Rutgers, The State University of New Jersey, School of Nursing, 180 University Avenue, Newark, NJ 07107, USA.
Massachusetts General Hospital, Harvard Medical School, 151 Merrimac St. 6th Floor, Boston, MA 02114, USA.
Addict Behav. 2019 Oct;97:35-41. doi: 10.1016/j.addbeh.2019.05.005. Epub 2019 May 8.
Previously published findings from a study of university students living in substance use disorder (SUD) recovery housing showed an eight-session heart rate variability biofeedback (HRVB) intervention significantly reduced craving. That study, however, uncovered pronounced inter-participant variability in craving change patterns through the course of HRVB that warranted further exploration. The purpose of the current investigation was to examine how within- and between-person factors may have differentially influenced craving changes.
A longitudinal multilevel modeling approach was used with time at level-1 nested within persons at level-2. Multilevel models of change were estimated to model craving trajectories and predictor relationships over time as a function of age, sex, length of abstinence, daily HRVB practice, anxiety, depression, and stress.
A quadratic pattern of craving reductions was found, indicating that craving reductions accelerated over time for some participants. Daily HRVB practice of >12 min and older age significantly enhanced craving reductions over time. Increases in depressive symptoms attenuated the effects of HRVB on craving. The other predictors were not significantly associated with craving in this study. The true R for the final model indicated that 20.5% of the variance in craving was explained by older age, daily HRVB >12 min, and within-person changes in depression.
HRVB shows promise as an accessible, scalable, and cost-effective complementary anti-craving intervention. Healthcare providers may help persons recovering from SUD to better manage substance craving by the routine and strategic use of HRVB practice.
先前一项针对居住在物质使用障碍（SUD）康复住房的大学生的研究结果表明，八次心率变异性生物反馈（HRVB）干预显著降低了渴求感。然而，该研究发现 HRVB 过程中渴求感变化模式存在明显的个体间差异，这需要进一步探索。本研究的目的是探讨个体内和个体间因素如何对渴求感变化产生不同的影响。
采用纵向多层建模方法，将时间作为水平 1 嵌套在个体中，将个体作为水平 2。采用多层模型变化来模拟渴求轨迹和预测因素与时间的关系，作为年龄、性别、禁欲时间、每日 HRVB 练习、焦虑、抑郁和压力的函数。
发现渴求感降低呈二次曲线模式，表明一些参与者的渴求感降低随着时间的推移而加速。每日 HRVB 练习时间>12 分钟和年龄较大显著增强了随时间的渴求感降低。抑郁症状的增加减弱了 HRVB 对渴求感的影响。其他预测因素在本研究中与渴求感没有显著关联。最终模型的真实 R 表明，年龄较大、每日 HRVB>12 分钟和个体内抑郁变化解释了渴求感 20.5%的变异。
HRVB 作为一种易于获得、可扩展且具有成本效益的补充抗渴求干预措施具有潜力。医疗保健提供者可以通过常规和策略性地使用 HRVB 练习，帮助 SUD 康复者更好地管理物质渴求感。
