The Effect of Quantitative Electroencephalography-Based Neurofeedback Therapy on Anxiety, Depression, and Emotion Regulation in People with Generalized Anxiety Disorder

Abstract

Introduction: Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders that has significant adverse effects on social functioning, occupational/academic performance, and daily living. This study aimed to evaluate the effect of Quantitative Electroencephalography (QEEG)-based Neurofeedback (NFB) therapy on anxiety, depression, and emotion regulation of people with GAD. Methods: This research is a quasi-experimental study with a pre-test/post-test/follow-up design and a control group. The study participants were 29 college students with GAD living in Zanjan City, Iran, who were selected using a convenience sampling method. Then, they were randomly divided into two groups of intervention (n=15) and control (n=14). The protocol of NFB therapy was designed based on the QEEG method. The intervention group received QEEG-based NFB therapy for 8 weeks (20 sessions, 2 sessions per week, each session for 45 min), while the control group received no intervention. The samples were surveyed and measured by using a 7-item GAD scale, Emotion Regulation Questionnaire (ERQ), 21-item Depression, Anxiety, and Stress Scale (DASS), and Structured Clinical Interview for DSM (SCID) before and after the intervention and then at a 3-month follow-up. The collected data were analyzed in SPSS software V. 22 using univariate ANCOVA and repeated measures ANOVA. Results: The within-subjects effect of time (pre-test, post-test, and follow-up) was statistically significant (P=0.031). The intervention group showed significant changes in the post-test and follow-up phases in comparison with the control group. The anxiety and depression levels of patients reduced significantly (P=0.001), and their emotion regulation improved (P=0.001) after the intervention, and they remained unchanged in the follow-up period. Conclusion: QEEG-based NFB therapy can reduce anxiety and depression and improve emotion regulation in patients with GAD.

Examination of the importance of anger/irritability and limited prosocial emotion/callous-unemotional traits to understand externalizing symptoms and adjustment problems in adolescence: A 10-year longitudinal study

“…Indeed, neurofeedback refers to an brain training changing the number of synapses between neurons through learning and conditioning (86) improving the voluntary regulation of specific brain regions (87). It was demonstrated to be effective in improving self-control (88)(89)(90)(91). Thus, such tools empower young people and may help them to improve their ability to cope with anger.…”

Non-pharmacological Interventions for Mental Disorders

“…An NFB treatment is an operant conditioning training program that aims to modify brain activity for therapeutic or performance-enhancing purposes (Budzynski et al, 2009;Gruzelier, 2014;Sitaram et al, 2017). NFB treatments have an experimental treatment status (Thibault and Raz, 2016), with ongoing research of their effects on disorders such as ADHD (Lubar et al, 1995;Simkin et al, 2014Simkin et al, , 2016, anxiety disorders (Hammond, 2006;Abdian et al, 2021), epilepsy (Egner and Sterman, 2006;Sterman and Egner, 2006;Morales-Quezada et al, 2019), and LDs (Fernández et al, 2003;Becerra et al, 2006;Breteler et al, 2010;Nazari et al, 2012;Martínez-Briones et al, 2021). Children with LD often exhibit an abnormally slower resting-state EEG than children with typical development, characterized by an excess of theta activity and a deficit of alpha activity (Chabot, 2001;Fernández et al, 2002;Fonseca et al, 2006).…”

Effectiveness of Neurofeedback Therapy on Emotional Processing, Irrational Beliefs, and Aggression in Female Patients with Generalized Anxiety Disorder

“…Another significant therapeutic approach for improving anxiety disorders is neurofeedback (Aghaziarati et al, 2023;Dinarvand et al, 2020). Neurophysiological research examining the relationship between electroencephalography, underlying thalamocortical brain mechanisms, and psychological states has shown that creating optimal oscillations and changes in brain wave rhythm and frequency through neurotherapeutic methods can induce optimal changes in psychological states, particularly in patients with anxiety disorders (Abdian et al, 2021;Banerjee & Argáez, 2017;Dinarvand et al, 2020;Ghayour-Kazemi et al, 2015;Gholizadeh & Abdollahi, 2017;Hosseini et al, 2022;Naeinian et al, 2009).…”