Neurofeedback for Anxiety Symptoms Among University Students

  • Abstract
  • Keywords
  • References
  • PDF
  • Abstract

    Anxiety is a common, universal human emotion, but excessive feelings of anxiety can negatively affect one’s life satisfaction and quality of life. Psychotherapy and medication are the most common forms of intervention for anxiety disorders. In a recent development, researchers suggested that neurofeedback training (NFT) has the potential to reduce symptoms of anxiety, claiming to be less invasive while carrying fewer side effects compared to medication. Therefore, this preliminary study sought to assess whether neurofeedback training is a viable method to improve symptoms of anxiety in the nonclinical sample. Participants were randomly assigned to two groups (neurofeedback training group or a control group). Anxiety symptoms were assessed using the Depression, Anxiety and Stress Scale (DASS-21), the Beck Anxiety Inventory (BAI), and the State-Trait Anxiety Inventory (STAI). The findings showed an overall improvement in all of the psychological measurements in the neurofeedback group hence provide additional evidence to the field of neurotherapy that neurofeedback training is a viable option to improve anxiety symptoms among university students.



  • Keywords

    Anxiety; Neurofeedback; Nonclinical Sample; Nonpharmacological Intervention; University Students

  • References

      [1] Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H & Akaydin M, “Anxiety, Depression and Stressful Life Events among Medical Students: A Prospective Study in Antalya, Turkey”, Medical Education,Vol.35,(2001),pp.12–17.

      [2] Aldiabat KM, Matani NA & Le Navenec CL, “Mental Health among Undergraduate University Students: A Background Paper for Administrators, Educators and Healthcare Providers”, Universal Journal of Public Health,Vol.2,No.8,(2014),pp.209–214.

      [3] Ali Sabri R, Ghasak Ghazi F, Syed Masroor A & Maung Ko, HMI, “Source of Stressors and Emotional Disturbances among Undergraduate Science Students in Malaysia”, International Journal of Medical Research & Health Sciences,Vol.3,No.2, (2014),pp.401–410.

      [4] Al-naggar RA & Al-Naggar DH, “Prevalence and Associated Factors of Emotional Disorder among Malaysian University Students”, International Journal of Collaborative Research on Internal Medicine & Public Health,Vol.14,No.7, (2012),pp.1401–1410.

      [5] Beck AT, Epstein N, Brown G, & Steer RA, “An Inventory For Measuring Clinical Anxiety: Psychometric Properties”, Journal of Consulting and Clinical Psychology,Vol.56,No.6,(1988), pp.893–897.

      [6] Bink M, Bongers IL, Popma A, Janssen TWP & van Nieuwenhuizen C, “1-Year Follow-Up of Neurofeedback Treatment in Adolescents With Attention-Deficit Hyperactivity Disorder: Randomised Controlled Trial”, British Journal of Psychiatry Open,Vol.2,No.2,(2016),pp.107–115.

      [7] Chaló P, Pereira A, Batista P & Sancho L, “Brief Biofeedback Intervention on Anxious Freshman University Students”, Applied Psychophysiology Biofeedback", Vol.42,No.3,(2017), pp.163–168.

      [8] Chapin TJ & Russell-Chapin LA, Neurotherapy and Neurofeedback: Brain-Based Treatment for Psychological and Behavioral Problems, Routledge, (2014),pp. 1-220.

      [9] Chong SA, Abdin E, Vaingankar JA, Heng D, Sherbourne CD, Yap M, … Subramaniam M, “A Population-Based Survey of Mental Disorders in Singapore”, Annals of the Academy of Medicine,Vol.41,No.2, (2012),pp.49–66.

      [10] Coben R & Padolsky I, “Assessment-Guided Neurofeedback for Autistic Spectrum Disorder”, Journal of Neurotherapy, Vol.11,No.1, (2016),pp.5–23.

      [11] Dachew BA, Bisetegn TA & Gebremariam RB, “Prevalence of Mental Distress and Associated Factors among Undergraduate Students of University of Gondar, Northwest Ethiopia: A Cross-Sectional Institutional Based Study”, PLOS ONE,Vol.10,No.3,(2015),pp.1–10.

      [12] Demos JN, Getting Started with Neurofeedback,W.W Norton & Company, (2005), pp. 1-272.

      [13] Dilbaz N & Darcin AE, Treatment of Generalized Anxiety Disorders : Unmet Needs. In Federico Durbano (Ed.), New Insights into Anxiety Disorders, (2013), IntechOpen, pp. 327–342, available online, 10.03.2018.

