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

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.

Abstract

Aim: Psychological disorders have a significant impact on the global burden of disease, making it essential to identify and evaluate the effectiveness of non-invasive psychological interventions. This research aims to provide a comprehensive and systematic review of the efficacy of interventions based on polyvagal theory, 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. Nine high-quality studies were selected based on the PRISMA statement. Data analysis was performed using the third version of Comprehensive Meta-Analysis software, yielding 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 medium 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. It is recommended that therapists and specialists utilize them in their treatment protocols.

Keywords

Main Subjects

References

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 disorders, 260, 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 Therapy, 31(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. Dreaming, 33(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 Disorders, 209, 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 psychology, 79(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 disorders, 41, 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 Health, 4(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 medicine, 11.‏[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 Neurophysiology, 153, 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 neuroscience, 16, 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 Psychology, 18(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 Journal, 21(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 research, 309, 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 psychiatry, 12, 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 Reports, 12(1) , 14091.‏[link]
 
 

Files

Share

How to cite

Statistics