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Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression
Open accessAbstract
Objective Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. Methods The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. Results Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. Conclusions Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implic…
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“Although existing literature confirms the widespread benefits of slow breathing practices for stress/anxiety reduction [23,24,25,35,36,37,38], null or negative results are reported in some studies [39,40,41,42,43,44,45,46,47,48,49,50].”
In the citing paper
“Breathing practices, when used in isolation, have the advantage of being universally accessible, scalable, and cost-free. They are not limited by access to healthcare services nor burdened by side effects and put potential treatment tools in the hands of the individual [23,24,25].”
In the citing paper
“and another recent meta-analysis found significant effects in both psychiatric and healthy populations [24].”
In the citing paper
“However, their analysis may have been underpowered with only one intervention in mental health populations; and another recent meta-analysis found significant effects in both psychiatric and healthy populations [24].”
In the citing paper
“Although these results contrast with other findings of no treatment duration effect [24,35], those reviews may have been limited by small samples, study heterogeneity, and exclusion of human-guided training, which may interact with long-term practice.”
In the citing paper
“While existing meta-analyses provide valuable insights [24,35,121], we included a broader array of studies to establish a deeper understanding of how various practice and implementation factors are associated with stress reduction.”
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Metadata
- Authors
- Leyro, T. M., Versella, M. V., Yang, M.-J., Brinkman, H. R., Hoyt, D. L., & Lehrer, P.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Leyro, Teresa M.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 84
- Pages
- 101980
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC8302658
- OpenAlex
- W3126092337
- Cited by
- 53
- References
- 252
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 15 · 2023: 11 · 2022: 4
- FWCI
- 1.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- respiratory care, anxiety, trait anxiety, treatment moderators, adjunctive therapy, cognitive-behavioral intervention, treatment effectiveness
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