Richard Gevirtz

Richard Gevirtz
Alliant International University · Clinical Psychology Ph.D Program

About

125
Publications
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Publications

Publications (125)
Article
Full-text available
We assessed the feasibility of using a consumer friendly, heart rate variability biofeedback (HRVB) wearable device in conjunction with a remote stress management coach to reduce symptoms of anxiety. We utilized a discreet, continuously wearable electrocardiogram device, the Lief Smart Patch, which measures and records heart rate and HRV in real ti...
Article
Full-text available
Major Depressive Disorder (MDD) is a psychiatric disorder characterized by high comorbidity with cardiovascular disease. Furthermore, a combination of high heart rate (HR) and low heart rate variability (HRV) has been frequently reported in depressed patients. The present review proposes a frontal-vagal (brain-heart) network that overlaps with func...
Poster
Full-text available
MBIs & HRV Biofeedback have been shown to be efficacious for heterogeneous chronic pain disorders. This study assesses outcomes of a combined MBI + HRVB 12-week group at Sharp Pain Rehabilitation at Sharp Memorial Hospital in San Diego, CA for patients with chronic muscle tension, vascular-, joint-, and nerve-related chronic pain disorders.
Conference Paper
Full-text available
Current study follows-up on a previous pilot study examining validity of three different Serial 7s task designs compared to a control condition & associated psychological processes related to ANS functioning. Results found that Serial 7s is equally effective at producing stress via the SNS but is not affecting short-term parasympathetic nervous sys...
Article
Objective: Nearly 80% of cancer patients struggle with insomnia, which is associated with decreased heart rate variability (HRV) and quality of life (QOL). The aim of this secondary analysis was to evaluate the possible effects of Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI), delivered during chemotherapy visits, on QOL and HRV in...
Poster
Full-text available
*avoidance (psyc. inflex), mindful awareness, & acceptance were assessed as potential moderators of HRV (RMSSD) Recovery & State Anxiety in healthy young adults
Article
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Introduction There is a long history of pre-deployment PTSD prevention efforts in the military and effective pre-deployment strategies to prevent post-deployment PTSD are still needed. Materials and Methods This randomized controlled trial included three arms: heart rate variability biofeedback (HRVB), cognitive bias modification for interpretatio...
Article
Objective: There is little research in the current literature regarding contributing factors to nightmares in children. This study aimed to test potentially overlapping predictors of nightmare distress and severity, including anxiety, dissociation, trauma history, vagal tone, and parental processing of emotions. Method: Sixty parent-child dyads...
Article
Full-text available
Individuals with autism and intellectual impairments tend to be excluded from research due to their difficulties with methodological compliance. This study focuses on using Teaching with Acoustic Guidance-TAGteach-to behaviorally prepare children with autism and a IQ ≤ 80 to participate in a study on neurofeedback training (NFT). Seven children (ag...
Article
Objectives: To assess pre-/post-transplantation changes in autonomic tone, as measured by heart rate variability (HRV), among patients undergoing hematopoietic cell transplantation (HCT) and to look at those changes as they relate to post-transplantation survival rates. . Sample & setting: Data were derived from a sample of 27 English-speaking...
Poster
Empirical evidence indicates that non-suicidal self-injury (NSSI) is a function of emotion dysregulation.1 Individuals with emotion dysregulation have poorly functioning autonomic nervous systems (ANS), evidenced by reduced physiological resilience and high reactivity during stress.2,3 The ANS is comprised of the sympathetic nervous system, which i...
Article
Research on heart rate variability (HRV) in posttraumatic stress disorder (PTSD) and comorbid alcohol use disorder (AUD) is limited despite its use as a biomarker of both disorders. This study examined whether AUD comorbidity contributes an additive effect on HRV for veterans with PTSD. HRV was assessed in 70 male Operation Enduring Freedom/Operati...
