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Risbud RD, Guyer AE, Robins RW, Hastings PD. Development of Comorbid Alcohol Use and Depressive Symptoms During Late Adolescence: Examining the Roles of Emotion Regulation and Gender Differences. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01251-4. [PMID: 39340743 DOI: 10.1007/s10802-024-01251-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2024] [Indexed: 09/30/2024]
Abstract
Depression and alcohol use are highly comorbid, and often emerge during adolescence. Depressive symptoms may precede alcohol use, via the self-medication pathway, or alcohol use may precede depressive symptoms, via the alcohol induced disruption pathway. Yet little is known about other risks for developing comorbidity via either path. The present study hypothesized that poor cognitive and physiological emotion regulation (ER) are risk factors implicated in the development of comorbid depression and alcohol use during late adolescence. Participants were 229 (113 girls) Mexican-origin youth who reported on depressive symptoms and alcohol use at ages 17 (Time 1) and 19 years (Time 2). At age 17, cognitive reappraisal (CR), an adaptive ER strategy, and baseline respiratory sinus arrhythmia (RSA), a physiological index of ER capacity, were assessed. CR, RSA and gender were examined as predictors and moderators of the developing comorbidity of alcohol use and depression in cross-lagged panel models. Lower use of CR was concurrently associated with more depressive symptoms at age 17 and predicted greater depression at age 19. Age 17 alcohol use predicted age 19 depressive symptoms for boys. Lower RSA at age 17 also predicted more depressive symptoms at age 19 for boys. Neither CR nor RSA moderated the predicted relations between depression and alcohol use. Findings supported the alcohol induced disruption model of comorbidity for boys, and showed that poor cognitive and physiological ER increased risk for exacerbating depressive symptoms in late adolescence.
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Affiliation(s)
- R D Risbud
- Department of Psychology, University of California Davis, Davis, CA, USA.
- Center for Mind & Brain, University of California Davis, Davis, CA, USA.
| | - A E Guyer
- Center for Mind & Brain, University of California Davis, Davis, CA, USA
- Department of Human Ecology, University of California Davis, Davis, CA, USA
| | - R W Robins
- Department of Psychology, University of California Davis, Davis, CA, USA
| | - P D Hastings
- Department of Psychology, University of California Davis, Davis, CA, USA
- Center for Mind & Brain, University of California Davis, Davis, CA, USA
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Yang JJ, Piper ME, Indic P, Buu A. Statistical methods for predicting e-cigarette use events based on beat-to-beat interval (BBI) data collected from wearable devices. Stat Med 2024; 43:3227-3238. [PMID: 38816901 PMCID: PMC11250691 DOI: 10.1002/sim.10124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 04/09/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024]
Abstract
The prevalence of e-cigarette use among young adults in the USA is high (14%). Although the majority of users plan to quit vaping, the motivation to make a quit attempt is low and available support during a quit attempt is limited. Using wearable sensors to collect physiological data (eg, heart rate) holds promise for capturing the right timing to deliver intervention messages. This study aims to fill the current knowledge gap by proposing statistical methods to (1) de-noise beat-to-beat interval (BBI) data from smartwatches worn by 12 young adult regular e-cigarette users for 7 days; and (2) summarize the de-noised data by event and control segments. We also conducted a comprehensive review of conventional methods for summarizing heart rate variability (HRV) and compared their performance with the proposed method. The results show that the proposed singular spectrum analysis (SSA) can effectively de-noise the highly variable BBI data, as well as quantify the proportion of total variation extracted. Compared to existing HRV methods, the proposed second order polynomial model yields the highest area under the curve (AUC) value of 0.76 and offers better interpretability. The findings also indicate that the average heart rate before vaping is higher and there is an increasing trend in the heart rate before the vaping event. Importantly, the development of increasing heart rate observed in this study implies that there may be time to intervene as this physiological signal emerges. This finding, if replicated in a larger scale study, may inform optimal timings for delivering messages in future intervention.
