A multiday outdoor festival combining breathwork and cold water immersion is associated with reduced trait anxiety in a naturalistic pre-post study

Abstract Breathwork and cold exposure attract growing public interest, yet little is known about their psychological effects in real-world multi-day formats, and most evidence concerns acute physiological or state-level outcomes rather than more dispositional markers. This naturalistic uncontrolled pre-post study examined whether attending a 3-day outdoor festival combining breathwork, cold-water immersion and group movement (Festival du Froid, France, 2024) was associated with change in trait anxiety, resilience and cognitive emotion regulation. Of the 85 survey responses received, 19 participants (22%) provided complete paired pre- and post-festival data. The STAI-Trait scores were lower after than before the festival ( M pre: 42.6 ± 7.8 vs. M post: 39.8 ± 8.3, − 6.6%; Wilcoxon p = .002; mean difference 2.79 points, 95% CI [0.91, 4.67]; Hedges’ g = 0.68, 95% CI [0.19, 1.16]), which is a moderate-to-large effect by conventional benchmarks; 16 of 19 participants showed reduced or stable scores. Satisfaction was uniformly high; resilience and cognitive emotion regulation did not change. The STAI-Trait was interpreted as a marker of negative affectivity rather than a fixed disposition, and the design was treated as exploratory given the absence of a control group, the low completion rate and the small, self-selected sample. However, these findings provide preliminary evidence that a multi-day breathwork and cold-exposure festival is associated with an acute reduction in negative affective vulnerability and with high acceptability.