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http://dx.doi.org/10.4040/jkan.21155

Effects of Electroencephalogram Biofeedback on Emotion Regulation and Brain Homeostasis of Late Adolescents in the COVID-19 Pandemic  

Park, Wanju (College of Nursing, Kyungpook National University)
Cho, Mina (College of Nursing, Kyungpook National University)
Park, Shinjeong (College of Nursing, Kyungpook National University)
Publication Information
Journal of Korean Academy of Nursing / v.52, no.1, 2022 , pp. 36-51 More about this Journal
Abstract
Purpose: The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation. Methods: A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform. Results: Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = - 5.02, p < .001), self-regulation mode (t = - 4.74, p < .001), and volitional inhibition mode (t = - 2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = - 166.00, p < .001). Conclusion: The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.
Keywords
Biofeedback; Emotional Regulation; Anxiety; Adolescent; COVID-19;
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1 Pedrosa AL, Bitencourt L, Froes ACF, Cazumba MLB, Campos RGB, de Brito SBCS, et al. Emotional, behavioral, and psychological impact of the COVID-19 pandemic. Frontiers in Psychology. 2020;11:566212. https://doi.org/10.3389/fpsyg.2020.566212   DOI
2 Al-Rahimi JS, Nass NM, Hassoubah SA, Wazqar DY, Alamoudi SA. Levels and predictors of fear and health anxiety during the current outbreak of COVID-19 in immunocompromised and chronic disease patients in Saudi Arabia: A cross-sectional correlational study. PLoS One. 2021;16(4):e0250554. https://doi.org/10.1371/journal.pone.0250554   DOI
3 Khan KS, Mamun MA, Griffiths MD, Ullah I. The mental health impact of the COVID-19 pandemic across different cohorts. International Journal of Mental Health and Addiction. Forthcoming 2020 Jul 9.
4 Arain M, Haque M, Johal L, Mathur P, Nel W, Rais A, et al. Maturation of the adolescent brain. Neuropsychiatric Disease and Treatment. 2013;9:449-461. https://doi.org/10.2147/NDT.S39776   DOI
5 Spear LP. Adolescent neurodevelopment. Journal of Adolescent Health. 2013;52(2 Suppl 2):S7-S13. https://doi.org/10.1016/j.jadohealth.2012.05.006   DOI
6 Eisenberg N, Valiente C, Eggum ND. Self-regulation and school readiness. Early Education and Development. 2010;21(5):681-698. https://doi.org/10.1080/10409289.2010.497451   DOI
7 Beesdo K, Pine DS, Lieb R, Wittchen HU. Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Archives of General Psychiatry. 2010;67(1):47-57. https://doi.org/10.1001/archgenpsychiatry.2009.177   DOI
8 Vohs KD, Baumeister RF. Handbook of self-regulation: Research, theory, and applications. 3rd ed. New York (NY): The Guilford Press; 2016. p. 1-640.
9 Song YS. The effect of neurofeedback training on fatigue, stress, and immune reaction in nursing students. Health & Nursing. 2006;18(2):22-30.
10 Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020;287:112934. https://doi.org/10.1016/j.psychres.2020.112934   DOI
11 Petanjek Z, Judas M, Simic G, Rasin MR, Uylings HB, Rakic P, et al. Extraordinary neoteny of synaptic spines in the human prefrontal cortex. Proceedings of the National Academy of Sciences of the United States of America. 2011;108(32): 13281-13286. https://doi.org/10.1073/pnas.1105108108   DOI
12 Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews. Neuroscience. 2009;10(6):434-445. https://doi.org/10.1038/nrn2639   DOI
13 Steinberg L. A social neuroscience perspective on adolescent risk-taking. Developmental Review. 2008;28(1):78-106. https://doi.org/10.1016/j.dr.2007.08.002   DOI
14 Salovey P, Mayer JD, Goldman SL, Turvey C, Palfai TP. Emotional attention, clarity, and repair: Exploring emotional intelligence using the Trait Meta-Mood Scale. In: Pennebaker JW, editor. Emotion, Disclosure, & Health. Washington, D.C.: American Psychological Association; 1995. p. 125-154.
