scholarly journals Biofeedback-Based Connected Mental Health Interventions for Anxiety: Systematic Literature Review

10.2196/26038 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e26038
Author(s):  
Mahra Alneyadi ◽  
Nidal Drissi ◽  
Mariam Almeqbaali ◽  
Sofia Ouhbi

Background Connected mental health, which refers to the use of technology for mental health care and technology-based therapeutic solutions, has become an established field of research. Biofeedback is one of the approaches used in connected mental health solutions, which is mainly based on the analysis of physiological indicators for the assessment and management of the psychological state. Biofeedback is recommended by many therapists and has been used for conditions including depression, insomnia, and anxiety. Anxiety is associated with several physiological symptoms, including muscle tension and breathing issues, which makes the inclusion of biofeedback useful for anxiety detection and management. Objective The aim of this study was to identify interventions using biofeedback as a part of their process for anxiety management and investigate their perceived effectiveness. Methods A systematic literature review of publications presenting empirically evaluated biofeedback-based interventions for anxiety was conducted. The systematic literature review was based on publications retrieved from IEEE Digital Library, PubMed, ScienceDirect, and Scopus. A preliminary selection of papers was identified, examined, and filtered to include only relevant publications. Studies in the final selection were classified and analyzed to extract the modalities of use of biofeedback in the identified interventions, the types of physiological data that were collected and analyzed and the sensors used to collect them. Processes and outcomes of the empirical evaluations were also extracted. Results After final selection, 13 publications presenting different interventions were investigated. The interventions addressed either primarily anxiety disorders or anxiety associated with health issues such as migraine, Parkinson disease, and rheumatology. Solutions combined biofeedback with other techniques including virtual reality, music therapy, games, and relaxation practices and used different sensors including cardiovascular belts, wrist sensors, or stretch sensors to collect physiological data such as heart rate, respiration indicators, and movement information. The interventions targeted different cohorts including children, students, and patients. Overall, outcomes from the empirical evaluations yielded positive results and emphasized the effectiveness of connected mental health solutions using biofeedback for anxiety; however, certain unfavorable outcomes, such as interventions not having an effect on anxiety and patients’ preferring traditional therapy, were reported in studies addressing patients with specific physical health issues. Conclusions The use of biofeedback in connected mental health interventions for the treatment and management of anxiety allows better screening and understanding of both psychological and physiological patient information, as well as of the association between the two. The inclusion of biofeedback could improve the outcome of interventions and boost their effectiveness; however, when used with patients suffering from certain physical health issues, suitability investigations are needed.

2020 ◽  
Author(s):  
Mahra Alneyadi ◽  
Nidal Drissi ◽  
Mariam Almeqbaali ◽  
Sofia Ouhbi

BACKGROUND Connected mental health, which refers to the use of technology for mental health care and technology-based therapeutic solutions, has become an established field of research. Biofeedback is one of the approaches used in connected mental health solutions, which is mainly based on the analysis of physiological indicators for the assessment and management of the psychological state. Biofeedback is recommended by many therapists and has been used for conditions including depression, insomnia, and anxiety. Anxiety is associated with several physiological symptoms, including muscle tension and breathing issues, which makes the inclusion of biofeedback useful for anxiety detection and management. OBJECTIVE The aim of this study was to identify interventions using biofeedback as a part of their process for anxiety management and investigate their perceived effectiveness. METHODS A systematic literature review of publications presenting empirically evaluated biofeedback-based interventions for anxiety was conducted. The systematic literature review was based on publications retrieved from IEEE Digital Library, PubMed, ScienceDirect, and Scopus. A preliminary selection of papers was identified, examined, and filtered to include only relevant publications. Studies in the final selection were classified and analyzed to extract the modalities of use of biofeedback in the identified interventions, the types of physiological data that were collected and analyzed and the sensors used to collect them. Processes and outcomes of the empirical evaluations were also extracted. RESULTS After final selection, 13 publications presenting different interventions were investigated. The interventions addressed either primarily anxiety disorders or anxiety associated with health issues such as migraine, Parkinson disease, and rheumatology. Solutions combined biofeedback with other techniques including virtual reality, music therapy, games, and relaxation practices and used different sensors including cardiovascular belts, wrist sensors, or stretch sensors to collect physiological data such as heart rate, respiration indicators, and movement information. The interventions targeted different cohorts including children, students, and patients. Overall, outcomes from the empirical evaluations yielded positive results and emphasized the effectiveness of connected mental health solutions using biofeedback for anxiety; however, certain unfavorable outcomes, such as interventions not having an effect on anxiety and patients’ preferring traditional therapy, were reported in studies addressing patients with specific physical health issues. CONCLUSIONS The use of biofeedback in connected mental health interventions for the treatment and management of anxiety allows better screening and understanding of both psychological and physiological patient information, as well as of the association between the two. The inclusion of biofeedback could improve the outcome of interventions and boost their effectiveness; however, when used with patients suffering from certain physical health issues, suitability investigations are needed.


