Heart rate variability biofeedback: Theoretical basis, delivery, and its potential for the treatment of substance use disorders

Eddie, David; Vaschillo, Evgeny; Vaschillo, Bronya; Lehrer, Paul M.

doi:10.3109/16066359.2015.1011625

Cited by 48 publications

(37 citation statements)

References 94 publications

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“…Interestingly, the intervention was not accompanied by long-term increase in HRV parameters 129. By reducing craving and anxiety accompanying abstinence HRVB represents a useful adjunct therapeutic option in substance use disorders 130. In a mixed group of alcohol or drug addict men, HRVB proved to be an efficient add-on therapy for reducing craving 131.…”

Section: Heart Rate Variability Biofeedbackmentioning

confidence: 95%

Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy

Pintér¹,

Szatmári²,

Horváth³

et al. 2019

NDT

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Depressive disorders are among the most important health problems and are predicted to constitute the leading cause of disease burden by the year 2030. Aside significant impact on quality of life, psychosocial well-being and socioeconomic status of affected patients, depression is associated with impaired cardiovascular health and increased mortality. The link between affective and cardiovascular disease has largely been attributed to dysregulation of the autonomic nervous system resulting in a chronic shift toward increased sympathetic and decreased parasympathetic activity and, consecutively, cardiac dysautonomia. Among proposed surrogate parameters to capture and quantitatively analyze this shift, heart rate variability (HRV) and baroreflex sensitivity have emerged as reliable tools. Attenuation of these parameters is frequently seen in patients suffering from depression and is closely linked to cardiovascular morbidity and mortality. Therefore, diagnostic and therapeutic strategies were designed to assess and counteract cardiac dysautonomia. While psychopharmacological treatment can effectively improve affective symptoms of depression, its effect on cardiac dysautonomia is limited. HRV biofeedback is a non-invasive technique which is based on a metronomic breathing technique to increase parasympathetic tone. While some small studies observed beneficial effects of HRV biofeedback on dysautonomia in patients with depressive disorders, larger confirmatory trials are lacking. We reviewed the current literature on cardiac dysautonomia in patients suffering from depression with a focus on the underlying pathophysiology as well as diagnostic workup and treatment.

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Section: Heart Rate Variability Biofeedbackmentioning

confidence: 95%

Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy

Pintér¹,

Szatmári²,

Horváth³

et al. 2019

NDT

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“…HRV, as an indicator of self-regulation abilities, has been reported to have a strong association with substance-use behaviors. 18 For example, higher HRV-R (vagal withdrawal, a decrease in HRV from baseline to stress) is associated with reduced alcohol use risk 19 and can buffer the associations between early life stress and problem behaviors, 20 including alcohol-related risks. 21 In contrast, low HRV-R (vagal augmentation, an increase in HRV from baseline to the stress) is associated with hypervigilance and youths' risk for behavioral problems.…”

Section: Hrv As a Biomarker Addiction Riskmentioning

confidence: 99%

Heart Rate Variability Reactivity Moderates the Indirect Link Between Child Maltreatment and Young Adult Alcohol Use Problems Via Depressive Symptoms

2020

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Background and Objectives Young adults with childhood maltreatment (CM) histories are particularly vulnerable to depressive symptoms and alcohol use problems. Research suggests that maltreated youth may misuse alcohol in part to alleviate depressive symptoms. However, many youths with depressive symptoms exercise self‐control and abstain from heavy alcohol use. The present study aimed to examine the influence of heart rate variability reactivity (HRV‐R), a psychophysiological biomarker of self‐regulation, in the indirect link between CM and alcohol‐use problems via depressive symptoms among low socioeconomic‐status rural young adults. Methods Two waves of data were collected from a community sample of 225 low socioeconomic‐status nonmetropolitan young adults (Mage = 21.56, 52.9% female). HRV data were obtained with an electrocardiogram during a social stress task. CM was assessed through the Childhood Trauma Questionnaire. Alcohol use problems were measured using the Alcohol Use Disorders Identification Test. Results The indirect effect of CM on alcohol use problems via elevated depressive symptoms was positive and significant (α × β = .159, P < .001). Self‐regulation, indicated by high HRV‐R (ie, vagal withdrawal), was found to significantly buffer the link between depressive symptoms and alcohol use problems (β = .193, P = .022). Discussion and Conclusions Adequate self‐regulation capacities can protect maltreated youths from self‐medicating alcohol use problems. Scientific Significance This study will advance researchers’ understanding of the development of alcohol use problems through unwrapping the risk and protective mechanisms underlying the association between young adults’ early life stress and alcohol use behaviors. (Am J Addict 2020;29:141–150)

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“…It could be explained from the related study showing that the PMK model could a significantly reduce or stop drinking among patients with alcohol use disorder to improve their quality of life such as their physical and mental health 20. The PMK model also involved the inpatient rehabilitation program to limit stimuli and external factors 21. Consequently, these might have affected the stress and craving scores after the intervention in both groups declined greatly.…”

Section: Discussionmentioning

confidence: 99%

Stress and craving reduction under treatment with heart rate variability biofeedback and the Phramongkutklao model among patients with alcohol use disorder

Teeravisutkul¹,

Chumchua²,

Saengcharnchai³

et al. 2019

PRBM

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Background and objective Stress is an environmental cue, which may lead to increased alcohol craving, and vulnerability to relapse. Heart rate variability (HRV) biofeedback, a supplement standard for inpatient rehabilitation, has been applied for treatment and has been shown to effectively reduce craving and anxiety, increase HRV, and improve vasomotor function, among patients who have alcohol dependence problems. Therefore, the purpose of this study was to investigate the impact of HRV biofeedback and the Phramongkutklao model (PMK model) as an intensive inpatient rehabilitation program concerning stress and craving reduction of inpatients with alcohol use disorder. The findings could benefit treatment design to increase the effectiveness regarding stress and craving reduction among patients with alcohol use disorder and may also reduce rehabilitation costs. Methods We conducted this study as a randomized controlled intervention trial, which was also performed single blinded. In all, 35 patients with alcohol use disorder were recruited and randomly assigned in two groups. Patients in the intervention group (n=17) were treated under the PMK model and underwent 16 sessions of the HRV biofeedback program, which included 30 minute long sessions, 4 days per week, for 4 weeks continuously. Patients in the control group (n=18) received PMK model treatment only. Participants were asked to complete a Stress Test (ST-5) and the Penn Alcohol-Craving Scale at baseline, after completing treatment, and at one month afterward (follow-up). Results The study showed decreased stress and craving in the intervention group immediately after treatment and at one-month follow-up, whereas the control group had reduced stress and craving only immediately after treatment. Furthermore, we found a significant effect concerning stress and craving between baseline and at one-month follow-up that showed the intervention group exhibited higher difference of scores than the control group. Conclusion The study results showed that applying HRV biofeedback may be considered beneficial for standard rehabilitation inpatients to reduce stress and craving for patients with alcohol use disorder.

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Heart rate variability biofeedback: Theoretical basis, delivery, and its potential for the treatment of substance use disorders

Cited by 48 publications

References 94 publications

<p>Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy</p>

<p>Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy</p>

Heart Rate Variability Reactivity Moderates the Indirect Link Between Child Maltreatment and Young Adult Alcohol Use Problems Via Depressive Symptoms

<p>Stress and craving reduction under treatment with heart rate variability biofeedback and the Phramongkutklao model among patients with alcohol use disorder</p>

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