# A Heart Rate Variability Biofeedback Enhanced Behavioral Intervention to Improve Psychological and Disease Functioning in Youth with Inflammatory Bowel Disease (IBD)

> **NIH NIH R01** · EMORY UNIVERSITY · 2024 · $481,515

## Abstract

PROJECT SUMMARY
Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are immune-mediated
gastrointestinal disorders associated with chronic medical and psychosocial dysfunction. IBD is increasingly
conceptualized as a product of the bidirectional communications between the central nervous system, the
autonomic nervous system (ANS), and the gut, referred to as the brain-gut axis. Consistent with this model,
adolescents with IBD demonstrate dysfunction of the ANS indicative of a chronic stress response and are at
increased risk for chronic psychological distress characterized by anxiety and depression. Treating ANS
dysfunction has emerged as a common and relatively easy to treat target to reduce psychological symptoms
as well as potentially ameliorate the disease symptoms of IBD. Through our prior work with pediatric IBD
patients, we have demonstrated that heart rate variability (HRV) is a non-invasive, acceptable, and feasible
measure of ANS functioning that we can reliably assess in youth with IBD and treat through HRV biofeedback.
In our prior work, we developed and evaluated the feasibility, acceptability, and preliminary efficacy of a
virtually delivered, group-based HRV biofeedback-enhanced coping skills treatment program for adolescents
diagnosed with IBD (K23DK122115). The goal of the proposed work is to build upon compelling preliminary
findings to test intervention efficacy via a randomized waitlist-controlled trial of our HRV biofeedback-enhanced
coping skills treatment program in a sample of adolescents ages 13-18 diagnosed with IBD and who screen
positive for symptoms of anxiety and/or depression; n = 128. The treatment program is based on evidence-
based cognitive behavioral therapy treatment principles and uses HRV biofeedback as an adjunctive treatment
component to treat autonomic dysfunction. With R01 support, our multidisciplinary team of experts in
behavioral interventions incorporating HRV biofeedback, pediatric IBD, and clinical trial design will determine if
treatment (1) improves psychological outcomes and (2) symptoms of IBD including reductions in disease
activity and inflammatory markers, relative to controls. Further, we will determine the mechanistic role of HRV
on psychological and IBD symptoms as a function of treatment. Support for a virtually delivered, HRV
biofeedback-enhanced coping skills treatment program for youth with IBD to address psychological outcomes
and symptoms of IBD would provide a scalable, innovative treatment option for the growing number of affected
pediatric patients. Further, if successful, we will demonstrate that HRV is a modifiable biomarker of autonomic
dysfunction responsive to biofeedback training and mechanistically responsible for intervention effects on
psychological and clinical outcomes as well as markers of inflammation.

## Key facts

- **NIH application ID:** 10900230
- **Project number:** 1R01DK139653-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Bonney Reed
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $481,515
- **Award type:** 1
- **Project period:** 2024-07-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10900230

## Citation

> US National Institutes of Health, RePORTER application 10900230, A Heart Rate Variability Biofeedback Enhanced Behavioral Intervention to Improve Psychological and Disease Functioning in Youth with Inflammatory Bowel Disease (IBD) (1R01DK139653-01). Retrieved via AI Analytics 2026-06-23 from https://api.ai-analytics.org/grant/nih/10900230. Licensed CC0.

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