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Biofeedback-Enhanced Cognitive-Behavioral Therapy Delivered Virtually to Youth With Inflammatory Bowel Disease: A
Kelly Rea1, Abigail Robbertz2, Adrianna Westbrook3
1Division of Pediatric Psychology, Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA.
Inflammatory Bowel Diseases
|April 29, 2025
Summary
This study found a virtual coping skills program using heart rate variability (HRV) biofeedback is feasible and acceptable for youth with inflammatory bowel diseases (IBD). It effectively reduced anxiety, depression, and gastrointestinal symptoms.
Area of Science:
- Psychoneuroimmunology
- Pediatric gastroenterology
- Behavioral medicine
Background:
- Inflammatory bowel diseases (IBD) are increasingly linked to brain-gut axis dysfunction and chronic stress.
- Understanding the role of stress response systems in IBD is crucial for developing effective treatments.
- Targeting psychological and physiological stress markers may improve outcomes for youth with IBD.
Purpose of the Study:
- To assess the feasibility, acceptability, and preliminary efficacy of a virtual, group-based intervention for adolescents with IBD.
- The intervention combined cognitive-behavioral therapy (CBT) with heart rate variability (HRV) biofeedback.
- Key targets included reducing anxiety, depression, gastrointestinal (GI) symptoms, and perceived stress.
Main Methods:
- A randomized controlled trial involving 53 youth (ages 13-18) with IBD and their caregivers.
- Participants were assigned to either immediate treatment or a waitlist control group.
- The intervention comprised 6 weekly virtual group sessions focused on coping skills, CBT, and HRV biofeedback.
Main Results:
- The intervention demonstrated high feasibility (84% attendance) and acceptability, with strong participant and parent satisfaction.
- Significant reductions in adolescent depressive symptoms, anxiety, and GI symptoms were reported by parents compared to controls.
- Adolescents reported decreased GI symptoms and perceived stress, alongside reduced anxiety within the treatment group; no HRV changes were observed.
Conclusions:
- This pilot study indicates that a virtual, group-based HRV biofeedback intervention is feasible and acceptable for adolescents with IBD.
- Preliminary evidence suggests efficacy in alleviating psychological and physical symptoms associated with IBD.
- Future research should focus on larger, diverse samples with higher baseline psychological symptom levels to further validate efficacy.
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