The short-term effects of a body awareness program: better self-management of health problems for individuals with chronic a-specific psychosomatic symptoms.

A three-day residential Body Awareness Program (BAP) was developed to teach people with Chronic A-specific Psychosomatic Symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The short-term effects of the program for people with CAPS are presented in this study. The design is a non-control group design with pre- and post-measures (2 months after the program). The sample for this paper was formed by 187 participants. The mean age is 42.3 (S.D. = 8.9), and 57% is female. The results showed decreased stress-related symptoms, increased quality of life, increased self-efficacy, less depressive attribution style, more expression of emotions, and a positive change of lifestyle. Most of these measured changes can be interpreted as clinically relevant outcomes with medium-to-large effect sizes. Personal pre-training goals were attained by 85% of the participants. Spouses also confirmed the found effects. Evaluation of the BAP gives enough evidence to conclude that this program leads to positive effects in CAPS. Participants react more adequately to disturbances between daily workload and the capacity to deal with this load. They are more capable of self-management in coping with stress and psychosomatic symptoms. Conclusions are drawn about the prevention by early interventions for patients with a-specific physical symptoms.

[1]  R. Lazarus.  Coping with the stress of illness. , 1992, WHO regional publications. European series.

[2]  Richard S. Lazarus,et al.  EMOTIONS: A COGNITIVE–PHENOMENOLOGICAL ANALYSIS , 1980 .

[3]  J. Vries,et al.  The World Health Organization Quality of Life Assessment Instrument (WHOQOL-100): Validation Study with the Dutch Version , 1997 .

[4]  W. A. Arrindell,et al.  SCL-90. Handleiding bij een multidimensionele psychopathologie-indicator , 2003 .

[5]  J. Barling,et al.  Coping with Chronic Work Stress , 1997 .

[6]  S. Folkman,et al.  The relationship between coping and emotion: implications for theory and research. , 1988, Social science & medicine.

[7]  Bruce Thompson,et al.  If Statistical Significance Tests are Broken/Misused, What Practices Should Supplement or Replace Them? , 1999 .

[8]  R. Kirk.  Practical Significance: A Concept Whose Time Has Come , 1996 .

[9]  M. Foreman.  Reliability and Validity Of Mental Status Questionnaires In Elderly Hospitalized Patients , 1987, Nursing research.

[10]  H. Livneh,et al.  A multidimensional approach to the study of the structure of coping with stress. , 1996, The Journal of psychology.

[11]  H. Kraemer,et al.  How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. , 2001, The American journal of psychiatry.

[12]  B. Thornton,et al.  Development and validation of a physical self-efficacy scale. , 1982 .

[13]  B. Thornton,et al.  Physical self-efficacy and actualization , 1985 .

[14]  C. Spielberger.  Assessment of state and trait anxiety: Conceptual and methodological issues. , 1985 .

[15]  B. Reger,et al.  Evaluation of a Wellness-Based Mindfulness Stress Reduction Intervention: A Controlled Trial , 2001, American journal of health promotion : AJHP.

[16]  P Salmon,et al.  Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. , 2001, Clinical psychology review.

[17]  Peter H. Rossi,et al.  The Multi-Goal, Theory-Driven Approach to Evaluation: A Model Linking Basic and Applied Social Science , 1980 .

[18]  S G Halford,et al.  The art of fitting into our lives. , 2000, AORN journal.

[19]  Goal Attainment Scaling , 2000 .

[20]  M. Watson,et al.  Development of a questionnaire measure of emotional control. , 1983, Journal of psychosomatic research.

[21]  Huey-tsyh Chen.  Theory-driven evaluations , 1990 .

[22]  Daniel H. Robinson,et al.  Further Reflections on Hypothesis Testing and Editorial Policy for Primary Research Journals , 1999 .

[23]  A. Hagihara,et al.  Type A and Type B behaviors, work stressors, and social support at work. , 1997, Preventive medicine.

[24]  S. Baker,et al.  Effects of Stress Inoculation Training on Anxiety, Stress, and Academic Performance among Adolescents. , 1994 .

[25]  J. Teasdale.  Self-efficacy: Toward a unifying theory of behavioural change? , 1978 .

[26]  Edwin Boudreaux,et al.  Aerobic fitness and leisure physical activity as moderators of the stress-illness relation , 1999, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[27]  C. Achilles,et al.  Evaluation: A Systematic Approach , 1980 .

[28]  L. Middel.  Assessment of change in clinical evaluation , 2001 .

[29]  P. Thoits,et al.  Stress, coping, and social support processes: where are we? What next? , 1995, Journal of health and social behavior.