Article
Background: Given that many studies suggest a role of DLPFC-sgACC connectivity in depression and prior research demonstrating that neuromodulation of either of these nodes modulates parasympathetic activity and results in a heart rate deceleration, a new method is proposed to individualize localization of the DLPFC. This can, among others, be usef...
Article
This article briefly describes a cardiorespiratory type of biofeedback called heart rate variability biofeedback. The rationale for the technique is outlined and the protocol described. Gevirtz (2013) has reviewed the HRVB outcome literature up to 2013. For a more theoretical paper see Lehrer & Gevirtz (2014).
Poster
Decades of treatment research has established that treatments are much more likely to help people improve their functioning and sense of well being when they perceive the treatment as credible and expect it to help them. Biofeedback is a well-established intervention with evident success in improving a variety of conditions such as hypertension, di...
Article
Full-text available
Heart rate variability is a physiological measure associated with autonomic nervous system activity. This study hypothesized that lower pre-deployment HRV would be associated with higher post-deployment post-traumatic stress disorder (PTSD) symptoms. Three-hundred-forty-three Army National Guard soldiers enrolled in the Warriors Achieving Resilienc...
Poster
Background: Neuropsychology has recently focused on understanding potential evidence-based enhancers and modulators of neurocognitive performance. The Neurovisceral Integration Model proposes that the reciprocity between autonomic and central nervous systems facilitates an individual’s ability to respond appropriately to cognitive and other demands...
Chapter
Biofeedback application is an evidence-based technique to induce relaxation. Literature highlighted the efficacy of this technique in helping selected patients modify specific responses or response patterns associated with a mental disorder. For example, a “relaxed” Autonomic Nervous System (ANS) pattern include slow, regular heart rate, increased...
Poster
Full-text available
The Neurovisceral Integration Model proposes that the reciprocity between autonomic and central nervous systems facilitates an individual’s ability to respond appropriately to environmental demands by proper vagal withdrawal and recovery. Resting Heart Rate Variability has been shown to be associated with performance on tasks involving executive fu...
Poster
Full-text available
Recent research has shown vagal-related indices to be differentially associated with exercise at varying intensities, particularly moderate and strenuous intensity. However, little is known about the relationship between regular exercise and vagal withdrawal and recovery, potential markers of physiological resilience. The purpose of this study is t...
Article
Full-text available
Practitioners using heart rate variability biofeedback (HRVB) often must supplement the biofeedback training with other therapeutic techniques. In this article, I describe some of the ways in which my interns and I integrate a mindfulness-based therapy called ACT (acceptance and commitment therapy) into our biofeedback based clinical protocols. I d...
Article
Full-text available
Arousal systems are one of the recently announced NIMH Research Domain Criteria to inform future diagnostics and treatment prediction. In major depressive disorder (MDD), altered central nervous system (CNS) wakefulness regulation and an increased sympathetic autonomic nervous system (ANS) activity have been identified as biomarkers with possible d...
Article
Full-text available
Physiological assessment of post-traumatic stress disorder (PTSD) presents an additional avenue for evaluating the severity of PTSD symptoms. We investigated whether the presence of a high number of uncommon symptoms attenuated the relation between self-reported PTSD symptoms and heart rate variability (HRV). Participants were 115 Veterans from the...
Article
Conversion symptoms-functional neurological disturbances of body function-occur in association with extreme arousal, often in the context of emotional distress. The mechanisms that determine how and why such symptoms occur remain unknown. In this study, we used cardiac measures to assess arousal and cardiac autonomic regulation in children and adol...
Poster
Full-text available
The Neurovisceral Integration Model proposes that the reciprocity between the autonomic and central nervous systems facilitates an individual’s ability to respond appropriately to environmental demands by proper vagal withdrawal and recovery. Neuroimaging studies have shown the prefrontal cortex to be significantly associated with Heart Rate Variab...
Poster
Full-text available
High levels of trait anxiety (TA) as measured by the State-Trait Anxiety Inventory (STAI) have consistently been shown to be associated with low cardiac vagal control. While the current literature illustrates that TA is associated with reduced autonomic regulation; dynamic measures of vagal activity as assessed by vagal withdrawal and recovery in r...
