Using Neurofeedback to Lower Anxiety Symptoms Using Individualized qEEG Protocols:  A Pilot Study

Stephanie M Dreis; Angela M Gouger; Edward G Perez; G. Micheal Russo; Michael A Fitzsimmons; Mark S. Jones

doi:10.15540/nr.2.3.137

Authors

Stephanie M Dreis The University of Texas at San Antonio
Angela M Gouger The University of Texas at San Antonio
Edward G Perez The Department of Texas at San Antonio
G. Micheal Russo The University of Texas at San Antonio
Michael A Fitzsimmons The University of Texas at San Antonio
Mark S. Jones The University of Texas at San Antonio

DOI:

https://doi.org/10.15540/nr.2.3.137

Keywords:

anxiety, anxiety symptoms, qEEG guided amplitude neurofeedback, neurofeedback

Abstract

Introduction: Anxiety disorders affect approximately 40 million Americans ages 18 and over (NIMH, 2015). Although qualitative and small-scale quantitative neurofeedback (NF) studies show reduction in anxiety symptoms, large-scale studies and quantitative electroencephalogram (qEEG) driven protocols are non-existent. This retrospective pilot study intended to assess whether qEEG guided amplitude NF is viable in symptom reduction of anxiety. Methods: Nineteen clients were assessed for anxiety, 14 were included in the data. Demographics include age ranges from 11–61 (M = 31.71, SD = 16.33), 9 male and 5 female; six identified as Caucasian, five as Hispanic/Latino, and three Caucasian/Hispanic ethnicity. Pre- and post-assessments included the Zung Self-Rating Anxiety Scale, Screen for Child Anxiety Related Disorders (SCARED), and the Achenbach System of Empirically Based Assessment (ASEBA). Clients received 30-min qEEG guided NF treatment sessions, twice a week. The range of attended session was 7–28 (M = 12.93, SD = 6.32). Results: Enhancement in clients’ well-being was evidenced by statistically significant improvement in symptom measures scores. Although improvements for the two most anxiety-related categories on the ASEBA were not significant, other anxiety-related categories did show significant improvement. Yet, qEEG findings were not statistically significant. Directions for future research are discussed.

Author Biography

Mark S. Jones, The University of Texas at San Antonio

DMin, LPC, LMFT, BCN, QEEGD

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Busner, J., & Targum, S. D. (2007). The clinical global impressions scale: Applying a research tool in clinical practice. Psychiatry (Edgmont), 4(7), 28–37.

Cannon, R. L. (2015). Editorial perspective: Defining neurofeedback and its functional processes. NeuroRegulation, 2(2), 60–69.

http://dx.doi.org/10.15540/nr.2.2.60

Cheon, E.-J., Koo, B.-H., Seo, W.-S., Lee, J.-Y., Choi, J.-H., & Song, S.-H. (2015). Effects of neurofeedback on adult patients with psychiatric disorders in a naturalistic setting. Applied Psychophysiology and Biofeedback, 40(1), 17–24.

http://dx.doi.org/10.1007/s10484-015-9269-x

Dantendorfer, K., Prayer, D., Kramer, J., Amering, M., Baischer, W., Berger, P., … Katschnig, H. (1996). High frequency of EEG and MRI brain abnormalities in panic disorder. Psychiatry Research: Neuroimaging. 68(1), 41–53.

http://dx.doi.org/10.1016/S0925-4927(96)03003-X

Demerdzieva, A., & Pop-Jordanova, N. (2011). Alpha asymmetry in QEEG recordings in young patients with anxiety. Prilozi, 32(1), 229–244.

Demos, J. N. (2005). Getting started with neurofeedback. New York, NY: W. W. Norton & Company.

Galbraith, T., Heimberg, R. G., Wang, S., Schneier, F. R., & Blanco, C. (2014). Comorbidity of social anxiety disorder and antisocial personality disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Journal of Anxiety Disorders, 28(1), 57–66.

http://dx.doi.org/10.1016/j.janxdis.2013.11.009

Gold, C., Fachner, J., & Erkkilä, J. (2013). Validity and reliability of electroencephalographic frontal alpha asymmetry and frontal midline theta as biomarkers for depression. Scandinavian Journal of Psychology, 54(2), 118–126.

http://dx.doi.org/10.1111/sjop.12022

Goodwin, R. D., & Hamilton, S. P. (2003). Lifetime comorbidity of antisocial personality disorder and anxiety disorders among adults in the community. Psychiatry Research, 117(2), 159–166.

http://dx.doi.org/10.1016/S0165-1781(02)00320-7

Gunkelman, J. (2006). Transcend the DSM using phenotypes. Biofeedback, 34(3), 95–98.

Gurnee, R. (2000, September). EEG Based Subtypes of Anxiety (GAD) and Treatment Implications. [Abstract]. Oral Presentation at the 8th Annual Conference of the

International Society for Neurofeedback and Research, St. Paul, MN.

