QEEG Guided Neurofeedback Treatment for Anxiety Symptoms
Anxiety represents one of the most commonly diagnosed mental illnesses among adults in the United States, affecting an estimated 19.1% of the adult population annually, with a lifetime occurrence of 31.1% (NIMH, 2017). This retrospective study intended to assess whether qEEG guided amplitude neurofeedback (NF) is a viable treatment for anxiety symptom reduction. 40 participants were assessed for anxiety using symptom and EEG measures. Demographics include age ranges from 19-62 (M = 37.7, SD =13.87). Gender identification comprised 21 male and 19 female. 15 clients self-identified as White (Non-Latino) (38%), 14 as Latino/Latina (35%), and 11 did not self-report ethnicity (28%). Pre/post-assessments were given to the participants. Symptom assessments included the Zung Self-Rating Anxiety Scale and Achenbach (ASEBA) Adult Self Report (ASR). A qEEG was used to determine protocols for each participant. Participants were scheduled to receive 30-minute NF treatment sessions twice a week for one academic semester. The range of attended sessions was 7-19 (M = 12.72, SD = 2.78). Accurate number of session data was unavailable for 4 of the subjects. Symptom measures showed statistically significant improvement. Limitations include small sample size and no control group or sham NF group. Suggestions are included for future studies.
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.
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 / Makedonska Akademija Na Naukite i Umetnostite, Oddelenie Za Biološki i Medicinski Nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences, 32(1), 229–244.
Dreis, S. M., Gouger, A. M., Perez, E. G., Russo, G. M., Fitzsimmons, M. A., & Jones, M. S. (2015). Using Neurofeedback to Lower Anxiety Symptoms Using Individualized qEEG Protocols: A Pilot Study. NeuroRegulation, 2(3), 137–148. http://dx.doi.org/10.15540/nr.2.3.137
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
Gunkelman, J. (2006). Transcend the DSM using phenotypes. Biofeedback, 34(3), 95–98.
Gurnee, R. (2003). QEEG/Topographic Brain Maps: Generalized Anxiety Disorder Subtypes. Retrieved from http://www.add-clinic.com/anxietytreatment.html
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.
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
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 (NIMH). (2017). Any Anxiety Disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
National Institute of Mental Health (NIMH). (2018). Anxiety Disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
Mennella, R., Patron, E., & Palomba, D. (2017). Frontal alpha asymmetry neurofeedback for the reduction of negative affect and anxiety. Behaviour Research and Therapy, 92, 32–40. http://dx.doi.org/10.1016/j.brat.2017.02.002
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 (2nd ed., pp. 453–472). Burlington, MA: Elsevier Academic Press. http://dx.doi.org/10.1016/B978-0-12-374534-7.00017-4
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.
Singer, K. (2004). The effect of neurofeedback on performance anxiety in dancers. Journal of Dance Medicine & Science, 8(3), 78–81.
Spielberger, C. D. (1983). State-Trait Anxiety Inventory for Adults. Redwood City, CA: MindGarden, Inc.
Stern, J. M. (2005). 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 7th 2014 Biomedical Engineering International Conference, Fukuoka, Japan, pp. 1–4. http://dx.doi.org/10.1109/BMEiCON.2014.7017400
Walker, J. E. (2009). Anxiety associated with posttraumatic stress disorder—The role of quantitative electroencephalograph in diagnosis and in guiding neurofeedback training to remediate the anxiety. Biofeedback, 37(2), 67–70. http://dx.doi.org/10.5298/1081-5937-37.2.67
Wigton, N. L. (2014). Evaluating 19-channel z-score neurofeedback: Addressing efficacy in a clinical setting (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 3625170)
Wigton, N. L. & Krigbaum, G. (2015). 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
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).