Biofeedback and Anxiety Disorders: A Critical Review of EMG, EEG, and HRV Feedback
Anxiety disorders are characterized by ongoing and situationally disproportionate fear and anxiety, and the associated significant distress and impairment of normal functioning (American Psychiatric Association, 2013). These disorders affect nearly one third of Americans in their lifetimes, indicating that a massive group of people stand to benefit from the development of effective and feasible treatments for anxiety symptoms (Valentiner, Fergus, Behar, & Conybeare, 2014). There are certainly many reasons why pharmaceutical treatments for anxiety disorders are so popular with patients and clinicians today, but there are significant drawbacks that should motivate researchers to develop better treatments. Researchers are investigating the general efficacy of biofeedback for anxiety, as well as which types of biofeedback may be most effective for which types of symptoms and disorders. In this review, I summarize findings on electromyography (EMG), electroencephalography (EEG), and heart rate variability (HRV) biofeedback treatments for anxiety. While EMG research seems to have stalled due to minimal supporting evidence, I recommend further research on EEG and HRV as adjunctive treatments for anxiety disorders. Overall, further research on biofeedback will contribute to the transition away from the disease model of psychopathology with purely pharmaceutical treatment to the complex systems learning model in which the individual patient may receive unique skill-building therapies targeted to his or her particular needs.
Keywords: biofeedback, anxiety disorders, alternative treatment, neurofeedback