Reducing Anxiety and Social Stress in Primary Education: A Breath-Focused Heart Rate Variability Biofeedback Intervention

Abstract

Primary school students suffer from high levels of anxiety and stress. Having emotional regulation abilities can help them to manage challenging emotional situations. Conscious and slow breathing is a physiological, emotional regulation strategy that is feasible for primary school students to learn. Following Polyvagal Theory and PMER Theory, this research presents the results of a breath-focused heart rate variability biofeedback intervention. The intervention aimed to reduce anxiety and physiological and social stress in primary school children. A total of 585 students (46.4% girls and 53.6% boys) from the same public school, aged between 7 and 12 years (M = 8.51; SD = 1.26), participated in this study. To assess the impact of training, a mixed design was used with two groups (Treatment and Control groups), two evaluation phases (Pretest and Post-test), and three educational cycles (first, second and third cycles). To examine heart rate variability, emWave software was used and anxiety and social stress were measured by the BASC II test. The results showed that after the intervention, the students learned to breathe consciously. Moreover, they reduced their levels of anxiety (M(SD)pretest = 12.81(2.22) vs. M(SD)posttest = 13.70(1.98)) and stress (M(SD)pretest = 12.20(1.68) vs. M(SD)posttest = 12.90(1.44)). The work also discusses the limitations and benefits of this type of intervention in primary schools.

The effects of HeartMath Heart Lock‐In on elementary students' HRV and self‐reported emotion regulation skills

“…The iPods were rotated daily through each classroom, giving students an equal opportunity to witness changes in HRV as they practiced. It provides a total HRV of 100 points visually distributed by bars between low (red/incoherent), medium (blue), or high (green/coherent) HRV, as well as a coherence score, with higher scores reflecting greater (and healthier) HRV (Aranberri-Ruiz et al, 2022). Although this HRV biofeedback was used during practice with students, it was not collecting data on HRV throughout practice time.…”

“…A parasympathetic reaction occurs when safety is perceived, whereas a sympathetic reaction occurs in response to perceptions that safety is at risk (c.f. Aranberri-Ruiz et al, 2022). The ANS, and particularly the vagus nerve, is essential to the development of emotional experience as well as the ability to self-regulate emotions and social behavior (McCraty, 2015).…”

“…As mentioned, research has indicated that practicing HeartMath ER techniques can lead to improvements in children's HRV, ER, and academic success (e.g., Aranberri-Ruiz et al, 2022;Bothe et al, 2014;Bradley et al, 2007Bradley et al, , 2010McCraty, 2015;McCraty et al, 2006;McLeod & Boyes, 2021). However, HeartMath and HRV research with younger children is relatively new, and additional research is required.…”

“…Children are suffering from elevated levels of anxiety and stress (c.f. Aranberri‐Ruiz et al, 2022). Cartwright‐Hatton et al (2006) conducted a review that yielded rates of anxiety diagnosis in children ranging from 2.6% to 41.2% globally; anxiety disorders are the most common psychological challenge in children and adolescence.…”

“…During childhood, emotional intensity and reactivity are heightened, and ER is underdeveloped; thus, this is an ideal time to instill effective strategies (c.f. Aranberri‐Ruiz et al, 2022). Skills that enhance heart rate variability (HRV) are a promising direction, as higher HRV contributes to the healthy functioning of self‐regulatory capability and psychophysiological resilience (McCraty, 2022; McCraty et al, 2006).…”