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Affiliation(s)
- James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, Department of Medicine, University of Wisconsin, Madison, Madison, Wisconsin, USA
| | - Premananda Indic
- Department of Electrical Engineering, University of Texas at Tyler, Tyler, Tyler, Texas, USA
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Conway FN, Kane H, Dorsainvil M, Kennedy P, Cance JD. Mobile resonance frequency breathing smartphone application to support recovery among people with opioid use disorder: Study protocol for feasibility study. PLoS One 2024; 19:e0296278. [PMID: 38295049 PMCID: PMC10829996 DOI: 10.1371/journal.pone.0296278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Experiencing drug cravings is an aspect of substance use disorders that frequently compromises the recovery efforts of people who use drugs. Most treatment approaches that address drug cravings either involve cognitive strategies or medication. Few interventions directly address the physiological aspects of craving, such as increased heart rate. Previous research has demonstrated that slow-paced breathing may be effective in managing drug cravings by manipulating an individual's heart rate. The purpose of this paper is to describe a study protocol for an intervention that offers resonance frequency breathing training for managing cravings via a smartphone application (app). METHODS This trial is registered in ClinicalTrials.gov (Identifier: NCT05830773). The intervention focuses on persons in recovery from opioid use disorder who receive services from the Texas Health and Human Service Commission Recovery Support Services division. Participants will be trained to use Camera Heart Rate Variability (CHRV), a resonance frequency breathing app. The CHRV app measures heart rate and the volumetric variations of blood circulation. When experiencing stress, anxiety, or cravings, participants will use the app to practice breathing exercises. Participants (N = 60) will also complete surveys at baseline, 4 weeks, and 8 weeks; the survey questions, covers demographic characteristics, personal trauma history, substance use experience, and utilization of substance use treatment services. The surveys will also include psychosocial measures of craving, stress, and anxiety to allow the study team to assess changes between baseline and study completion. Participants who complete the full 8-week intervention will be invited to participate in a 30-minute interview about their experience with the app. Interviews will provide details on implementation outcomes, including acceptability, appropriateness, and feasibility. CONCLUSION Many evidence-based interventions for opioid use require interpersonal communication with individuals in one's recovery network. However, individuals may be unable to engage others in their recovery network in the moments when they are experiencing cravings or stress- and anxiety-related triggers. Therefore, recovery support interventions that emphasize individual self-management of cravings, stress, and anxiety when they occur can empower individuals in recovery and enhance existing interventions.
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Affiliation(s)
- Fiona N. Conway
- Addiction Research Institute, Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, United States of America
| | - Heather Kane
- RTI International, Durham, North Carolina, United States of America
| | | | - Patrick Kennedy
- Addiction Research Institute, Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, United States of America
| | - Jessica D. Cance
- RTI International, Durham, North Carolina, United States of America
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Ruyak S, Roberts MH, Chambers S, Ma X, DiDomenico J, De La Garza R, Bakhireva LN. The effect of the COVID-19 pandemic on substance use patterns and physiological dysregulation in pregnant and postpartum women. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1088-1099. [PMID: 37526587 PMCID: PMC10394275 DOI: 10.1111/acer.15077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/19/2023] [Accepted: 03/25/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND The SARS-CoV-2/COVID-19 pandemic has been associated with increased stress levels and higher alcohol use, including in pregnant and postpartum women. In the general population, alcohol use is associated with dysregulation in the autonomic nervous system (ANS), which is indexed by heart rate variability (HRV). The objectives of this study were to: (1) characterize changes in substance use during the SARS-CoV-2/COVID-19 pandemic via a baseline self-report survey followed by mobile ecological momentary assessment (mEMA) of substance use; and (2) examine the associations between momentary substance use and ambulatory HRV measures in pregnant and postpartum women. METHODS Pregnant and postpartum women were identified from the ENRICH-2 prospective cohort study. Participants were administered a baseline structured phone interview that included the Coronavirus Perinatal Experiences (COPE) survey and ascertained the prevalence of substance use. Over a 14-day period, momentary substance use was assessed three times daily, and HRV measurements were captured via wearable electronics. Associations between momentary substance use and HRV measures (root mean square of successive differences [RMSSD] and low frequency/high frequency [LF/HF] ratio) were examined using a mixed effects model that included within-subject (WS) and between-subject (BS) effects and adjusted for pregnancy status and participant age. RESULTS The sample included 49 pregnant and 22 postpartum women. From a combination of a baseline and 14-day mEMA surveys, 21.2% reported alcohol use, 16.9% reported marijuana use, and 8.5% reported nicotine use. WS effects for momentary alcohol use were associated with the RMSSD (β = -0.14; p = 0.005) and LF/HF ratio (β = 0.14; p = 0.01) when controlling for pregnancy status and maternal age. No significant associations were observed between HRV measures and instances of marijuana or nicotine use. CONCLUSIONS These findings highlight the negative effect of the SARS-CoV-2/COVID-19 pandemic on the psychological health of pregnant and postpartum women associated with substance use, and in turn, ANS dysregulation, which potentially puts some women at risk of developing a substance use disorder.