      [14] Dreis SM, Gouger AM, Perez EG, Russo GM, Fitzsimmons MA & Jones MS, “Using Neurofeedback to Lower Anxiety Symptoms Using Individualized qEEG Protocols: A Pilot Study”, NeuroRegulation,Vol.2,No.3, (2015),pp.137-148.

      [15] Dugas MJ, Brillon P, Savard P, Turcotte J, Gaude, A, Ladouceur R, … Gervais NJ, “A Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults With Generalized Anxiety Disorder”, Behavior Therapy, Vol.41,No.1, (2010),pp.46–58.

      [16] Dyson R & Renk K, “Freshmen Adaptation to University Life: Depressive Symptoms, Stress, and Coping”, Journal of Clinical Psychology,Vol.62,No.10, (2006),pp.1231–1244.

      [17] Engelbregt HJ, Keeser, D, van Eijk, L, Suiker, EM, Eichhorn, D, Karch, S, … Pogarell, O, “Short And Long-Term Effects Of Sham-Controlled Prefrontal EEG-Neurofeedback Training In Healthy Subjects”,Clinical Neurophysiology,Vol.127,No.4, (2016),pp.1931–1937.

      [18] Enriquez Geppert, S, Huster, RJ & Herrmann, C,“EEG-Neurofeedback As A Tool to Modulate Cognition and Behavior: A Review Tutorial”, Frontiers in Human Neuroscience,Vol.11,No.51, (2017),pp.1–19.

      [19] Evans JR, Handbook of Neurofeedback: Dynamics and Clinical Applications, The Haworth Medical Press, (2007),pp.1-378.

      [20] Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, & Roy-Byrne PP, “Pharmacological Treatment of Anxiety Disorders: Current Treatments and Future Directions”, Journal of Anxiety Disorders, Vol.26,No.8,(2012),pp.833–843.

      [21] Grachev ID & Apkarian AV, “Anxiety in Healthy Humans is Associated with Orbital Frontal Chemistry”, Molecular Psychiatry,Vol.5,No.5,(2000),pp.482–488.

      [22] Gunkelman JD & Johnstone J,“Neurofeedback and the Brain”, Journal of Adult Development,Vol.12,No.2/3, (2005), pp.93–98.

      [23] Hammond DC, “Neurofeedback Treatment of Depression and Anxiety”, Journal of Adult Development,Vol.12,No.2/3, (2005a),pp.131–137.

      [24] Hammond DC, “Neurofeedback with Anxiety and Affective Disorders”, Child and Adolescent Psychiatric Clinics of North America, Vol.14,(2005b), pp.105-123.

      [25] Hammond DC, “What is Neurofeedback: An Update”, Journal of Neurotherapy, Vol.15,No.4,(2011),pp.305–336.

      [26] Hassan M, Hayati, K & Salmiah M,“Are Fresh Undergraduate Students in A Public University Free Of Psychological Problems: A Proposed Study of Depression, Anxiety, Stress and Their Coping Mechanisms”, International Journal of Public Health and Clinical Sciences,Vol.2,No.1,(2015),pp. 174–190.

      [27] Heller W, Etienne MA & Miller GA, “Patterns of Perceptual Asymmetry in Depression and Anxiety: Implications for Neuropsychological Models of Emotion and Psychopathology”, Journal of Abnormal Psychology, Vol.104,No.2,(1995),pp.327–33.

      [28] Institute for Public Health (IPH) 2016, National Health and Morbidity Survey 2016 (NHMS 2016): Maternal and Child Health. Vol. I: Methodology and General Findings,Institute for Public Health, (2016),pp.1-110.

      [29] Institute for Public Health (IPH) 2016, National Health and Morbidity Survey 2016 (NHMS 2016): Maternal and Child Health. Vol. I: Methodology and General Findings, Institute for Public Health, (2016), pp. 1-176.

      [30] Kessler RC, Chiu WT, Demier O & Walters EE,“Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS- R)”, Archives of General Psychiatry,Vol.62,No.6, (2005),pp.617–627.

      [31] Kroenke K, Spitzer RL, Williams JBW, Mohanan PO & Lowe B, “Anxiety Disorders in Primary Care: Prevalence, Impairment, Comorbidity, and Detection”, Annals Internatioal Medical Journal, Vol.146, No.5, (2005), pp. 317–325.

      [32] Lindsey C, “Trait Anxiety in College Students: The Role of the Approval Seeking Schema and Separation Individuation”, College Student Journal, Vol.48, No.3, (2014), pp.407–418.