Article
Although there has been much support for HRV Biofeedback as an effective intervention for various disorders, there is a lack of comprehension of the underlying mechanisms. The predominant theories of increased vagal efferents and baroreflex gain are insufficient in explaining the frequent observations that HRV Biofeedback impacts changes in constru...
Article
Full-text available
Irritable bowel syndrome (IBS) and Functional Abdominal Pain (FAP) are among the most commonly reported Functional Gastrointestinal Disorders. Both have been associated with varying autonomic dysregulation. Heart Rate Variability Biofeedback (HRVB) has recently begun to show efficacy in the treatment of both IBS and FAP. The purpose of this multipl...
Article
Full-text available
In recent years there has been substantial support for heart rate variability biofeedback (HRVB) as a treatment for a variety of disorders and for performance enhancement (Gevirtz, 2013). Since conditions as widely varied as asthma and depression seem to respond to this form of cardiorespiratory feedback training, the issue of possible mechanisms b...
Poster
Full-text available
Vagal tone has become a prominent index of stress vulnerability and reactivity in many studies of populations with affective disorders. Recent research has shown that trauma significantly influences respiratory-sinus arrhythmia (RSA) recovery from mild exercise. Women with no traumatic history showed that RSA returned to baseline levels, while trau...
Poster
Full-text available
The sympathetic and parasympathetic nervous systems control the physiological expression of stress in mammals. These branches work in conjunction to regulate heart rate pattern. Porges (1995) has hypothesized that the vagus nerve evolved within the parasympathetic nervous system as a cardiac brake that creates a rhythmic acceleration and decelerati...
Article
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Heart rate variability biofeedback has enjoyed increased popularity in recent years. In this review, empirical evidence from multiple sources is presented from the point of view of possible mechanisms of effect. While more research is clearly needed, the data thus far are certainly promising.
Article
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The importance of the bi-directional communication between the heart and brain has been known for over 100 years (Lane et al. in NeuroImage 44:213-222, 2009a, Psychosom Med 2:117-134, 2009b) and plays an important role in many of the prominent theories of psychophysiology today. Utilizing heartbeat evoked potentials (HEPs), we sought to determine w...
Article
This study examined the efficacy of a cardiorespiratory biofeedback intervention compared to bed rest in the treatment of 47 women diagnosed with pregnancy-induced hypertension (PIH). The investigation consisted of a historical control group with 31 PIH subjects receiving treatment as usual (TAU), bed rest and antihypertensive medications, and an e...
Poster
Full-text available
Several studies have shown that heart-rate variability (HRV) biofeedback training is successful in treating symptoms of anxiety and autonomic dysregulation. Some studies have proposed that electromyography (EMG) biofeedback training can be used to treat symptoms of anxiety. Both training modalities are viewed as relaxation interventions. However, r...
Article
Full-text available
The emphasis on the sympathetic nervous system (SNS) in cardiology has recently shifted to a view recognizing the extraordinarily protective role that the (parasympathetic) vagus nerve plays in prevention and rehabilitation of heart muscle and pacemaker function. This article summarizes some of the epidemiological evidence supporting this premise a...
Article
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Self-regulation is central to many of the most important individual and societal problems today. We sought to determine whether the relationship between self-regulation and heart rate variability (HRV) could be replicated and extended. We hypothesized that baseline HRV would predict persistence on an anagram task, and that under conditions requirin...
Article
Full-text available
Exposure to combat experiences is associated with increased risk of developing Post Traumatic Stress Disorder. Prolonged exposure therapy and cognitive processing therapy have garnered a significant amount of empirical support for PTSD treatment; however, they are not universally effective with some patients continuing to struggle with residual PTS...