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Affiliation(s)
- Sharon Ruyak
- College of Nursing, University of New Mexico, Albuquerque, New Mexico, USA
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Stephanie Chambers
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Xingya Ma
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Richard De La Garza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
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Bates ME, Price JL, Leganes-Fonteneau M, Muzumdar N, Piersol K, Frazier I, Buckman JF. The Process of Heart Rate Variability, Resonance at 0.1 hz, and the Three Baroreflex Loops: A Tribute to Evgeny Vaschillo. Appl Psychophysiol Biofeedback 2022; 47:327-340. [PMID: 35536496 PMCID: PMC9088144 DOI: 10.1007/s10484-022-09544-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Marsha E. Bates
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
| | - Julianne L. Price
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
| | - Mateo Leganes-Fonteneau
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
| | - Neel Muzumdar
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
| | - Kelsey Piersol
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
| | - Ian Frazier
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
| | - Jennifer F. Buckman
- Department of Kinesiology & Health, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
- Center of Alcohol & Substance Use Studies, Rutgers University—New Brunswick, 08854 Piscataway, NJ United States
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Roberts RL, Garland EL. Association between opioid use disorder and blunted heart rate variability among opioid-treated chronic pain patients. Addict Biol 2022; 27:e13230. [PMID: 36301218 PMCID: PMC10234179 DOI: 10.1111/adb.13230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/14/2022] [Accepted: 08/21/2022] [Indexed: 01/24/2023]
Abstract
Given the severity of the ongoing opioid epidemic, it is essential to understand the mechanisms of risk for development and maintenance of opioid use disorder (OUD). The aim of the current large-scale psychophysiological investigation was to test whether patients with OUD had lower resting-state high-frequency heart rate variability (HF-HRV) than those without OUD, controlling for sociodemographic and clinical confounds. Additionally, we tested whether HF-HRV was associated with opioid craving in this population. Participants in this cross-sectional study were 490 chronic pain patients (50.4% female) treated with long-term opioid therapy. OUD diagnosis was determined by psychiatric interview. HF-HRV was measured at resting baseline. We computed the association between OUD and resting-state HF-HRV, controlling for age, gender, race, pain severity, emotional distress and opioid dose. Opioid craving was measured with visual analogue scales to assess whether HF-HRV was associated with craving. Results showed that resting HF-HRV was significantly lower for patients with OUD than for those without OUD (p < 0.001, d = 0.36), indicating deficits in autonomic flexibility. OUD diagnosis (p = 0.002) and OUD severity (p = 0.03) were associated with lower HF-HRV in regression models accounting for a range of confounders. Additionally, lower HF-HRV was significantly (but weakly) correlated with heightened opioid craving (r = -0.166, p < 0.001). Overall, findings suggest that resting-state HF-HRV may serve as a valid biomarker of addiction among people on long-term opioid therapy.
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Affiliation(s)
- R Lynae Roberts
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, Salt Lake City, Utah, USA
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, Salt Lake City, Utah, USA
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
- Veterans Health Care Administration VISN 19 Whole Health, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
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Sistla KT, Rai S, Praharaj SK, Rege S. The subjective experience of craving among individuals with alcohol dependence syndrome: A phenomenological study. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2110953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Krishnaa Thandra Sistla
- Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shweta Rai
- Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Samir Kumar Praharaj
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sumita Rege
- Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Price JL, Bates ME, Morgano J, Todaro S, Uhouse SG, Vaschillo E, Vaschillo B, Pawlak A, Buckman JF. Effects of arousal modulation via resonance breathing on craving and affect in women with substance use disorder. Addict Behav 2022; 127:107207. [PMID: 34953433 DOI: 10.1016/j.addbeh.2021.107207] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Craving for alcohol and other drugs is a complex in-the-moment experience that involves within-person changes in physiological arousal and affect. We evaluated the utility of a just-in-time, self-administered resonance breathing smartphone application (app) to reduce craving and improve affect in women during outpatient treatment for substance use disorders (SUD). METHODS Women (N = 57) receiving outpatient addiction treatment were randomized to practice either cardiovascular resonance breathing (0.1 Hz/6 breaths per minute) or a sham (∼0.23 Hz/14 breaths per minute) in the face of urges over an 8-week intervention. Craving (Penn Alcohol Craving Scale) and affect (Positive and Negative Affect Scale) were collected weekly throughout the intervention. App data were uploaded weekly to assess frequency of use. Generalized Estimated Equations modeled craving and affect as a function of group randomization and app use frequency across the 8-week intervention. FINDINGS Higher levels of craving were associated with more frequent app use. The group X app use interaction was significant for craving. Frequent app use during the intervention phase was associated with lower craving levels in the resonance breathing group relative to the sham group over the 8-week intervention. There was no effect of app use frequency on affect measures. CONCLUSIONS Women assigned to practice sham breathing who used the intervention frequently experienced elevations in craving that are commonly reported during outpatient SUD treatment. Women assigned to resonance breathing who used the intervention frequently did not experience such increases. Resonance breathing may be protective against triggers in outpatient treatment. Physiological mechanisms are discussed.