15 Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (Swine Flu) pandemic. Cognitive Therapy and Research. 2012;36(3):210-218. https://doi.org/10.1007/s10608-011-9353-3   DOI
16 Shin JM, Cho SH. The effects of emotional clarity on anger expression attitude: The mediating effects of anger rumination. Journal of Human Understanding and Counseling. 2014; 35(1):129-148.
17 Marzbani H, Marateb HR, Mansourian M. Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic and Clinical Neuroscience. 2016;7(2):143-158. https://doi.org/10.15412/J.BCN.03070208   DOI
18 Finger SR, Gamper-Rabindran S. Testing the effects of self-regulation on industrial accidents. Journal of Regulatory Economics. 2013;43(2):115-146. https://doi.org/10.1007/s11149-012-9201-8   DOI
19 Berger H. uber das Elektrenkephalogramm des Menschen. Archiv fur Psychiatrie und Nervenkrankheiten. 1932;97:6-26. German. https://doi.org/10.1007/BF01815532   DOI
20 Simkin DR, Thatcher RW, Lubar J. Quantitative EEG and neurofeedback in children and adolescents: Anxiety disorders, depressive disorders, comorbid addiction and attention-deficit/hyperactivity disorder, and brain injury. Child and Adolescent Psychiatric Clinics of North America. 2014;23(3):427-464. https://doi.org/10.1016/j.chc.2014.03.001   DOI
21 Heo SY, Oh JY, Kim JH. The Korean version of the Barratt Impulsiveness Scale, 11th version: Its reliability and validity. The Korean Journal of Psychology: General. 2012;31(3):769-782.
22 Wolters CA. Understanding procrastination from a self-regulated learning perspective. Journal of Educational Psychology. 2003;95(1):179-187. https://doi.org/10.1037/0022-0663.95.1.179   DOI
23 Weon HW, Yi SG, Kang HG. Effects of a neurofeedback program on brain function and stress in high school students. Journal of Korean Academy of Child Health Nursing. 2008;14(3):315-324.
24 Dilworth-Bart JE. Does executive function mediate SES and home quality associations with academic readiness? Early Childhood Research Quarterly. 2012;27(3):416-425. https://doi.org/10.1016/j.ecresq.2012.02.002   DOI
25 Cheong MJ, Jo H, Chae EY. Meta analysis on the effects of neuro-feedback training programme. Journal of the Korea Academia-Industrial cooperation Society. 2016;17(12):582-593. https://doi.org/10.5762/KAIS.2016.17.12.582   DOI
26 Lee YM. The relationship of metacognition and emotional dysregulation to planned happenstance in career decision. The Journal of Career Education Research. 2007;30(3):49-69. https://doi.org/10.32341/JCER.2017.09.30.3.49   DOI
27 Lipp A, Cohen Kadosh K. Training the anxious brain: Using fMRI-based neurofeedback to change brain activity in adolescence. Developmental Medicine & Child Neurology. 2020;62(11):1239-1244. https://doi.org/10.1111/dmcn.14611   DOI
28 Yoon YS. A study on self-regulatory ability of adolescents and its relationship with personality, parenting, behavior problems, and life stress [dissertation]. Seoul: Sookmyung Women's University; 2007. p. 1-112.
29 Kim JH, Park EJ, Oh N. Effects of neurofeedback training on life stress and depression in female college students. Journal of Digital Convergence. 2016;14(3):299-307. https://doi.org/10.14400/JDC.2016.14.3.299   DOI
30 Ko J, Park W. Effects of quantitative electroencephalography based neurofeedback training on autonomous regulations in patients with alcohol use disorder. Asian Nursing Research. 2018;12(2):136-144. https://doi.org/10.1016/j.anr.2018.05.003   DOI
31 Hassan MA, Fraser M, Conway BA, Allan DB, Vuckovic A. The mechanism of neurofeedback training for treatment of central neuropathic pain in paraplegia: A pilot study. BMC Neurology. 2015;15:200. https://doi.org/10.1186/s12883-015-0445-7   DOI
32 Choi MJ, Park WJ. The effects of neurofeedback training on physical, psychoemotional stress response and self-regulation for late adolescence: A non-randomized trial. Journal of Korean Academy of Nursing. 2018;48(2):208-220. https://doi.org/10.4040/jkan.2018.48.2.208   DOI
33 Hammond DC. The need for individualization in neurofeedback: Heterogeneity in QEEG patterns associated with diagnoses and symptoms. Applied Psychophysiology and Biofeedback. 2010;35(1):31-36. https://doi.org/10.1007/s10484-009-9106-1   DOI
34 Pintrich PR. A conceptual framework for assessing motivation and self-regulated learning in college students. Educational Psychology Review. 2004;16(4):385-407. https://doi.org/10.1007/s10648-004-0006-x   DOI
35 Sukhodolsky DG, Golub A, Cromwell EN. Development and validation of the anger rumination scale. Personality and Individual Differences. 2001;31(5):689-700. https://doi.org/10.1016/S0191-8869(00)00171-9   DOI
36 Lee GB, Cho HC. Validation study of the Korean version of the anger rumination scale. Journal of Emotional & Behavioral Disorders. 2008;24(1):1-22.
