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Heart Rate Variability Biofeedback

Effect of heart rate variability biofeedback on extinction learning in healthy individuals and individuals with panic disorder and agoraphobia (DFG WE5873/1-2)

Principal investigator: Dr. Julia Wendt


Exposure therapy, which involves confronting the feared stimulus or situation, is a well-established and effective treatment for pathological anxiety. However, high dropout and non-responder rates call for the investigation of individual differences that mediate the treatment response and its underlying mechanisms. We recently demonstrated that low levels of vagally mediated heart rate variability (vmHRV) in patients with panic disorder and agoraphobia predict dropout from and residual symptoms after exposure treatment. Moreover, we found in several studies that individuals with low levels of vmHRV show deficits in extinction learning which serves as a laboratory model for exposure therapy.

In the current project we, therefore, want to test the assumption that heart rate variability (HRV) biofeedback training has a facilitating effect on extinction learning. First, we want to investigate this research question in a larger sample of healthy individuals to test whether HRV biofeedback effects extinction learning particularly in individuals with low levels of vmHRV, thus, providing the basis for an individualized indication. In addition, we want to investigate the effect of HRV biofeedback in individuals with panic disorder and agoraphobia since this patient population shows generally lower levels of vmHRV and also deficits in extinction learning. Earlier findings, predominantly in non-clinical populations, show that HRV biofeedback effectively reduces stress and anxiety. Thus, the current state of research raises the question whether HRV biofeedback training in individuals with panic disorder and agoraphobia facilitates extinction learning and reduces pathological anxiety levels.



Smartphone-based heart rate variability biofeedback to treat depression and premenstrual syndromes – a feasibility study

Principal investigator: Dr. Julia Wendt

Many menstruating individuals suffer from physical and psychological symptoms in the days before their menstruation, e.g. depressive mood. The exact causes of these underdiagnosed and undertreated premenstrual syndromes are not well understood. However, a link with the autonomic nervous system, particularly heart rate variability (HRV), is hypothesized. HRV biofeedback, which aims to systematically increase HRV, has shown reliable effects in reducing depressive symptomatology. With the planned feasibility study, we aim to (1) validate Kenkou's smartphone-based HRV biofeedback SDK and (2) investigate the potential efficacy of HRV biofeedback in the treatment of premenstrual syndrome.

The project is financed by the FöWiTec of the University of Potsdam and preregistered in the Open Science Framework (

If you are interested in participating, feel free to sign up via the SONA system ( or directly via the email address pms.studien.potsdamgmailcom.
You can receive up to 65 Euros or 9.25 Versuchspersonenstunden for participating in this study.

Participation requirements are knowledge of German at B2 level; BMI between 18.5 and 30 kg/m²; exclusion of cardiovascular, neurological and respiratory diseases and exclusion of pregnancy.