Real-time heart rate variability biofeedback amplitude during a large-scale digital mental health intervention differed by age, gender, and mental and physical health.

Journal: Psychophysiology

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Affiliated Institutions:  Meru Health, San Mateo, California, USA. Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA. Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Monmouth Junction, New Jersey, USA. Department of Clinical Psychology, California School of Professional Psychology, Alliant International University, San Diego, California, USA. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.

Abstract summary 

Heart rate variability biofeedback (HRVB) is an efficacious treatment for depression and anxiety. However, translation to digital mental health interventions (DMHI) requires computing and providing real-time HRVB metrics in a personalized and user-friendly fashion. To address these gaps, this study validates a real-time HRVB feedback algorithm and characterizes the association of the main algorithmic summary metric-HRVB amplitude-with demographic, psychological, and health factors. We analyzed HRVB data from 5158 participants in a therapist-supported DMHI incorporating slow-paced breathing to treat depression or anxiety symptoms. A real-time feedback metric of HRVB amplitude and a gold-standard research metric of low-frequency (LF) power were computed for each session and then averaged within-participants over 2 weeks. We provide HRVB amplitude values, stratified by age and gender, and we characterize the multivariate associations of HRVB amplitude with demographic, psychological, and health factors. Real-time HRVB amplitude correlated strongly (r = .93, p < .001) with the LF power around the respiratory frequency (~0.1 Hz). Age was associated with a significant decline in HRVB (β = -0.46, p < .001), which was steeper among men than women, adjusting for demographic, psychological, and health factors. Resting high- and low-frequency power, body mass index, hypertension, Asian race, depression symptoms, and trauma history were significantly associated with HRVB amplitude in multivariate analyses (p's < .01). Real-time HRVB amplitude correlates highly with a research gold-standard spectral metric, enabling automated biofeedback delivery as a potential treatment component of DMHIs. Moreover, we identify demographic, psychological, and health factors relevant to building an equitable, accurate, and personalized biofeedback user experience.

Authors & Co-authors:  Aschbacher Mather Lehrer Gevirtz Epel Peiper

Study Outcome 

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Statistics
Citations :  Abhishekh, H. A., Nisarga, P., Kisan, R., Meghana, A., Chandran, S., Raju, T., & Sathyaprabha, T. N. (2013). Influence of age and gender on autonomic regulation of heart. Journal of Clinical Monitoring and Computing, 27(3), 259-264. https://doi.org/10.1007/s10877-012-9424-3
Authors :  6
Identifiers
Doi : 10.1111/psyp.14533
SSN : 1469-8986
Study Population
Men
Mesh Terms
Other Terms
biofeedback;epidemiology;mental health services;psychophysiology
Study Design
Study Approach
Country of Study
Publication Country
United States