title: A randomized-controlled trial of heart rate variability biofeedback for psychotic symptoms.
abstract: Arousal and the way it is coped with are relevant to the emergence of psychotic symptoms. Heart rate variability (HRV) stems from autonomic responses to environmental demands such as stress and is an index of physiological arousal, adaptability, and homeostatic reflexes forming autonomic balance. A randomized-controlled between-subjects trial that compared HRV-biofeedback (BF) to an active relaxation and to a waiting control condition was conducted in a sample with attenuated subclinical psychotic symptoms (N = 84). A 20-min intervention was preceded and followed by repeated assessments of stress responses. Change scores of the post-stress periods were analyzed using ANOVAs for HRV, subjective stress, perceived control, and state paranoia. As expected, BF participants showed greater improvements in perceived control than waiting controls (p = 0.006). However, no group differences occurred in HRV, paranoid symptoms or subjective stress. In exploratory analyses in a subset of participants who were breathing per protocol, the expected effects were found for total HRV and state paranoia. Thus, this trial of HRV-BF for people with attenuated psychotic symptoms indicates that the intervention may hold potential if conducted per protocol. To reach this, longer training might be inevitable. Future studies are needed to further elucidate efficacy and applicability of HRV-BF in clinical samples.
authors: University of Hamburg, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146 Hamburg, Germany. Electronic address: annika.clamor@uni-hamburg.de.
authors: Annika
authors: A
authors: Clamor
authors: University of Heidelberg, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Building 25, 2nd Floor, Thibautstraße 6, 69115 Heidelberg, Germany; The Ohio State University, Department of Psychology, 133 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210, USA. Electronic address: Julian.Koenig@med.uni-heidelberg.de.
authors: Julian
authors: J
authors: Koenig
authors: The Ohio State University, Department of Psychology, 133 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210, USA. Electronic address: thayer.39@osu.edu.
authors: Julian F
authors: JF
authors: Thayer
authors: University of Hamburg, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146 Hamburg, Germany. Electronic address: tania.lincoln@uni-hamburg.de.
authors: Tania M
authors: TM
authors: Lincoln
mesh_terms: D000328:Adult; D025461:Feedback, Physiological; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012064:Relaxation Therapy; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Breathing; HRV; Perceived control; Progressive muscle relaxation; Schizophrenia; Subjective stress