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CONTROLLED TRIALS OF THERAPEUTIC OUTCOME

The Effectiveness of A Slow-Paced Diaphragmatic Breathing Exercise in Children’s Daily Life: A Micro-Randomized Trial

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ABSTRACT

Objective

Breathing exercises have been proposed as an effective intervention to improve subjective well-being and manage anxiety symptoms. As they are comparatively easy to learn and to implement, breathing exercises may be particularly beneficial for children. Although breathing exercises are ultimately supposed to provide salutary effects in individuals’ everyday lives, immediate effects of breathing exercises in naturalistic contexts have received limited empirical attention. The purpose of this study was to examine immediate effects of slow-paced diaphragmatic breathing on negative affect as well as on relaxation in an ecologically valid setting. To that end, we conducted a micro-randomized trial in children’s daily life.

Method

On each of 15 days, children (N = 171, aged 9–13 years, 54% female) were randomized to different conditions: performing a video-guided slow-paced diaphragmatic breathing exercise (experimental condition), watching a different video (active control condition), or a passive control condition.

Results

The breathing exercise had no immediate effects on negative affect or relaxation compared to both control conditions. However, in situations when children reported higher levels of worries than usual, relaxation was higher when children performed the breathing exercise compared to the passive control condition. Compared to the active control condition, the breathing exercise did not result in higher levels of relaxation in situations when children worried more than normally.

Conclusions

Findings highlight that context-specific factors can modulate the effectiveness of breathing exercises and should be taken into account to tailor interventions to individuals’ needs.

Acknowledgments

We thank Michaela Menstell and a team of highly committed student assistants for their help in conducting the study.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Supplementary Material

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2022.2084743

Notes

1 The intended sample size was planned a-priori as part of the preregistration (for detailed information on power planning please see the Online Supplement, S1).

2 Please note that one within-person SD represents 0.77 units on the worry scale.

Additional information

Funding

This study was preregistered on the Open Science Framework (OSF): https://osf.io/fwp7d. There are no relevant financial or non-financial competing interests to report. Our work was supported by the Jacobs Foundation under Grant 2016-1245-00.

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