37 Lee SJ, Lee HG. The research on the validation of the Trait Meta-Mood Scale: The domain exploration of the emotional intelligence. The Korean Journal of Social and Personality Psychology. 1997;11(1):95-116.
38 Kuhl J, Fuhrmann A. Decomposing self-regulation and self-control: The volitional components inventory. In: Heckhausen J, Dweck CS, editors. Motivation and Self-Regulation across the Life Span. Cambridge: Cambridge University Press; 1998. p. 15-49.
39 Barrows KA, Jacobs BP. Mind-body medicine: An introduction and review of the literature. Medical Clinics of North America. 2002;86(1):11-31. https://doi.org/10.1016/S0025-7125(03)00069-5   DOI
40 Kim M, Kwon K. A study on the emotional clarity and the cognitive emotion regulation of resilient adolescents. The Korea Journal of Youth Counseling. 2008;16(1):15-32. https://doi.org/10.35151/kyci.2008.16.1.002   DOI
41 Banerjee S, Argaez C. Neurofeedback and biofeedback for mood and anxiety disorders: A review of clinical effectiveness and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2017. p. 1-28.
42 Hammond DC. Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America. 2005;14(1):105-123, vii. https://doi.org/10.1016/j.chc.2004.07.008   DOI
43 Lazarus RS, Kanner AD, Folkman S. Emotions: A cognitive-phenomenological analysis. In: Plutchik R, Kellerman H, editors. Theories of Emotion. New York: Academic Press; 1980. p. 189-217.
44 Anttila S, Knuuttila M, Ylostalo P, Joukamaa M. Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need. European Journal of Oral Sciences. 2006;114(2):109-114. https://doi.org/10.1111/j.1600-0722.2006.00334.x   DOI
45 Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, et al. Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review. Child and Adolescent Mental Health. Forthcoming 2021 Aug 28.
46 Thompson M, Thompson L. The neurofeedback book: An introduction to basic concepts in applied psychophysiology. 2nd ed. Toronto: The Association for Applied Psychophysiology and Biofeedback; 2015. p. 1-858.
47 Cho M, Lim W, Lee GE, Lim JH. Neurofeedback training for anxiety: A systematic review. Journal of Oriental Neuropsychiatry. 2018;29(2):79-97. https://doi.org/10.7231/jon.2018.29.2.079   DOI
48 Patton JH, Stanford MS, Barratt ES. Factor structure of the barratt impulsiveness scale. Journal of Clinical Psychology. 1995;51(6):768-774. https://doi.org/10.1002/1097-4679(199511)51:6<768::AIDJCLP2270510607>3.0.CO;2-1   DOI
49 Joo MW, Son CN. Effects of neurofeedback training on EEG, impulsivity, sensation seeking, game addiction symptoms, and game craving in university students with game addiction. Journal of Digital Convergence. 2019;17(9):479-486. https://doi.org/10.14400/JDC.2019.17.9.479   DOI
50 Park WJ, Son HW, Byun CY, Son HL, Lee SH, Lee YJ. Influencing factors of infection anxiety, impulsivity, decision making type on health information seeking behavior on the internet among college students in COVID-19. Journal of Kyungpook Nursing Science. 2021;25(1):13-24. https://doi.org/10.38083/JKNS.25.1.202102.013   DOI