Pilot Testing the Effects of Heart-rate Variability Biofeedback Training for College-aged Women with Eating Problems: A Qualitative Study

Background: Eating disorders, categorized as severe mental illnesses, can manifest at any stage of life. Young women with eating disorders have demonstrated hyporeactivity in both the parasympathetic (PNS) and sympathetic (SNS) nervous systems indicating depression and chronic stress respectively (. Considering these factors, understanding the causal links between eating disorders and heart rate variability (HRV) is essential, as it seeks to reduce HRV to improve overall function. The introduction of heart-rate variability biofeedback training may enhance the psychosocial wellbeing and resilience of young women with disordered eating. Aims: This study was part of a larger mixed-methods randomized controlled trial. In this current study, we aimed to qualitatively explore the overall experiences of individuals participating in a HRVB intervention. Methods: Participants were recruited at Arizona State University. Participants (N=20, M age = 21.7 years) were randomly assigned into two groups: HRVB group and waitlist control group. Participants in the HRVB intervention group were invited to conduct in-depth interviews over Zoom. Using the content of the stories shared in the intervention, qualitative content analyses were conducted with 5 research project members. Results: While 60 individuals initially expressed interest in the study, 40 individuals agreed to be contacted and were emailed. Of these 40, 4 declined to participate and 16 were ineligible. This yielded 20 consented participants. All consented individuals attended 2 in-person meetings (T1 training/ data collection and T2 data collection) and completed the post-intervention data collection (100% retention). Optional qualitative interviews (T3) were conducted with individuals in the HRVB group (N=5). Three major themes emerged from the data: (1) HRVB has a positive impact on physical and mental health, (2) improved resiliency, and (3) improved eating behavior. Conclusion: HRVB intervention demonstrates a promising coping tool in helping college females with eating problems.