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Psychosocial Factors Predict the Level of Substance Craving of People with Drug Addiction: A Machine Learning Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212175. [PMID: 34831930 PMCID: PMC8621163 DOI: 10.3390/ijerph182212175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to explore which factors had a greater impact on substance craving in people with substance use and the direction of the impact. A total of 895 male substance users completed questionnaires regarding substance craving, psychological security, positive psychological capital, interpersonal trust, alexithymia, impulsivity, parental conflict, aggression behavior, life events, family intimacy, and deviant peers. Calculating the factor importance by gradient boosting method (GBM), found that the psychosocial factors that had a greater impact on substance craving were, in order, life events, aggression behavior, positive psychological capital, interpersonal trust, psychological security, impulsivity, alexithymia, family intimacy, parental conflict, and deviant peers. Correlation analysis showed that life events, positive psychological capital, interpersonal trust, psychological security, and family intimacy negatively predicted substance craving, while aggression behavior, impulsivity, alexithymia, parental conflict, and deviant peers positively predicted substance cravings. These findings have important implications for the prevention and intervention of substance craving behavior among substance users.
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Substance Use and Addiction Affect More Than the Brain: the Promise of Neurocardiac Interventions. CURRENT ADDICTION REPORTS 2021; 8:431-439. [DOI: 10.1007/s40429-021-00379-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis. Appl Psychophysiol Biofeedback 2021; 45:109-129. [PMID: 32385728 DOI: 10.1007/s10484-020-09466-z] [Citation(s) in RCA: 169] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We performed a systematic and meta analytic review of heart rate variability biofeedback (HRVB) for various symptoms and human functioning. We analyzed all problems addressed by HRVB and all outcome measures in all studies, whether or not relevant to the studied population, among randomly controlled studies. Targets included various biological and psychological problems and issues with athletic, cognitive, and artistic performance. Our initial review yielded 1868 papers, from which 58 met inclusion criteria. A significant small to moderate effect size was found favoring HRVB, which does not differ from that of other effective treatments. With a small number of studies for each, HRVB has the largest effect sizes for anxiety, depression, anger and athletic/artistic performance and the smallest effect sizes on PTSD, sleep and quality of life. We found no significant differences for number of treatment sessions or weeks between pretest and post-test, whether the outcome measure was targeted to the population, or year of publication. Effect sizes are larger in comparison to inactive than active control conditions although significant for both. HRVB improves symptoms and functioning in many areas, both in the normal and pathological ranges. It appears useful as a complementary treatment. Further research is needed to confirm its efficacy for particular applications.
