Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression

TY - JOUR

T1 - Respiratory therapy for the treatment of anxiety

T2 - Meta-analytic review and regression

AU - Leyro, Teresa M.

AU - Versella, Mark V.

AU - Yang, Min Jeong

AU - Brinkman, Hannah R.

AU - Hoyt, Danielle L.

AU - Lehrer, Paul

N1 - Publisher Copyright: © 2021

PY - 2021/3

Y1 - 2021/3

N2 - Objective: Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. Methods: The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. Results: Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. Conclusions: Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.

AB - Objective: Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. Methods: The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. Results: Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. Conclusions: Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.

KW - Anxiety

KW - Breathing

KW - Intervention

KW - Meta-analysis

KW - Respiration

KW - Treatment

UR - https://www.scopus.com/pages/publications/85100314073

UR - https://www.scopus.com/pages/publications/85100314073#tab=citedBy

U2 - 10.1016/j.cpr.2021.101980

DO - 10.1016/j.cpr.2021.101980

M3 - Review article

C2 - 33540222

SN - 0272-7358

VL - 84

JO - Clinical Psychology Review

JF - Clinical Psychology Review

M1 - 101980

ER -