Using the body to calm the mind: An examination of heart rate variability biofeedback as a tool to reduce generalised anxiety disorder symptoms

用身体平静心灵：心率变异性生物反馈检查作为减少广泛性焦虑症症状的工具

• 批准号: MR/W005077/1
• 负责人: Frances Meeten
• 金额: $ 100.69万
• 依托单位: University of Sussex
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FW005077%2F1
• 关键词: Using; body; calm; mind; examination

We all worry from time to time, but for some people who experience an illness called generalised anxiety disorder (GAD), worrying can become uncontrollable, time consuming and distressing. As well as having a negative impact on the way we think and feel, GAD also affects our physical wellbeing. When people experience excessive worry over a long time period, this is often accompanied by changes in the body. One important change is in the time interval between each heartbeat. In a healthy body, the time interval between each heartbeat is not regular. The time gap (measured in milliseconds) between each consecutive heartbeat is called heart rate variability (HRV). High HRV (e.g. high variation in the time between consecutive heartbeats) is associated with a healthy body and mind. Previous research suggests that high HRV is associated with being able to better manage our mood states, for example being able to reduce the intensity of a negative mood state. People with GAD tend to experience low HRV over a prolonged period of time, as there is an association between experiencing very high levels of worry and low HRV. Left untreated, low HRV also puts people at risk of poor heart health later in life. A recommended treatment for GAD is cognitive behavioural therapy (CBT). This therapy helps people to better understand the relationship between thoughts, feelings and behaviours. Although this treatment is helpful for many people, there is a lot of variation in recovery rates, with only 50% of people recovering from GAD after CBT. This means that while CBT is helpful for lots of people, there are others who do not recover after treatment. It is therefore very important that we examine new approaches to treating GAD. We know that there is a link between experiencing high levels of worry and experiencing low HRV. One approach that may be successful in reducing key symptoms of GAD such as excessive worry, is to increase people's HRV to see if it reduces worry levels. HRV is linked to breathing patterns, so HRV can be increased by teaching people to beathe at a specific rate. Previous research has shown that increasing people's HRV is associated with lower levels of anxiety. However, this research did not include people who experience very high levels of anxiety and worry (as seen in GAD) and the research did not always have a high-quality design. So, based on the current information we have, it is difficult to draw firm conclusions about the effectiveness of increasing HRV as a treatment for GAD. I propose to examine the relationship between increased HRV and symptoms of GAD and to provide answers as to whether increasing HRV may reduce symptoms of GAD (e.g. reduce worry levels). I will do this by:1. Examining whether increasing HRV affects the thinking patterns that are known to underpin excessive worry.2. Examining whether increasing HRV over a number of sessions reduces symptoms of GAD.3. Examining whether providing a body-based intervention (increasing HRV) in combination with a mind-based intervention (cognitive training to reduce worry) is more effective at reducing GAD symptoms than either intervention by itself. This research has potential to provide a new type of therapy for GAD. If increasing HRV is as effective at reducing GAD symptoms as other treatments, then this new treatment approach could ensure that service-users have greater choice when thinking about what treatment they would prefer to engage with. If increasing HRV combined with cognitive therapy improves the effectiveness of cognitive training, then there is potential to examine the usefulness of offering both treatments in combination in future research.

我们都时不时地担心，但对于一些经历了一种名为广泛性焦虑症(GAD)的疾病的人来说，担忧可能会变得无法控制、耗时和痛苦。GAD不仅会对我们的思维和感觉产生负面影响，还会影响我们的身体健康。当人们在很长一段时间内经历过度担忧时，这往往伴随着身体的变化。一个重要的变化是每次心跳之间的时间间隔。在一个健康的身体里，每次心跳之间的时间间隔是不规律的。每一次连续心跳之间的时间间隔(以毫秒为单位)称为心率变异性(HRV)。高心率变异性(例如，连续心跳之间的时间变化很大)与健康的身心有关。之前的研究表明，高心率变异性与更好地管理我们的情绪状态有关，例如能够降低负面情绪状态的强度。患有广泛性AD的人往往会在很长一段时间内经历低HRV，因为经历非常高的担忧水平与低HRV之间存在关联。如果不进行治疗，低HRV还会使人们在以后的生活中面临心脏健康状况不佳的风险。广泛性焦虑症的推荐疗法是认知行为疗法(CBT)。这种疗法有助于人们更好地理解思想、感觉和行为之间的关系。虽然这种疗法对许多人有帮助，但恢复率存在很大差异，只有50%的人在CBT后从广泛性AD中恢复。这意味着，尽管CBT对许多人都有帮助，但也有一些人在接受治疗后无法恢复。因此，我们研究治疗广泛性AD的新方法是非常重要的。我们知道，经历高水平的担忧和经历低HRV之间存在联系。在减少广泛性AD的关键症状，如过度担忧方面，一个可能成功的方法是增加人们的HRV，看看它是否降低了担忧水平。心率变异性与呼吸模式有关，因此可以通过教人以特定的速率呼吸来增加心率变异性。先前的研究表明，人们心率变异性的增加与较低的焦虑水平有关。然而，这项研究没有包括那些经历非常高水平焦虑和担忧的人(如在GAD中看到的)，而且这项研究并不总是有高质量的设计。因此，根据我们目前掌握的信息，很难得出关于增加HRV作为GAD治疗方法的有效性的确切结论。我建议研究心率变异性增加与广泛性焦虑症症状之间的关系，并提供关于增加心率变异性是否可以减少广泛性焦虑症症状的答案(例如，降低焦虑水平)。我将通过以下方式来做这件事：1.检查心率变异性的增加是否会影响已知的支撑过度担忧的思维模式。检查在多个疗程中增加心率变异性是否能减少GAD3症状。研究是否提供基于身体的干预(增加HRV)与基于思维的干预(减少担忧的认知训练)相结合在减少GAD症状方面比单独提供任何一种干预更有效。本研究有可能为广泛性AD提供一种新的治疗方法。如果增加HRV在减少GAD症状方面与其他治疗方法一样有效，那么这种新的治疗方法可以确保服务用户在考虑他们更喜欢进行什么治疗时有更多的选择。如果增加心率变异性并结合认知疗法提高认知训练的有效性，那么在未来的研究中就有可能检验同时提供这两种疗法的有用性。