCI able to monitor anxiety levels, to identify an individual's optimal breathing patterns, and to adapt breathing entrainment parameters in real-time, is to determine whether anxiety can be classified on the basis of ongoing EEG data.…”