Hammond, D. C. (2010). The Need for Individualization in Neurofeedback: Heterogeneity in QEEG Patterns Associated with Diagnoses and Symptoms. Applied Psychophysiology and Biofeedback, 35(1), 31–36.

http://dx.doi.org/10.1007/s10484-009-9106-1

Heller, W., Nitschke, J. B., Etienne, M. A., & Miller, G. A. (1997). Patterns of regional brain activity differentiate types of anxiety. Journal of Abnormal Psychology, 106(3), 376–385.

http://dx.doi.org/:10.1037/0021-843X.106.3.376

Hill, R. W., & Castro, E. (2002). Getting rid of ritalin: How neurofeedback can successfully treat attention deficit disorder without drugs. Charlottesville, VA: Hampton Roads.

Hodgins, S., De Brito, S. A., Chhabra, P., & Côté, G. (2010). Anxiety disorders among offenders with antisocial personality disorders: A distinct subtype? Canadian Journal of Psychiatry, 55(12), 784–791.

Johnstone, J., Gunkelman, J., & Lunt, J. (2005). Clinical database development: Characterization of EEG phenotypes. Clinical EEG and Neuroscience, 36(2), 99–107.

http://dx.doi.org/10.1177/155005940503600209

Jones, M. S. (2015). Comparing DC Offset and Impedance Readings in the Assessment of Electrode Connection Quality. NeuroRegulation, 2(1), 29–36.

http://dx.doi.org/10.15540/nr.2.1.29

Kerson, C., Sherman, R. A., & Kozlowski, G. P. (2009). Alpha Suppression and Symmetry Training for Generalized Anxiety Symptoms. Journal Of Neurotherapy, 13(3), 146–155.

http://dx.doi.org/10.1080/10874200903107405

Kirsch, I. (2009). Antidepressants and the placebo response. Epidemiology and Psychiatric Sciences, 18(4), 318–322.

http://dx.doi.org/10.1017/S1121189X00000282

Krigbaum, G., & Wigton, N. L. (2014). When Discussing Neurofeedback, Does Modality Matter? NeuroRegulation, 1(1), 48–60.

http://dx.doi.org/10.15540/nr.1.1.48

National Institute of Mental Health. (2015). What are anxiety disorders? Retrieved from http://www.nimh.nih.gov/health/topics/anxietydisorders/index.shtml

Machleidt, W., Gutjahr, L., Muegge, L., & Hinrich, A. (1985). Anxiety processes in the EEG. Electroencephalography and Clinical Neurophysiology, 61(3), S118–S119. http://dx.doi.org/10.1016/0013-4694(85)90468-7

Price, J., & Budzynski T. (2009). Anxiety, EEG patterns, and neurofeedback. In T. H. Budzynski, H. K. Budzynski, J. R. Evans, & A. Abarbanel (Eds.), Introduction to Quantitative EEG and Neurofeedback: Advanced Theory and Applications (pp. 453–470). Burlington, MA: Elsevier.

Savostyanov, A. N., Tsai, A. C., Liou, M., Levin, E. A., Lee, J.-D., Yurganov, A. V., & Knyazev, G. G. (2009). EEG-correlates of trait anxiety in the stop-signal paradigm. Neuroscience Letters, 449(2), 112–116.

http://dx.doi.org/10.1016/j.neulet.2008.10.084

Scheinost, D., Stoica, T., Saksa, J., Papademetris, X., Constable, R. T., Pittenger, C., & Hampson, M. (2013). Orbitofrontal cortex neurofeedback produces lasting changes in contamination anxiety and resting-state connectivity. Translational Psychiatry, 3(4), e250.

http://dx.doi.org/10.1038/tp.2013.24

Siciliani, O., Schiavon, M., & Tansella, M. (1975). Anxiety and EEG alpha activity in neurotic patients. Acta Psychiatrica Scandinavica, 52(2), 116–131.

http://dx.doi.org/10.1111/j.1600-0447.1975.tb00028.x

Singer, K. (2004). The effect of neurofeedback on performance anxiety in dancers. Journal of Dance Medicine and Science, 8(3), 78–81.

Spielberger, C. D. (1983). State-Trait Anxiety Inventory for Adults. Redwood City, CA: Mind Garden, Inc. Stern, J. (2005). An Atlas of EEG Patterns. Philadelphia, PA: Lippincott Williams & Wilkins.

Tharawadeepimuk, K., & Wongsawat, Y. (2014, November). QEEG evaluation for anxiety level analysis in athletes. Paper presented at the 2014 7th Biomedical Engineering International Conference (BMEiCON) of IEEE, Fukuoka, Japan. http://dx.doi.org/10.1109/BMEiCON.2014.7017400

Thompson, M., & Thompson, L. (2003). The neurofeedback book: An introduction to basic concepts in applied psychobiology. Wheat Ridge, CO: The Association for Applied Psychophysiology and Biofeedback.

Walker, J. E. (2009). Anxiety associated with post traumatic stress disorder—the role of quantitative electroencephalograph in diagnosis and in guiding neurofeedback

training to remediate the anxiety. Biofeedback, 37(2), 67–70.

Wigton, N. L., & Krigbaum, G. (2015a). Attention, executive function, behavior, and electrocortical function, significantly improved with 19-channel z-score neurofeedback in a clinical setting: A pilot study. Journal of Attention Disorders. Advance online publication.

http://dx.doi.org/10.1177/1087054715577135

Wigton, N. L., & Krigbaum, G. (2015b). A review of qEEG-guided neurofeedback. NeuroRegulation, 2(3), 149–155.

http://dx.doi.org/10.15540/nr.2.3.149