2016 ◽  
Vol 11 (1) ◽  
pp. 92 ◽  
Author(s):  
Gwen Katheryn Healey ◽  
Jennifer Noah ◽  
Ceporah Mearns

<p><strong><em>Objective:</em> </strong>This study responded to a community-identified need to form an evidence base for interventions to promote mental health and wellness among youth in Nunavut. <strong><em>Methods: </em></strong>A literature review was conducted using the terms <em>adolescence </em>and <em>Inuit</em> and <em>intervention </em>or <em>program </em>or <em>camp </em>or <em>land-based</em>. PubMed and Google Scholar databases were used to find peer-reviewed and grey literature on community-based youth programs. The literature review was presented to parents, elders, and youth for discussion over several months in 2009-2010. <strong><em>Results:</em></strong> Key themes included: self-esteem, physical activity, stress and coping, positive peer relationships, Inuit identity, mental health and well-being, and the effects of intergenerational trauma on youth in Nunavut. Themes were incorporated into a model for youth mental health interventions based on Inuit terminology, philosophy, and societal values—the Eight <em>Ujarait</em>/Rocks Model. The model was implemented as a camp program in 6 pilots in 5 communities from 2011 to 2013. Data were collected before and after the camp. Results indicated that the program fostered physical, mental, emotional, and spiritual wellness among youth. Parent observations of participants included an improvement in behaviour and attitude, strong cultural pride, greater confidence in identity, and improved family and community relationships. <strong><em>Conclusion: </em></strong>Evidence-based, community-driven models for youth mental health interventions in the North hold promise. The application of one such model through a camp program had a lasting impact on the individuals involved, beyond their immediate participation. Long-term monitoring of the participants, and ongoing evaluations of camps as they continue to unfold across Nunavut, are needed to contribute to the robust evidence base for this program over time.</p>


2018 ◽  
Author(s):  
Brad Ridout ◽  
Andrew Campbell

BACKGROUND The onset of mental health problems peaks between adolescence and young adulthood; however, young people face barriers to treatment and are often reluctant to seek professional help. Many are instead seeking support and information regarding their mental health via the Web, especially via social networking sites (SNSs), and hence, there is a promising opportunity to use SNSs to deliver or integrate with youth-focused online mental health interventions. Previous reviews have evaluated the effectiveness of SNSs for specific disorders in young people; however, none of the reviews have covered the breadth of SNS–based youth mental health interventions available across all mental health issues. OBJECTIVE This review aimed to systematically identify available evidence regarding the use of SNS–based interventions to support the mental health of young people aged up to 25 years, to evaluate their effectiveness, suitability, and safety, and identify gaps and opportunities for future research. METHODS The PubMed and PsycINFO databases were searched using Medical Subject Headings terms and exploded keywords and phrases. Retrieved abstracts (n=974) were double screened, yielding 235 articles for screening at the full-text level. Of these, 9 articles met the review inclusion criteria. Given the small number of studies, and the variety of outcome measures used, a quantitative meta-analysis was not possible. RESULTS The 9 articles (quantitative studies, qualitative studies, and descriptions of the iterative design process) covered 5 separate interventions. Of the 5 interventions, 2 interventions used purpose-built platforms based on the moderated online social therapy (MOST) model, 2 used Facebook, and 1 evaluated a purpose-built mobile app. The 2 MOST interventions targeted specific mental health issues (depression and psychosis), whereas the others focused on improving mental health literacy, social support, and general well-being. Only 3 quantitative studies were identified, and all used a pre-post design (without a control group) to establish proof of concept. Of the outcome variables assessed, there were significant improvements in mental health knowledge and number of depressive symptoms but no improvement in anxiety or psychosis symptoms. Acceptability of and engagement with the SNS platforms were generally high, as were perceptions of usefulness and safety. Moderation by clinical experts was identified as a key component of the more successful interventions. When offered a choice, users showed a preference for mobile apps over Web-based interfaces. CONCLUSIONS The evidence reviewed suggests young people find SNS–based interventions highly usable, engaging, and supportive. However, future studies need to address the current lack of high-quality evidence for their efficacy in reducing mental health symptoms. Given young people are already turning to SNSs to engage in knowledge seeking and peer-to-peer support, SNS–based youth mental health interventions provide an opportunity to address some of the barriers young people face in accessing qualified mental health support and information.


