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14 participants residing in a forensic psychiatric hospital completed 15 Heart Rate Variance (HRV) biofeedback sessions. They completed 4 psychometric questionnaires, pre, during and post biofeedback training.
This study aimed to establish whether Heart Rate Variance (HRV) biofeedback improved HRV coherence as well as psychological well-being (depression, anxiety, emotion regulation, and mindfulness) over the course of 15 biofeedback sessions in a sample of 14 patients with varying diagnoses; Paranoid Schizophrenia, Schizoaffective Disorder, Personality Disorder or Mixed Diagnosis. All 14 participants (n=10 male, n=4 female) participated in 15 biofeedback sessions. The study was researched and treatment was facilitated by a trainee forensic psychologist working with both male and female offenders residing within a Forensic Psychiatric Hospital, on both low and medium secure wards. An average coherence percentage was captured using the Wild Devine Programme® Relaxing Rhythms software for each session. Quantitative data were collected and analysed before, during and after biofeedback treatment to assess whether there was improvement in psychometric measures of depression, anxiety, emotion regulation and facets of mindfulness. A quasi experimental 'A-B-A design' was employed to assess the research questions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Heart Rate Variance (HRV) biofeedback training | Experimental | Patients to participate in 15 biofeedback sessions, 3 times a week (5 weeks in total). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Difficulties in Emotional Regulation Scale, Five Facet Mindfulness Questionnaire, Becks Depression and Becks Anxiety | Other | Patients asked to complete these 4 questionnaires pre, during and post biofeedback training |
| Measure | Description | Time Frame |
|---|---|---|
| Difficulties in Emotional Regulation (DERS) | a 36 item self-report questionnaire developed to assess adult difficulties in emotional regulation. six specific dimensions which include; difficulties accepting emotional responses (acceptance), controlling impulse behaviours (impulse), emotional awareness (awareness), emotional clarity (clarity), assessing emotion regulation strategies (strategies) and engaging in goal oriented behaviour when emotionally aroused (goals). Internal consistency for Cronbach's alpha was .93 for the total scale and for DERS-A, .85, DERS-I, .89, DERS-A, .86, DERS-C, .80, DERS-S, .88, and DERS-G, .84 | 30 minutes (pre, during and post biofeedback training) |
| Five Facet Mindfulness Questionnaire (FFMQ) | Consists of 39 items assessing five facets of mindfulness: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience. Items are rated on a Likert scale ranging from 1 (never or very rarely true) to 5 (very often or always true). The FFMQ has been shown to have good internal consistency and significant relationships in the predicted directions with a variety of constructs related to mindfulness. The internal consistencies (Cronbach α) for these facets have been reported as 0.75 for FFMQ-NR, 0.83 for FFMQ-O, 0.87 for FFMQ-A, 0.91 for FFMQ-D, and 0.87 for FFMQ-NJ | 30 minutes (pre, during and post biofeedback training) |
| Becks Depression Inventory (BDI-II) | A 21-item self-report scale that surveys common symptoms of depression on a 4-point scale ranging from 0 to 3. Internal consistency of the BDI-II was demonstrated to be good (Cronbach's α=.91; Beck, Steer, Ball et al., 1996) and the 1-week test-retest reliability was shown to be high. | 15 minutes (pre, during and post biofeedback training) |
| Becks Anxiety Inventory (BAI) | Consists of 21 statements used to measure the severity of an individual's anxiety. When completing the BAI, individuals rate the severity of each symptom on a 4-point scale ranging from 0 (not at all) to 3 (severely-I could barely stand it). Good internal consistency (Cronbach's α=.92) and test-retest reliability (r=.75). |
| Measure | Description | Time Frame |
|---|---|---|
| Heart Rate Variance (HRV) biofeedback | Heart rate coherence scores were assessed using the IoM butterfly Grapher. The coherence score is based upon a composite score of 0-100%; 0 being no coherence, 100% being perfect coherence. | 10 minutes per session |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Georgina V Atkinson | University of Birmingham | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Birmingham | Birmingham | United Kingdom |
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| HRV Biofeedback (Healing Rhythms) | Behavioral | Sensors placed on fingers to capture heart rate and skin temperature |
|
| 15 minutes (pre, during and post biofeedback training) |
| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D003863 | Depression |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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