Heart rate variability (hrv) biofeedback training with young adult male patients in treatment for addiction

Persons in treatment for substance use disorders often experience stress and craving which are major precipitants of relapse. The present study examined the psychophysiological function of heart rate variability (HRV), its relation to clinical symptoms of stress and craving, and the feasibility of a brief HRV biofeedback (BFB) intervention as an addendum to a substance use disorder (SUD) treatment as usual. The HRV BFB training was implemented in a traditional 28-day SUD inpatient treatment program. Forty-eight young adult male patients received either treatment as usual plus three sessions of HRV BFB training over three weeks, or treatment as usual only. Participants receiving HRV BFB training were instructed to practice daily using a hand-held HRV BFB device. HRV BFB training was well tolerated by participants and supported by treatment staff. Overall, lower values for various HRV indices that suggest diminished neurocardiac adaptability were associated with reasons for drinking, higher craving, and higher levels of stress. Patients who received HRV BFB training in addition to treatment as usual demonstrated a greater, medium effect size reduction in alcohol and drug craving compared to those receiving treatment as usual only, although group differences did not reach statistical significance. In addition, HRV indices at baseline were significantly correlated with change in craving scores. Specifically, lower basal HRV was associated with less reduction in craving scores across groups. Higher respiration frequency indices in the last session were positively correlated with increased craving scores after discharge. Results suggest that HRV indices may be potential psychophysiological markers of decreased autonomic cardiac control and need for more intensive treatment, although replication and extension with larger samples is needed prior to reaching firm conclusions. Given that alcohol and drug craving often precipitates relapse, HRV BFB intervention merits further study as an adjunct treatment to ameliorate craving experienced by persons with substance use disorders.Psy.D.Includes bibliographical referencesby Hakyung Ki