2020 ◽  
Vol 6 ◽  
pp. 205520762094939
Author(s):  
Russell Pine ◽  
Kylie Sutcliffe ◽  
Simon McCallum ◽  
Theresa Fleming

Background Mental distress and disorders among adolescents are well documented. Despite the array of treatments available, many mental health issues remain untreated and often undiagnosed. In an attempt to narrow the treatment gap, researchers have adapted existing mental health interventions into digital formats. Despite their efficacy in trial settings, however, real-world uptake of digital mental health interventions is typically low. Casual video games (CVGs) are popular among adolescents and may be a promising tool to reduce stress, anxiety and depression. Aim We set out to explore young adolescents’ views of CVGs and their opinions of mental health CVG prototypes, to help determine whether this idea warrants further investigation. Methods Pen and paper feedback forms following a brief presentation to 13–15-year-old adolescents in seven high schools (n = 207) followed by more detailed focus groups (n = 42) and workshops (n = 21) with interested students. Findings Across all three methods, participants reported playing CVGs several times a week or day to help relieve stress, feel more relaxed and relieve boredom. Most were also interested in the idea of a mental health CVG. Participants in focus groups and workshops confirmed that playing CVGs was common among themselves and their peers, and that the idea of a CVG with subtle and brief mental health content such as game-linked ‘micro messages’ was appealing. Participants recommended that the game should have an engaging interface and subtle mental health skills and information. Conclusions Findings from this exploratory study suggest that the concept of a mental health CVG appears to be appealing to adolescents. This novel approach should be tested.


Author(s):  
Christopher R Shelton ◽  
Anitgoni Kotsiou ◽  
Melanie D. Hetzel-Riggin

This chapter will provide a brief background on the need for digital mental health interventions given the high rates of mental health issues and the barriers to access quality care. Three main types of digital mental health interventions (internet-based interventions [IBIs], smartphone apps, and virtual and augmented reality [VR and AR, respectively]) will be discussed, followed by a consideration of the ethical and logistical issues surrounding digital mental health interventions. The chapter will then address issues related to content and design, user engagement, user contact, and formatting of the interventions. Finally, the chapter will end with a discussion of future directions.


Author(s):  
Alan Maddock ◽  
Carolyn Blair ◽  
Nil Ean ◽  
Paul Best

Abstract Background Mental health issues and disorders are major public health challenges, particularly in low- and middle-income countries in Southeast Asia, where chronic shortages in mental health services and human resources exist. The development of effective and accessible mental health systems in Southeast Asia will require evidence based psychological and social interventions. This systematic review provides a narrative synthesis of the evidence on the effectiveness of such interventions for mental health issues and disorders in Southeast Asia. Methods A comprehensive literature search of 7 electronic databases (PsycINFO, Medline (Ovid), Cochrane library, EMBASE, SCOPUS, APA PsycArticles, and Social Care Online) was undertaken. Results Thirty two studies employing RCT designs to evaluate the effectiveness of a range of psychological and social mental health interventions on a number of different mental health outcomes were included in this review. The disparate intervention programmes reviewed were categorised as: lay delivered, yoga, aerobic and/or meditation based, cognitive behavioural therapy oriented, eye movement desensitization and reprocessing based (EMDR), health worker delivered, and hybrid programmes. The majority of the studies included in this review were of low to moderate quality due to the variability in the quality of the study design. The highest quality, and most promising evidence came from the evaluations of lay delivered interventions. This evidence demonstrates the feasibility and potential sustainability of implementing such interventions in resource constrained contexts. Conclusions The review findings indicate that a disparate array of mental health interventions can be implemented effectively in a range of Southeast Asian mental health and health settings. There is a clear need for significantly more research however, through higher quality and larger scale RCTs before it will be known more definitively, if these interventions are effective, and for whom they are most effective in different Southeast Asian contexts.


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