Evaluation of HRV Biofeedback as a Resilience-Building Intervention in the Reserve Component
Abstract
This study addresses the Program Announcement focus of "Rigorous longitudinal studies of integrative medicine approaches for enhancing resilience and for treating psychological health issue and co-occurring disorders" by studying the effects of resilience training with heart rate variability (HRV; i.e., variation in the time interval between heartbeats) biofeedback. HRV can be used to measure the ability to regulate emotional responses, and higher HRV reflects more positive responses. Several physical and mental health issues have been associated with lower HRV, such as depression, anxiety, and mortality. Outcomes from research studies support that relaxation training can reduce hyperarousal and increase HRV. Biofeedback is a technique that allows individuals to receive feedback about their internal physiological processes, and biofeedback training teaches them to learn to manipulate these internal processes through this awareness. HRV biofeedback, in particular, has been tested with conditions like depression, anxiety, chronic pain, tension headache, and asthma, and when used with controlled breathing, it can help individuals deal with mental and physical. However, information is not available about under what conditions and for what issues HRV biofeedback is valuable, or how it compares to other popular relaxation techniques. This project will test HRV biofeedback-assisted resilience training (HRV-BART) versus relaxation breathing training without BART to see if resilience (i.e., the ability to bounce back from adversity) and post-traumatic growth (PTG) can be increased. We will also study participants who meet screening criteria for post-traumatic stress disorder (PTSD) and see if HRV biofeedback can be used as a treatment supplement and potential resilience-building intervention. We hypothesize that (1) higher HRV at baseline will be associated with higher levels of resilience, PTG, and hardiness, and more symptoms of PTSD, depression, anxiety, substance abuse, physical health, and stress; (2) the relationships between HRV and resilience and PTG differ by age (with the younger Soldiers showing a stronger relationship), gender (with the women showing a stronger relationship), and PTSD, anxiety, depression, and substance abuse (meaning that these mental health symptoms reduce the positive relationship between HRV and PTG); (3) HRV, PTG, resilience, and hardiness will increase over the course of training, and PTSD, depression, anxiety, and stress will decrease over the course of training and the following year; and (4) participants who were highest in resilience, hardiness, and PTG will experience the least amount of change from baseline to follow-up; participants with the highest depressive, anxiety, and stress symptoms at baseline will gain the most benefits in HRV from baseline to follow-up; and probable traumatic brain injury diagnoses and comorbid substance abuse problems will weaken the effects of training on improvements in HRV. The specific aims of this study are to (1) develop and pilot test the Personal Health Intervention Tool (PHIT) mobile app for use with the BART protocol; (2) examine the relationship between baseline HRV and resilience, mental health, substance use, stress and physical health measures; (3) examine how much Soldiers with mental health symptoms (compared with those not meeting criteria for mental health and resilience-related problems) have lower HRVs and resilience measures at baseline and change over time; (4) find out how having other mental health issues may affect the impact of HRV-BART on resilience, coping, and PTG scale scores. Specifically, we want to know how PTSD, depressive symptoms, sleep disturbances, and chronic pain affect the training. We will recruit 500 Reserve Component Service members (RCSMs) through behavioral health providers and inactive duty training activities. RCSMs will be randomized to receive a 1.5-hour group introductory training in either HRV-BART
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610346
Entities
People
- Laurel L Hourani
Organizations
- RTI International
- United States Army