Breathe Well, Be Well? Exploring the Relationship Between Objective and Subjective Measures of Breathing and Well-Being

Breathing interventions are a commonly used and effective tool for improving well-being. Surprisingly, few breathing interventions include assessments of breathing, which limits the understanding of how breathing interventions contribute to specific well-being outcomes. This thesis addresses this oversight by exploring the relationship between objective and subjective breathing measures and well-being. This was achieved through three studies: Study 1 aimed to synthesise what is known about existing breathing measures as they relate to well-being through a systematic review and meta-analysis of literature that measured both an aspect of breathing and an aspect of subjective well-being. Three electronic databases (MEDLINE, PsycINFO and Web of Science) were searched, yielding 5735 results, of which 57 met inclusion criteria. The main findings were that breathing was most often measured using objective measures, but these were not as strongly related to well-being as subjective measures. However, all subjective measures were deficit based, focusing on breathing dysfunction and symptoms. Most studies also used deficit-based measures of subjective well-being, such as anxiety, depression, and panic. Study 2 aimed to address this gap by developing and validating the first positive self-reported breathing measure – the ‘Perceived Breath Mastery Scale (PBM-S)’. The PBM-S was hypothesised to be associated with positive well-being. Results supported this, showing moderate to large correlations between the PBM-S and all positive well-being measures. Study 3 aimed to construct and validate a short form (9-item) alternative version of the PBM-S as well as a 12-item version that included dysfunctional breathing as a fourth factor. Results supported the validity of all versions of the PBM-S. This thesis marks a significant advancement in understanding regarding the relationship between measures of breathing and subjective well-being. It introduces the first research-based conceptulisation of subjectively optimal/masterful breathing, distinguishing it clearly from dysfunctional breathing and showing that each is relevant to different aspects of well-being. The development and validation of three novel measures offer researchers and practitioners a suite of tools to efficiently assess both perceived breath mastery and dysfunction. Ultimately, this thesis provides a foundation for understanding how breathing interventions can be designed, implemented, and evaluated to achieve desired well-being outcomes.

This work © 2024, Rory Darkins.