Comprehensive Meta-Analysis and Systematic Review of the Effectiveness of Interventions Based on Polyvagal Theory on

Document Type : Original Article

Authors

1 Ph.D .Student, Department of Psychology and Education of Children with Special Needs, Faculty of Educational Sciences and Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

2 Associate Professor, Department of Psychology and Education of Children with Special Needs, Faculty of Educational Sciences and Psychology, Isfahan University, Isfahan, Iran

3 Assistant professor, Department of Clinical Health Psychology, Faculty of Educational Sciences and Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

10.48308/apsy.2024.234006.1589

Abstract

Aim: Psychological disorders have a significant impact on the global burden of disease, so it is essential to identify and evaluate the effectiveness of non-invasive psychological interventions. Therefore, the aim of this research was to provide a comprehensive and systematic review of the efficacy of interventions based on polyvagal theory as a type of non-invasive neurobiological intervention for psychological disorders.
 
Method: Relevant studies from 1994 to 2023 were searched using reputable scientific databases and relevant keywords, and nine high-quality studies were selected based on the PRISMA statement. Data analysis was performed using the third version of comprehensive meta-analysis software. The extracted effect sizes included 26 effect sizes.
 
Results: The results showed a combined effect size of 0.26, which was statistically significant at the 0.001 level. According to Cohen's interpretation of effect size, this indicates a large effect size. In other words, interventions based on polyvagal theory can play a significant role in reducing psychological disorders. The meta-analysis results demonstrated high statistical validity, and there was no evidence of publication bias, enhancing the reliability of the results.
 
Conclusion: Interventions based on polyvagal theory can have a significant role in the treatment of psychological disorders, and it is recommended that therapists and specialists utilize them in the treatment of psychological disorders.

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Main Subjects


Afrooz G, Hashemian K, Bagheri M. Comparing Effectiveness of Short Term Psychodynamic Psychotherapy and Emotion-Focused Couple Therapy on Couples with Alexithymia. Rooyesh 2023; 12 (4) :1-14.[link]
 
