Biocueing and ambulatory biofeedback to enhance emotion regulation: A review of studies investigating non-psychiatric and psychiatric populations

• Published in: International journal of psychophysiology 2021-01, Vol.159, p.94-106
• Main Authors: ter Harmsel, J.F., Noordzij, M.L., Goudriaan, A.E., Dekker, J.J.M., Swinkels, L.T.A., van der Pol, T.M., Popma, A.
• Format: Article
• Language: English
• Subjects: Ambulatory biofeedback; Biocueing; Emotion regulation; Systematic review; Wearable technology
• ISSN: 0167-8760; 1872-7697
• DOI: 10.1016/j.ijpsycho.2020.11.009

Over the last years, biofeedback applications are increasingly used to enhance interoceptive awareness and self-regulation, in psychiatry and beyond. These applications are used to strengthen emotion regulation skills by home training (ambulatory biofeedback) and real-time support in everyday life stressful situations (biocueing). Unfortunately, knowledge about the feasibility and effectivity of these applications is still scarce. Therefore, a systematic literature search was performed. In total, 30 studies (4 biocueing, 26 ambulatory biofeedback) were reviewed; 21 of these studies were conducted in non-psychiatric samples and 9 studies in psychiatric samples. Study characteristics, biofeedback characteristics, effectivity and feasibility outcomes were extracted. Despite the rapid advances in wearable technology, only a few biocueing studies were found. In the majority of the studies significant positive effects were found on self-reported (stress-related) psychological measures. Significant improvements on physiological measures were also reported, though these measures were used less frequently. Feasibility of the applications was often reported as sufficient, though not adequately assessed in most studies. Taken into account the small sample sizes and the limited quality of the majority of the studies in this recently emerging field, biocueing and ambulatory biofeedback interventions showed promising results. Future research is expected to be focusing on biocueing as a just-in-time adaptive intervention. To establish this research field, closer cooperation between research groups, use of more rigorous as well as individually tailored research designs and more valid feasibility and effectivity assessment are recommended. •New, wearable biofeedback applications have been developed to enhance emotion regulation•Ambulatory biofeedback supports users to perform biofeedback training at home•Biocueing prompts users in everyday life stressful situations to practice regulation skills•A systematic search yielded only a few biocueing studies, indicating the need for more research and more valid assessment•First results suggest that these interventions can be considered useful treatment supplements to enhance emotion regulation