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You M, Laborde S, Salvotti C, Zammit N, Mosley E, Dosseville F. Influence of a Single Slow-Paced Breathing Session on Cardiac Vagal Activity in Athletes. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00467-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Tatschl JM, Hochfellner SM, Schwerdtfeger AR. Implementing Mobile HRV Biofeedback as Adjunctive Therapy During Inpatient Psychiatric Rehabilitation Facilitates Recovery of Depressive Symptoms and Enhances Autonomic Functioning Short-Term: A 1-Year Pre-Post-intervention Follow-Up Pilot Study. Front Neurosci 2020; 14:738. [PMID: 32792897 PMCID: PMC7386054 DOI: 10.3389/fnins.2020.00738] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE New treatment options for depression are warranted, due to high recurrence rates. Recent research indicates benefits of heart rate variability biofeedback (HRVBF) on symptom recovery and autonomic functioning in depressed individuals. Slow-paced breathing-induced amplification of vagus nerve activity is the main element of HRVBF. Thus, the latter represents a safe and non-invasive complementary depression treatment. However, its efficacy in patients undergoing inpatient psychiatric rehabilitation receiving highly comprehensive treatments has not been evaluated. METHODS Ninety-two inpatients were randomly assigned to an intervention group (IG) or control group (CG). While the latter received the standard treatment only, adjunctive HRVBF was provided to the IG over 5 weeks. Depression severity and heart rate variability (HRV) were assessed before (pre) and after 5 weeks (post). Moreover, 1-year follow-up depression scores were available for 30 participants. RESULTS Although depression improved in both groups, the IG exhibited significantly larger improvements at post-assessment ( η p 2 = 0.065) and significant increases in resting LF-HRV (d = 0.45) and cardiorespiratory coherence (d = 0.61). No significant effects for RMSSD, SDNN, HF-HRV, or HR were found (ps > 0.05). Additionally, the IG showed a medium- to large-sized reduction in resting respiratory rate from 13.2 to 9.8 breaths per minute (p < 0.001, d = 0.86), with the CG exhibiting only a small decrease from 13.5 to 12.4 (p = 0.49; d = 0.35). While the IG exhibited significantly lower depression scores at post-assessment (p = 0.042, d = 0.79), this effect decreased during follow-up (p = 0.195, d = 0.48). CONCLUSION HRVBF as adjuvant therapy during inpatient psychiatric rehabilitation facilitated depression recovery. Additionally, amplified LF-HRV as well as cardiorespiratory coherence at rest and a decrease in resting breathing frequency was observed in the HRVBF group. These findings emphasize HRVBF's value as complementary therapy regardless of concurrent treatments. Moreover, these incremental benefits could serve as resource even after the actual training period. However, the additional antidepressant gains vanish during the long-term follow-up, indicating the need for more intense training or regular practice afterward, respectively. Thus, future studies are warranted to examine how the initial benefits of HRVBF during inpatient psychiatric rehabilitation can be preserved post discharge.
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Affiliation(s)
- Josef M. Tatschl
- Health Psychology Unit, Institute of Psychology, University of Graz, Graz, Austria
| | | | - Andreas R. Schwerdtfeger
- Health Psychology Unit, Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
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14
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Leyro TM, Buckman JF, Bates ME. Theoretical implications and clinical support for heart rate variability biofeedback for substance use disorders. Curr Opin Psychol 2019; 30:92-97. [PMID: 31055246 DOI: 10.1016/j.copsyc.2019.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/26/2019] [Accepted: 03/07/2019] [Indexed: 12/12/2022]
Abstract
Heart rate variability (HRV) biofeedback is an accessible, cost-effective intervention that has demonstrated clinical value for numerous physical and mental health conditions; however, research on HRV biofeedback in substance use disorders (SUD) is in its nascence. We argue that HRV biofeedback may be particularly beneficial as an adjunct treatment for SUD by targeting bodily systems that are known to be disrupted by chronic substance use and are not historically the focus of psychosocial or pharmacological SUD treatment approaches. In addition to advocating for HRV biofeedback applications in SUD, we identify several gaps within the existing experimental literature, and propose new studies that could accelerate understanding of how and for whom HRV biofeedback is most likely to promote positive behavior change.
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Affiliation(s)
- Teresa M Leyro
- Rutgers University - New Brunswick, Department of Psychology, Tillett Hall, 53 Avenue E, Piscataway Township, NJ, 08854, USA.
| | - Jennifer F Buckman
- Rutgers University - New Brunswick, Department of Kinesiology and Health, 70 Lipman Drive, New Brunswick, NJ, 08854, USA; Rutgers University - New Brunswick, Center of Alcohol Studies, 607 Allison Road, Piscataway Township, NJ, 08854, USA
| | - Marsha E Bates
- Rutgers University - New Brunswick, Department of Kinesiology and Health, 70 Lipman Drive, New Brunswick, NJ, 08854, USA; Rutgers University - New Brunswick, Center of Alcohol Studies, 607 Allison Road, Piscataway Township, NJ, 08854, USA
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