Bai, Z., Luo, S., Zhang, L., Wu, S., & Chi, I. (2020). Acceptance and commitment therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of affective disorders260, 728-737.[link]
*Barnes, V. (2011). Using Mindfulness and the Dive Reflex as Techniques from Polyvagal Theory to Regulate Approach Motivation. University of Exeter (United Kingdom).[link]
Bonilla, G. (2020). Healing the body through awareness, and expression: The Polyvagal Theory and the expressive arts in therapy with women who have been abused.‏[link]
Conroy, J., & Perryman, K. (2022). Treating trauma with child-centered play therapy through the SECURE lens of polyvagal theory. International Journal of Play Therapy31(3), 143[link]‏
Dana,d.(2018).The Polyvagal Theory in Therapy.[link]
Dana, D. (2020). Polyvagal Flip Chart: Understanding the Science of Safety (Norton Series on Interpersonal Neurobiology). WW Norton & Company.‏[link]
*De, A., & Mondal, S. (2019). Immediate effect of yogic postures on autonomic neural responses. Research in Cardiovascular Medicine, 8(4), 106-106.‏[link]
Ellis, L. A. (2023). Solving the nightmare mystery: The autonomic nervous system as missing link in the aetiology and treatment of nightmares. Dreaming33(1), 45.‏[link]
Faulkner, S.C. (2023). Drumming, rhythm, and regulation through a polyvagal lens. JoCAT, 18(1). https://www.jocat-online.org/pp-23-faulkner.[link]
Fernandes, R. A., Fiquer, J. T., Gorenstein, C., Razza, L. B., Fraguas Jr, R., Borrione, L.,& Brunoni, A. R. (2017). Nonverbal behaviors are associated with increased vagal activity in major depressive disorder: Implications for the polyvagal theory. Journal of Affective Disorders209, 18-22.‏[link
Flores, P. J., & Porges, S. W. (2019). Group psychotherapy as a neural exercise: Bridging polyvagal theory and attachment theory. In Attachment in Group Psychotherapy (pp. 46-66).[link]
Flater, B. (2020). Safety and connection in the polyvagal theory. Implications for music therapy in mental health care (Master's thesis, Norges musikkhøgskole).‏[Link]
Geller, S. M. (2018). Therapeutic presence and polyvagal theory: Principles and practices for cultivating effective therapeutic relationships. Clinical applications of the polyvagal theory: The emergence of polyvagal-informed therapies, 106-126.‏[link]
Ghacibeh, G. A., Shenker, J. I., Shenal, B., Uthman, B. M., & Heilman, K. M. (2006). Effect of vagus nerve stimulation on creativity and cognitive flexibility. Epilepsy & Behavior, 8(4), 720-725.‏[link]
Hastings, P. D., Nuselovici, J. N., Utendale, W. T., Coutya, J., McShane, K. E., & Sullivan, C. (2008). Applying the polyvagal theory to children's emotion regulation: Social context, socialization, and adjustment. Biological psychology79(3), 299-306.‏[link]
Hadiprodjo, N. (2018). Clinical applications of the polyvagal theory and attachment theory to play therapy for children with developmental trauma (Doctoral dissertation, University of Roehampton).‏[link]
*Heilman, K. J., Heinrich, S., Ackermann, M., Nix, E., & Kyuchukov, H. (2023). Effects of the Safe and Sound Protocol TM (SSP) on Sensory Processing, Digestive Function and Selective Eating in Children and Adults with Autism: A Prospective Single-Arm Study. Journal on Developmental Disabilities, 28(1).‏[link]
 Hertzel, S. K. (2021). Developing an Intervention for Treating Sibling Survivors of Suicide Loss Through the Dual Lens of Polyvagal Theory and Functional Contextualism (Doctoral dissertation, Widener University).‏[link]
*Hoseinpourfard, M., & Shajarian, M. (2020). Polyvagal neural biofeedback training by pulse regulated abdominal breathing in sleep disorder: A suggestion for COVID-19 patients. Hospital Practices and Research, 5(3), 87-91.‏[link]
Jones, R. M., Buhr, A. P., Conture, E. G., Tumanova, V., Walden, T. A., & Porges, S. W. (2014). Autonomic nervous system activity of preschool-age children who stutter. Journal of fluency disorders41, 12-31.‏[link]
Jakubovic, R. J., & Drabick, D. A. (2023). Dialectical behavior therapy-based interventions for externalizing problems among adolescents: A meta-analysis. Clinical Psychology: Science and Practice.‏[link]
*Kawai, H., Kishimoto, M., Okahisa, Y., Sakamoto, S., Terada, S., & Takaki, M. (2023). Initial Outcomes of the Safe and Sound Protocol on Patients with Adult Autism Spectrum Disorder: Exploratory Pilot Study. International journal of environmental research and public health, 20(6), 4862[link]‏
*Lü, W., Wang, Z., & Liu, Y. (2013). A pilot study on changes of cardiac vagal tone in individuals with low trait positive affect: The effect of positive psychotherapy. International Journal of Psychophysiology, 88(2), 213-217.‏[link]
*Magnon, V., Dutheil, F., & Vallet, G. T. (2021). Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Scientific Reports, 11(1), 19267.‏[link]
