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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Jun 6, 2019
(closed for review but you can still tweet)

An Integrative Model for the Effectiveness of Biofeedback Interventions for Anxiety Regulation

  • Joanneke Weerdmeester; 
  • Marieke M.J.W. van Rooij; 
  • Rutger C.M.E. Engels; 
  • Isabela Granic; 


Biofeedback has shown to be a promising tool for the treatment of anxiety however several theoretical as well as practical limitations have prevented widespread adaptation until now. With current technological advances and the increasing interest in the use of self-monitoring technology to improve mental health we argue that this is an ideal time to launch a new wave of biofeedback training. In this review we reflect on the current state of biofeedback training including the more traditional mechanisms that have been thought to explain the effectiveness of biofeedback such as: changes in interoceptive awareness, changes in physiology and the implementation of operant learning and mindfulness techniques. Subsequently, we propose a new integrative model that includes a set of cognitive appraisals as potential determinants of adaptive trajectories within biofeedback training such as: growth mindset, self-efficacy, perceived control and threat-challenge appraisals. Finally, we present a set of detailed guidelines based on the integration of our model with the mechanics and mechanisms offered by emerging interactive technology to encourage a new phase of research and implementation using biofeedback. We believe that there is a great deal of promise for future biofeedback interventions that harness the power of wearables and video games, as well as adopt a user-centred approach to help people regulate their anxiety in a way that feels engaging, personal and meaningful.


Please cite as:

Weerdmeester J, van Rooij MM, Engels RC, Granic I

An Integrative Model for the Effectiveness of Biofeedback Interventions for Anxiety Regulation

JMIR Preprints. 06/06/2019:14958

DOI: 10.2196/14958


Per the author's request the PDF is not available.