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theses

Purpose: The purpose of this dissertation was to provide longitudinal evidence on heart rate variability biofeedback (HRVB) as an anti-craving intervention for college students recovering from substance use disorder (SUD). Methods: Previous studies showed promise of the therapeutic potential of HRVB to reduce substance craving. Gaps in the literature indicated the need for a longitudinal examination of craving changes that takes individual differences into consideration. Data from 46 college students recovering from SUD were used to examine craving changes before and during an eight-session HRVB intervention. Participants were assessed at four occasions in the control condition over the first 12 weeks followed by 8 occasions in the experimental condition, separated by an 11-week rest period. A longitudinal multilevel modeling approach was used with time at level-1 nested within persons at level-2. Unconditional and conditional multilevel models of change were estimated to model craving trajectories and predictor relationships over time. Results: Significant reductions in substance craving were observed during HRVB compared to waitlist. HRVB seemed to enhance the efficacy of conventional therapies by producing craving reductions that were not evident prior to the HRVB intervention despite usual treatment. A continued daily HRVB practice of more than 12 minutes was found to enhance treatment as usual outcomes and contribute to greater craving reductions over time. In our sample, younger participants seemed to be more committed to daily HRVB practice, although many did not achieve the recommended daily practice of 15 minutes twice daily. Increases in depressive symptoms were found to attenuate the effects of HRVB on craving. Anxiety and perceived stress were not significantly associated with craving in this study. The true R2 for the final model indicated that 20.5% of the variance in craving was explained by age, daily HRVB >12 minutes, and the within-person aspect of depression. Conclusions: HRVB is an easily accessible and affordable intervention that shows promise as a complementary anti-craving intervention. The outcomes of this study have implications for hypothesized HRVB practice-dose relationships. Nurses may help persons recovering from SUD to better manage the symptom of craving by the routine and strategic use of personal HRVB practice.

ETD_8237

Ph.D.

Includes bibliographical references

by Nour Alayan

doi:10.7282/T3DF6V9Z

ETD doctoral

The author owns the copyright to this work.