A pilot study of ambulatory Heart Rate Variability Biofeedback for substance use disorder

动态心率变异性生物反馈治疗物质使用障碍的初步研究

• 批准号: 10670398
• 负责人: DAVID EDDIE
• 金额: $ 26.58万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10670398
• 关键词: Abstinence; Addendum; Affect; Affective; Alcohol consumption; Alcohol or Other Drugs use; Anxiety; Arousal; Attention; Baroreflex; Behavioral; Biofeedback; Breathing; Buffers; Bypass; Cardiovascular system; Cellular Phone; Chronic; Clinical; Clinical Sciences; Cognitive; Conscious; Cues; Data; Decision Making; Devices; Disease; Drug usage; Emotional; Emotions; Event; Exposure to; Feedback; Frequencies; Generations; Goals; Individual; Interruption; Intervention; Intuition; Maintenance; Mental Depression; Modeling; Motion; Motivation; Participant; Patients; Periodicity; Persons; Physiological; Physiological Processes; Pilot Projects; Predisposition; Provider; Psychophysiology; Psychosocial Stress; Randomized, Controlled Trials; Reaction; Recovery; Schedule; Series; Stress; Substance Use Disorder; System; Technology; Testing; Time; Visceral; Work; addiction; alcohol and other drug; anxiety states; behavior change; biobehavior; biological adaptation to stress; cognitive control; cognitive performance; cost; craving; emotion dysregulation; emotion regulation; experience; goal oriented behavior; heart rate variability; improved; light weight; negative affect; pilot test; prevent; stressor; substance use; tool; uptake; wearable sensor technology

PROJECT SUMMARY Alcohol and other drug use (AOD) lapses in early substance use disorder (SUD) recovery typically arise from interactions between aversive affective states and stressors that together elicit urges to use. A central goal of first-line cognitive-behavioral SUD treatments is to strengthen affective and cognitive control to increase individuals’ ability to override impulses to use AOD. Yet certain automatic physiological processes compromised by SUD dynamically interact with internal affective states and environmental cues to undermine effortful cognitive control and outcompete cognitive goals to avoid substance use. Heart rate variability biofeedback (HRV BFB) is a biobehavioral intervention involving rhythmic breathing at resonance frequency (RF) that stimulates the body’s baroreflex mechanism to offset these psychophysiological deficits. The autonomic normalization effected by RF breathing is thought to bolster cognitive control efforts by interrupting or dampening automatic-visceral reactions that can undermine treatment gains, and in doing so support better decision-making, motivation, reductions in craving, and shifts in attention allocation. Previous studies of HRV BFB have focused on positive behavioral effects that accrue over a series of weeks or months, rather than ‘in-the-moment’. These chronic behavior changes, although clinically valuable, are labor and time intensive to elicit, reducing the likelihood of large-scale uptake of the intervention. Further, first-generation HRV BFB’s regular daily practice model is likely to only partially mitigate the intense momentary bouts of emotion dysregulation that are triggers for AOD use in those in early SUD recovery. In contrast, recent studies have demonstrated that a brief exposure to RF breathing in anticipation of psychosocial stress, or during induced stress, helps to control physiological arousal, reduce state anxiety, and improve cognitive performance. We posit that such bursts of in-the-moment HRV BFB practice could serve as a potent SUD treatment tool that helps individuals self-regulate intense emotions when needed most. Excitingly, recent advances in the field have given rise to small, lightweight, wearable biosensors that can allow wearers to do HRV BFB on-the-go. These devises also have the capacity to function as a just-in-time intervention by prompting in-the-moment HRV BFB practice when autonomic hyperarousal is detected, to buffer salient triggers and urges to use AOD. This application builds on a body of preliminary work speaking to HRV BFB’s potential as an addendum to first-line SUD treatments by exploring for the first time in this disorder this cutting edge, second-generation, ambulatory, HRV BFB technology. Our specific aims include, 1) assessing ambulatory HRV BFB’s uptake by individuals with SUD, 2) testing day-level effects of in-the-moment HRV BFB practice on affective states and substance use, and 3) testing the accumulative effects of scheduled daily HRV BFB practice, in-the-moment HRV BFB practice, and their interaction, on substance use.

项目总结