Biofeedback to treat anxiety in young people at clinical high risk for developing psychosis
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Aim: Anxiety is a common presenting concern for individuals at clinical high risk ( CHR ) for psychosis. Treatment for CHR is still in the early stages and has focused on transition to psychosis and positive symptom reduction, but little is known about what may be effective in reducing anxiety for these young people. One treatment that may be effective for anxiety is heart rate variability ( HRV ) biofeedback. The aim of this study was to test the efficacy and feasibility of using HRV biofeedback to reduce anxiety and distress in those at CHR . Methods: Twenty participants who met minimum scores for anxiety and distress completed 4 weeks of an HRV biofeedback intervention and received pre‐ and post‐intervention assessments. Repeated measures were used to examine changes in scores over time. Results: There was a significant decrease in impaired ability to tolerate normal stressors ( P ≤ 0.001) and dysphoric mood ( P ≤ 0.001) over time. There was no change on self‐reported measures of anxiety and distress. However, when two outliers were removed there was a trend towards improvement in self‐reported anxiety ( P = 0.07). These results were not impacted by including usage time as a covariate. Feedback and adherence were significant. Conclusions: HRV biofeedback may be a feasible treatment option for individuals at CHR who have concerns with impaired stress tolerance and dysphoric mood. Future studies with a randomized controlled trial design will be necessary to further determine efficacy.
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In another study, individuals at high risk for psychosis that underwent a 4-week HRV-biofeedback intervention showed a significant decrease in impaired ability to tolerate normal stressors and dysphoric mood.
“In another study, individuals at high risk for psychosis that underwent a 4-week HRV-biofeedback intervention showed a significant decrease in impaired ability to tolerate normal stressors and dysphoric mood108.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [108]
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Schiffman, J. E., Wislocki, K. E., Petti, E., Bridgwater, M. A., Hegwood, C. M., Sharif, S., Giljen, M., Boos, A. K., Coscolluela, S., Martin, E. A., et al. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf259
Do Psychological Interventions Reduce Paranoia in Adolescents? A Systematic Review
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- Authors
- McAusland, L., & Addington, J.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- McAusland, Laina
- Venue
- Early Intervention in Psychiatry
- Publisher
- Wiley
- Published
- 2016-08-29
- Volume
- 12
- Issue
- 4
- Pages
- 694-701
- ISSN
- 1751-7885 (ISSN-L)
- 1751-7893
- PMC
- PMC5376371
- OpenAlex
- W2462537307
- Cited by
- 37
- References
- 69
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 6 · 2020: 9 · 2019: 3 · 2018: 5 · 2017: 3
- FWCI
- 3.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Early Intervention in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (U01MH081984)
- University of Calgary
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- heart rate variability biofeedback, anxiety, clinical high risk for psychosis, psychosis prevention, stress tolerance, dysphoric mood, distress, youth, treatment feasibility
- MeSH terms
- Adolescent, Anxiety, Biofeedback, Psychology, Female, Heart Rate, Humans, Male, Pilot Projects, Psychotic Disorders, Young Adult, Self Report, Prodromal Symptoms
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