CLINICAL TRIAL article
Front. Public Health
Sec. Substance Use Disorders and Behavioral Addictions
Efficacy of Neurofeedback-Assisted Mindfulness for Anxiety and Nomophobia in Spanish Young Adults: A Randomized Controlled Trial
Provisionally accepted
Mei Fernandez-Crespo1,2,3*
M Isabel Rihuete-Galve2,4,5Natalia Sanchez-Aguadero2,4Nerea Sanchez-Sanchez4,5Jesus Gonzalez-Sanchez2,3,4,6Irene A Garcia-Yu2,3,4
Hsin-Chien Lee7
Jose I Recio-Rodriguez2,3,4,6- 1Institute of Biomedical Research, University of Salamanca, Salamanca, Spain
- 2Universidad de Salamanca, Salamanca, Spain
- 3Unidad de Investigación de Atención Primaria APISAL, Salamanca, Spain
- 4Instituto de Investigacion Biomedica de Salamanca, Salamanca, Spain
- 5Hospital Universitario de Salamanca, Salamanca, Spain
- 6Red de Investigacion en Cronicidad Atencion Primaria y Prevencion y Promocion de la Salud, Barcelona, Spain
- 7Taipei Medical University, Taipei City, Taiwan
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Background: Problematic use of new technologies has been associated with anxiety and other disorders in young adults. This study evaluated the efficacy of a Neurofeedback-Assisted Mindfulness Training Program (NAMTP) in reducing anxiety and related symptoms in young adults. Methods: A randomized clinical trial assigned participants to an intervention group (IG), receiving 20-25 NAMTP sessions, or a control group (CG). All participants received a brief workshop on responsible technology use. Anxiety was assessed using the DASS-21 anxiety subscale. Secondary outcomes included the Smartphone Addiction Scale – Short Version (SAS-SV), Nomophobia Questionnaire (NMP-Q), and Athens Insomnia Scale (AIS), all evaluated at baseline and three months. Results: A total of 40 participants completed the study (82.5% women; mean age 24.8 ± 3.4). No statistically significant differences were observed between the intervention group (IG) and the control group (CG) in any of the psychological variables assessed. For the DASS scales, the mean differences (IG–CG) were 0.1 (95% CI: –1.6 to 1.9; p=0.868) for anxiety, –2.4 (95% CI: –7.2 to 2.4; p=0.324) for depression, and –1.5 (95% CI: –5.3 to 2.4; p=0.453) for stress. Similarly, the mean difference in the SAS-SV score was –1.0 (95% CI: –5.0 to 2.9; p=0.606), while for the NMP-Q score it was 3.7 (95% CI: –8.9 to 16.4; p=0.553). Finally, the Athens Insomnia score showed a mean difference of –1.1 (95% CI: –2.9 to 0.7; p=0.211). Adherence to the NAMTP program was high (88.8%). Conclusions: The NAMTP did not produce significant improvements in anxiety, mobile phone addiction, nomophobia, or sleep quality. These findings suggest that, although NAMTP is feasible and well-tolerated, further research is needed to determine its potential benefits. Trial Registration: Clinicaltrials.gov NCT06188910. http://www.Clinicaltrials.gov/ct2/show/NCT06188910
Keywords: Neurofeedback, mindfulness, Anxiety, Nursing, young adults, randomized controlled trial
Received: 24 Sep 2025; Accepted: 13 Nov 2025.
Copyright: © 2025 Fernandez-Crespo, Rihuete-Galve, Sanchez-Aguadero, Sanchez-Sanchez, Gonzalez-Sanchez, Garcia-Yu, Lee and Recio-Rodriguez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mei Fernandez-Crespo, meifdez@usal.es
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