Article
Full-text available
This chapter explores the use of autonomic nervous system (ANS) measures as potential biomarkers for medically unexplained disorders. It is proposed that these disorders are better classified and treated as related symptom clusters with logical physiological and psychophysiological involving the sympathetic and parasympathetic branches of the ANS....
Article
Full-text available
Functional abdominal pain (FAP) causes disruption of daily activities/missed school days, over utilization of healthcare, unnecessary surgeries, and anxiety in 10-15% of children. Its etiology is not clearly understood, however the success of several clinical protocols suggests that autonomic dysregulation is a factor. In this study autonomic activ...
Article
Full-text available
Objectives: Previous studies in our laboratory have suggested that myofascial trigger points [MTrPs] are electrically active and are sensitive to psychological stressors even when surrounding muscle tissue is silent. This study investigated the effects of Autogenic Relaxation Training [AT] on the needle electromygraphic [EMG] response of active MTr...
Article
Full-text available
The objective of the study was to determine if there is dysregulated autonomic nervous system activity as manifested by depressed heart rate variability (HRV) among veterans of Operations Enduring and Iraqi Freedom (OEF/OIF). The study used a convenience sample of OEF/OIF veterans (n = 28) seen at a Level II Polytrauma Network Site at the Michael E...
Article
Full-text available
The objective of this study was to examine the acute effects of a portable respiratory sinus arrhythmia (RSA) biofeedback device as compared to passive biofeedback control on state anxiety, heart rate (HR), and Stroop task (Congedo, 2003) performance during repeated administration of the Stroop task cognitive stressor in a single brief session. Par...
Article
Because of the dynamic and complex nature of chronic pain, successful treatment usually requires addressing behavioral, cognitive, and affective processes. Many adjunctive interventions have been implemented in fibromyalgia (FM) treatment, but few are supported by controlled trials. Herein, some of the more commonly used nonpharmacologic interventi...
Article
Full-text available
Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia (RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle r...
Article
Decreased HRV has been consistently associated with increased cardiac mortality and morbidity in HF patients. The aim of this study is to determine if a 6-week course of heart rate variability (HRV) biofeedback and breathing retraining could increase exercise tolerance, HRV, and quality of life in patients with New York Heart Association Class I-II...
Article
Post traumatic stress disorder (PTSD) is a common mental health outcome associated with combat operations. Since October 2001, more than 1.6 million U.S. troops have deployed as part of Operation Enduring Freedom or Operation Iraqi Freedom. Current estimates for postdeployment post-traumatic stress disorder in Operation Enduring Freedom and Operati...
Article
Randomized control trial conducted between June 2000 and September 2002. To determine whether a short psycho-educational video shown in the Emergency Department shortly after the injury would produce follow-up pain reductions and reduced medical utilization. Chronic pain following a whiplash injury is one example of the massive medical/legal proble...
Article
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Bibliographic searches identified 14 controlled and uncontrolled outcome evaluations of biofeedback-based treatments for temporomandibular disorders published since 1978. This literature includes two randomized controlled trials (RCTs) of each of three types of biofeedback treatment: (1) surface electromyographic (SEMG) training of the masticatory...
Article
Full-text available
We evaluated systolic and diastolic blood pressure, heart rate variability and skin conductance at baseline, and 1 and 4 months in 38 participants with elevated blood pressure, randomly assigned to expressive writing or control groups. There was a significant interaction such that the very low frequency wave of heart rate variability increased over...
Article
We sought to determine whether an intervention labeled "biofeedback" could be implemented with patients who were diagnosed with "functional" disorders (Irritable Bowel Syndrome, Fibromyagia/Chronic Fatigue Syndrome, Myofascial Pain, Anxiety with somatic features, or Noncardiac Chest Pain), in a primary care setting, and whether cost savings through...
Article
To determine if cardiorespiratory biofeedback increases heart rate variability (HRV) in patients with documented coronary artery disease (CAD). Diminished HRV has been associated with increased cardiac morbidity and mortality. Evidence suggests that various lifestyle changes and pharmacologic therapies can improve HRV. The objective of this study w...