Research has shown that biofeedback training reduces depressive
symptoms. However, the precise mechanism for how it impacts affective, behavioral, and cognitive symptoms of depression is unknown. This study examined the effects of biofeedback training on affect (negative affect), behavior (resourceful behaviors), cognition (depressive cognitions), and depressive symptoms; explored relationships among those four variables; and evaluated the training program. The mixed-method research consisted of a quasi-experimental, pretest-posttest design; using open-ended questions. Hornby’s theory of human functioning, suggests that interrelationships exist among affect, behavior, and cognition and that changes in one of these may lead to changes in the other two
symptoms. Two senior assisted living facilities were chosen for the study; 50 elders were assigned to receive the usual care (control group) and another 50 were assigned to participate in the biofeedback training (experimental group). Participants completed measures of affect, behavior, cognitions, and depressive symptoms before and after biofeedback training and similar intervals for the control. The training included 10, 30-minute sessions, twice a week, for 5 weeks continuously.
The study found that there were significant intercorrelations (p<.01) among negative affect, resourceful behaviors, depressive cognitions, and depressive symptoms (r(range)= .28 to .79). Furthermore, there were no significant differences (p>.05) in baseline mean values of negative affect (t(98)=-1.57), resourceful behaviors (t(98)=-.92), depressive cognitions (t(98)=.16), and
depressive symptoms (t(98)=-1.02) between experimental and control groups. However, significant differences of mean values for negative affect (t(98)=5.38, p<.001), resourceful behaviors (t(98)=4.32, p<.001), depressive cognitions (t(85.792)= 3.10, p<.01), and depressive symptoms (t(98)= 8.06, p<.001) were found at post-intervention between the two groups. In addition, there were significant improvements in negative affect (F(1,98)=18.80, p<.001), resourceful behaviors (t(49)=-2.07, p<.05), depressive cognitions (F(1,98) = 5.24, p<.05), and depressive symptoms (F(1,98) = 108.14, p<.001) from pre-intervention to post-intervention. Moreover, the biofeedback training program was found to meet the six critical parameters of nursing intervention: necessity, acceptability, feasibility, fidelity, safety, and effectiveness.
The findings suggest beneficial effects of biofeedback training in reducing negative affect, depressive cognitions, and depressive symptoms and enhancing resourceful behaviors of Thai elders in assisted living facilities. This program may be a useful adjunct to exiting programs in facilities.