[30]  S. Bruehl,et al.  Relaxation training and opioid inhibition of blood pressure response to stress. , 1996, Journal of consulting and clinical psychology.

[31]  N. Dirubbo,et al.  Full Catastrophe Living , 1992 .

[32]  S. Braver,et al.  The measurement of clinical pain intensity: a comparison of six methods , 1986, Pain.

[33]  P. Hayes,et al.  Sensitivity to Change Following Liver Transplantation , 2000, Journal of health psychology.

[34]  L R Murphy,et al.  Stress Management in Work Settings: A Critical Review of the Health Effects , 1996, American journal of health promotion : AJHP.

[35]  J. Astin,et al.  Stress reduction through mindfulness meditation. Effects on psychological symptomatology, sense of control, and spiritual experiences. , 1997, Psychotherapy and psychosomatics.

[36]  A. Bandura.  Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[37]  C. Weiss.  How Can Theory-Based Evaluation Make Greater Headway? , 1997 .

[38]  M. Seligman,et al.  Learned helplessness in humans: critique and reformulation. , 1978, Journal of abnormal psychology.

[39]  R. Plutchik,et al.  Theories of emotion , 1980 .

[40]  H. M. van der Ploeg,et al.  Rationality, emotional expression and control: psychometric characteristics of a questionnaire for research in psycho-oncology. , 1993, Journal of psychosomatic research.

[41]  M. Manning,et al.  The relationship between stress and health care use: an investigation of the buffering roles of personality, social support and exercise. , 1999, Journal of psychosomatic research.

[42]  J. Duda,et al.  Goal Orientations and Beliefs about the Causes of Sport Success among Elite Skiers , 1992 .

[43]  Jon Kabat-Zinn,et al.  Full Catastrophe Living , 1990 .

[44]  J. Kabat-Zinn,et al.  The clinical use of mindfulness meditation for the self-regulation of chronic pain , 1985, Journal of Behavioral Medicine.

[45]  Myeong Soo Lee,et al.  Stress management by psychosomatic training : effects of ChunDoSunBup Qi-training on symptoms of stress : a cross-sectional study , 2000 .

[46]  S. Saxena,et al.  The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. , 1998, Social science & medicine.

[47]  B H Marcus,et al.  Determinants of physical activity and interventions in adults. , 1992, Medicine and science in sports and exercise.

[48]  Sarah Milne.  Self-efficacy in changing societies , 1999, Journal of health psychology.

[49]  Donald B. Rubin,et al.  The Counternull Value of an Effect Size: A New Statistic , 1994 .

[50]  D. Ahern,et al.  Evaluation of a daily activity diary for chronic pain patients , 1984, Pain.

[51]  James Campbell Quick.  Causes, Coping and Consequences of Stress at Work , 1989 .

[52]  L. Derogatis,et al.  The SCL-90 and the MMPI: A Step in the Validation of a New Self-Report Scale , 1976, British Journal of Psychiatry.

[53]  A. Bandura.  Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[54]  H. Feldman,et al.  The Effects of Relaxation Training On Clinical Symptons: A Meta‐Analysis , 1989, Nursing research.

[55]  P. Emmelkamp,et al.  The effects of a stress-management training program in individuals at risk in the community at large. , 1998, Behaviour research and therapy.

[56]  Martin E. P. Seligman,et al.  The attributional Style Questionnaire , 1982, Cognitive Therapy and Research.

[57]  R. Gonzalez.  Applied Multivariate Statistics for the Social Sciences , 2003 .

[58]  William R. Shadish,et al.  Evaluation studies : review annual , 1976 .

[59]  Robert Weinberg,et al.  Expectations and Performance: An Empirical Test of Bandura's Self-efficacy Theory , 1979 .

[60]  M. Power,et al.  Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment , 1998 .

[61]  Rollin McCraty,et al.  The impact of a new emotional self-management program on stress, emotions, heart rate variability, DHEA and cortisol , 1998, Integrative physiological and behavioral science : the official journal of the Pavlovian Society.

[62]  L. Flynn,et al.  Wellness programs: a review of the evidence. , 1998, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[63]  Bess H. Marcus,et al.  Motivational Readiness, self-efficacy and decision-making for exercise , 1992 .

[64]  K. Glanz,et al.  Health behavior and health education : theory, research, and practice , 1991 .

[65]  L. Pbert,et al.  Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. , 1992, The American journal of psychiatry.

[66]  J. Prochaska,et al.  The transtheoretical model and stages of change. , 1996 .