      [33] Michael T, Zetche U & Margaf J, “Epidemiology of Anxiety Disorders”, Psychiatry, Vol.6, No.4, (2007), pp.136–142.

      [34] Ministry of Health Malaysia, Psychiatric and Mental Health Services Operational Policy, Ministry of Health Malaysia, (2011), pp. 1-121.

      [35] Mnookin S, Out of the Shadows: Making Mental Health a Global Development Priority, World Bank Group, (2016) Availableonline

      759113/Out-of-the-shadows-making-mental-health-a-global-development-priority, last visit: 12.03.2018

      [36] Mohammed H, Hayati KS & Salmiah MS,“Coping with Depression, Anxiety, and Stress: A Cross-Sectional Study among Malaysian Students in A Public University”,Journal of Dental and Medical Sciences, Vol.15,No.11, (2016),pp.83–95.

      [37] Ozen NS, Ercan I, Irgil E & Sigirli D, “Anxiety Prevalence and Affecting Factors Among University Students”, Asia Pacific Journal of Public Health, Vol.22, No.1, (2010), pp.127–133.

      [38] Rapaport MH, Clary C, Fayyad R & Endicott J, “Quality-of-Life in Depressive and Anxiety Disorders”, American Journal of Psychiatry, Vol.162, No.6, (2005), pp.1171–1178.

      [39] Regehr C, Glancy D & Pitts A, “Interventions to Reduce Stress in University Students: A Review and Meta-Analysis”, Journal of Affective Disorders, Vol.148, No.1, (2013), pp.1–11.

      [40] Sahoo S & Khess CRJ,“Prevalence of Depression, Anxiety, and Stress Among Young Male Adults in India”,The Journal of Nervous and Mental Disease,Vol.198,No.12,(2010),pp.901–904.

      [41] Shamsuddin K, Fadzil F, Ismail WSW, Shah SA, Omar K, Muhammad NA, … Mahadevan R, “Correlates of Depression, Anxiety and Stress among Malaysian University Students”, Asian Journal of Psychiatry, Vol.6,No.4, (2013), pp.318–323.

      [42] Sherina M, Rampal L & Kaneson N, “Prevalence of Emotional Disorders among Medical Students in A Malaysian University”. Asia Pacific Family Medicine, Vol.2, (2003), pp.213–217.

      [43] Simpson, HB, Neria, Y, Lewis-Fernandez, R & Schneier, F, “Cognitive–behavioral treatment of anxiety disorders: model and current issues”, Anxiety Disorders: Theory, Research, and Clinical Perspectives, Cambridge University Press, (2010), pp. 204-215.

      [44] Stein MB & Craske MG, “Treating Anxiety in 2017: Optimizing Care to Improve Outcomes”, JAMA, Vol.318, No.3, (2017), pp.235–236.

      [45] Stein MB, Roy-Byrne PP, Craske MG, Bystritsky A, Sullivan G., Pyne JM., … Sherbourne CD, “Functional Impact and Health Utility of Anxiety Disorders in Primary Care Outpatients”, Medical Care, Vol.43, No.12, (2005), pp.1164–1170.

      [46] Strehl U, “What Learning Theories Can Teach Us in Designing Neurofeedback Treatments”, Frontiers in Human Neuroscience, Vol.8, (2014), pp.894.

      [47] Walters K, Rait G, Griffin M., Buszewicz M, & Nazareth I, “Recent Trends in the Incidence of Anxiety Diagnoses and Symptoms in Primary Care”,PLOS ONE,Vol.7,No.8, (2012),pp.1-9 .

      [48] WHO, Mental Health Action Plan 2013-2020, WHO Document Production Services, (2013), pp.1-48.

      [49] Wiedemann G, Pauli P, Dengler W, Lutzenberger W, Birbaumer N, & Buchkremer G, “Frontal Brain Asymmetry as A Biological Substrate of Emotions in Patients with Panic Disorders”, Archives of General Psychiatry,Vol.56,No.1, (1999), pp.78–84.

      [50] Yasin AS & Dzulkifli MA, “Differences in Depression, Anxiety and Stress between Low-And High-Achieving Students”, Journal of Sustainability Science and Management, Vol.6, No.1, (2011), pp.169–178.

      [51] Yucha C & Montgomery D, Evidence-Based Pactice in Biofeedback and Neurofeedback, (2008). Association for Applied Psychophysiology.




Article ID: 17119
DOI: 10.14419/ijet.v7i3.22.17119

Copyright © 2012-2015 Science Publishing Corporation Inc. All rights reserved.