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.