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. 2022 Aug 17;19(16):10181.
doi: 10.3390/ijerph191610181.

Reducing Anxiety and Social Stress in Primary Education: A Breath-Focused Heart Rate Variability Biofeedback Intervention

Ainara Aranberri-Ruiz  1 , Aitor Aritzeta  1 , Amaiur Olarza  1 , Goretti Soroa  2 , Rosa Mindeguia  1
Affiliations

Reducing Anxiety and Social Stress in Primary Education: A Breath-Focused Heart Rate Variability Biofeedback Intervention

Ainara Aranberri-Ruiz et al. Int J Environ Res Public Health. .

Abstract

Primary school students suffer from high levels of anxiety and stress. Having emotional regulation abilities can help them to manage challenging emotional situations. Conscious and slow breathing is a physiological, emotional regulation strategy that is feasible for primary school students to learn. Following Polyvagal Theory and PMER Theory, this research presents the results of a breath-focused heart rate variability biofeedback intervention. The intervention aimed to reduce anxiety and physiological and social stress in primary school children. A total of 585 students (46.4% girls and 53.6% boys) from the same public school, aged between 7 and 12 years (M = 8.51; SD = 1.26), participated in this study. To assess the impact of training, a mixed design was used with two groups (Treatment and Control groups), two evaluation phases (Pretest and Post-test), and three educational cycles (first, second and third cycles). To examine heart rate variability, emWave software was used and anxiety and social stress were measured by the BASC II test. The results showed that after the intervention, the students learned to breathe consciously. Moreover, they reduced their levels of anxiety (M(SD)pretest = 12.81(2.22) vs. M(SD)posttest = 13.70(1.98)) and stress (M(SD)pretest = 12.20(1.68) vs. M(SD)posttest = 12.90(1.44)). The work also discusses the limitations and benefits of this type of intervention in primary schools.

Keywords: anxiety; breathing; heart rate variability; primary school; stress.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Inchley J., Currie D., Vieno A., Torsheim T., Ferreira-Borges C., Weber M.M., Bernekow V., Breda S. Adolescent Alcohol-Related Behaviors: Trends and Inequalities in the WHO European Region, 2002–2014: Observations from the Health Behavior in School-aged Children (HBSC) WHO Collaborative Cross-National Study. World Health Organization; Copenhagen, Denmark: 2018.
    1. Kaczmarek M., Trambacz-Oleszak S. HRQoL impact of stressful life events in children beginning primary school: Results of a prospective study in Poland. Qual. Life Res. 2017;26:95–106. doi: 10.1007/s11136-016-1371-x. - DOI - PMC - PubMed
    1. Pirskanen H., Jokinen K., Karhinen-Soppi A., Notko M., Lämsä T., Otani M., Rogero-García J. Children’s emotions in educational settings: Teacher perceptions from Australia, China, Finland, Japan and Spain. Early Child. Educ. J. 2019;47:417–426. doi: 10.1007/s10643-019-00944-6. - DOI
    1. Valizadeh L., Farnam A., Farshi M.R. Investigation of stress symptoms among primary school children. Int. J. Caring Sci. 2012;1:25–30. doi: 10.5681/jcs.2012.004. - DOI - PMC - PubMed
    1. Varela-Garay R.M., Ávila E.M., Martínez B. School violence: An analysis from different contexts of interaction. Interv. Psicosoc. 2013;22:25–32. doi: 10.5093/in2013a4. - DOI