Majidinezhad, M., Pirmoradi, M., & Zahedi Tajrishi, K. (2023). The Effect of Transcranial Direct Current Stimulation (tDCS) on Attentional Bias and Affect in Adults with Major Depressive Disorder (MDD). Applied Psychology, 17(1), 35-11. doi: 10.48308/apsy.2022.225034.1224[link]
Mechler, J., Lindqvist, K., Carlbring, P., Topooco, N., Falkenström, F., Lilliengren, P., ... & Philips, B. (2022). Therapist-guided internet-based psychodynamic therapy versus cognitive behavioural therapy for adolescent depression in Sweden: a randomised, clinical, non-inferiority trial. The Lancet Digital Health4(8), e594-e603.‏[link]
Mojtabavi, H., Saghazadeh, A., Valenti, V. E., & Rezaei, N. (2020). Can music influence cardiac autonomic system? A systematic review and narrative synthesis to evaluate its impact on heart rate variability. Complementary therapies in clinical practice, 39, 101162.‏[link]
*Meier, M., Unternaehrer, E., Dimitroff, S. J., Benz, A. B., Bentele, U. U., Schorpp, S. M., ... & Pruessner, J. C. (2020). Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial. Scientific reports, 10(1), 14774.‏[link]
Mirghaed, M. T., Gorji, H. A., & Panahi, S. (2020). Prevalence of psychiatric disorders in Iran: a systematic review and meta-analysis. International journal of preventive medicine11.‏[link]
Neuhäußer, A. M., Bluschke, A., Roessner, V., & Beste, C. (2023). Distinct effects of different neurofeedback protocols on the neural mechanisms of response inhibition in ADHD. Clinical Neurophysiology153, 111-122.‏[link]
Porges, S. (2023). Vagal Nerve Stimulation Through the Lens of the Polyvagal Theory: Recruiting Neurophysiological Mechanisms to Dampen Threat Reactions and Promote Homeostatic Functions. In Vagus Nerve Stimulation (pp. 31-49). New York, NY: Springer US.‏[link]
Porges, S. W. (2022). Polyvagal theory: a science of safety. Frontiers in integrative neuroscience16, 27.‏[link]
Porges, S. W. (2017). The pocket guide to the polyvagal theory: The transformative power of feeling safe. WW Norton & Co[Link]‏
Porges, S. W., & Carter, C. S. (2017). Polyvagal theory and the social engagement system. Complementary and Integrative Treatments in Psychiatric Practice. Washington, DC: American Psychiatric Association Publishing, 221-241.‏[Link].
Reiter, E., & Pollack, D. (2023). How does polyvagal theory impact family law matters?.‏[link]
Rothberg, R. L. (2014). Application of somatic interventions in clinical practice.‏[link]
Rosenberg,S. (2017). Accessing the Healing Power of the Vagus Nerve: Self-Help Exercises for Anxiety, Depression,Trauma, and Autism. North Atlantic Books Berkeley, California.[link]
*Rizvi, M. R., Sharma, A., Hasan, S., Ahmad, F., Asad, M. R., Iqbal, A., & Alghadir, A. H. (2023). Exploring the impact of integrated polyvagal exercises and knee reinforcement in females with grade II knee osteoarthritis: a randomized controlled trial. Scientific Reports, 13(1), 18964.‏[link]
Sarimo, M. J. (2023). Befriending Your Vagus Nerve: A Storybook for Children.[link]
Sadeghzadeh, R., Razani, M., & Piriaei, H. (2024). Comparing the Effectiveness of Cognitive-Behavioral Therapy and Metacognitive Therapy on Resilience and Quality of Life in Patients with Obsessive-Compulsive Disorder. Applied Psychology18(1), 62-36. doi: 10.48308/apsy.2024.233879.1576.[link]
Streeter, C. C., Gerbarg, P. L., Saper, R. B., Ciraulo, D. A., & Brown, R. P. (2012). Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical hypotheses, 78(5), 571-579[link]‏
Sullivan, M. B., Erb, M., Schmalzl, L., Moonaz, S., Noggle Taylor, J., & Porges, S. W. (2018). Yoga therapy and polyvagal theory: The convergence of traditional wisdom and contemporary neuroscience for self-regulation and resilience. Frontiers in human neuroscience, 67.‏[link]
Talebi, S., Ghamarani, A., & Abedi, A. (2023). Effortful Control and Internalizing Emotional-Behavioral Disorders in Children: A Simultaneous Systematic Review and Meta-Analysis. Applied Psychology.[link]
Winhall, J., & Porges, S. W. (2022). Revolutionizing Addiction Treatment with The Felt Sense Polyvagal Model™. International Body Psychotherapy Journal21(1).‏[link]
Zhang, Q., Yi, P., Song, G., Xu, K., Wang, Y., Liu, J., ... & Li, X. (2022). The efficacy of psychodynamic therapy for social anxiety disorder–A comprehensive meta-analysis. Psychiatry research309, 114403.‏[link]
Zuberi, A., Waqas, A., Naveed, S., Hossain, M. M., Rahman, A., Saeed, K., & Fuhr, D. C. (2021). Prevalence of mental disorders in the WHO eastern mediterranean region: a systematic review and meta-analysis. Frontiers in psychiatry12, 665019.‏[link]
Živanović, M., Bjekić, J., Konstantinović, U., & Filipović, S. R. (2022). Effects of online parietal transcranial electric stimulation on associative memory: a direct comparison between tDCS, theta tACS, and theta-oscillatory tDCS. Scientific Reports12(1), 14091.‏[link]