Psychological and physiological changes following a mindfulness-based intervention integrating breathing training and HRV biofeedback in adults with anxiety disorders
Yi-Chun Lin, Chien-Chih Chen, Yu-Li Lan
Scientific Reports October 3, 2026 DOI: 10.1038/s41598-026-73678-2 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Quasi-experimental one-group pretest-posttest study Randomized Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Adults with anxiety disorders |
| Intervention | Mindfulness-based intervention integrating structured breathing training and HRV biofeedback |
| Duration | Four-week intervention |
| Measures | State–Trait Anxiety Inventory (STAI), heart rate variability (HRV; RMSSD and SDNN) |
| Topics | Anxiety Meditation |
| Key findings | State anxiety dropped 18.2% (43.83 to 35.87) and trait anxiety 11.5% (51.27 to 45.37) from before to after the four-week intervention, both significant. Averaged post-session HRV (RMSSD, SDNN) was higher than pre-session values, but repeated-measures models showed no significant change over time or week-by-time interaction across the four sessions. |
Abstract
Anxiety disorders are associated with psychological dysregulation and autonomic imbalance. Although mindfulness-based interventions and breathing training have shown potential benefits for anxiety management, evidence regarding their integrated psychological and physiological outcomes remains limited. To examine psychological and physiological changes following a four-week mindfulness-based intervention integrating structured breathing training and HRV biofeedback in adults with anxiety disorders. A quasi-experimental one-group pretest–posttest design was employed. Thirty adults with anxiety disorders completed a four-week intervention. Anxiety was assessed using the State–Trait Anxiety Inventory (STAI), and heart rate variability (HRV; RMSSD and SDNN) was assessed immediately before and after each weekly session. Paired-samples t tests examined aggregated pre–post changes, and linear mixed-effects models were used to analyze repeated HRV measurements across the four intervention sessions. State anxiety decreased from 43.83 to 35.87 (− 18.2%), and trait anxiety decreased from 51.27 to 45.37 (− 11.5%), with significant pre–post reductions in both measures ( p ≤ .001). Aggregated mean post-session RMSSD and SDNN values were significantly higher than the corresponding mean pre-session values (both p < .001). However, linear mixed-effects models showed no significant main effect of time or Week × Time interaction for either RMSSD or SDNN (all p > .05). The intervention was associated with significant pre–post reductions in state and trait anxiety. Although aggregated HRV measures showed significant pre–post differences, repeated-measures analyses did not demonstrate consistent changes in HRV across the four sessions. These preliminary findings warrant confirmation in adequately powered randomized controlled trials.
Comparable studies
Other experimental studies on anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A PILOT STUDY OF GROUP MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOR COMBAT VETERANS WITH POSTTRAUMATIC STRESS DISORDER (PTSD) Veterans with chronic combat posttraumatic stress disorder seeking treatment at a VA... | 2013 | Quasi-experimental with treatment-as-usual comparison group | n = 37 |
| Being present in the face of existential threat: The role of trait mindfulness in reducing defensive responses to mortality salience. | 2010 | Experimental study | |
| Neural correlates of mindfulness meditation-related anxiety relief Healthy adults with no prior meditation experience | 2013 | Within-subjects experimental study | n = 15 |
| Intensive mindfulness training-related changes in cognitive and emotional experience Community adults | 2009 | Quasi-experimental and longitudinal | n = 69 |
| Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment Volunteers | 2019 | Within-subjects experimental study | n = 11 |