Psychological and Physiological Response of Students to Different Types of Stress Management Programs

Purpose. To design, implement, and examine the psychoneuroendocrine responses of three different types of stress management programs. Design. Randomly assigned. A pre/post experimental design comparing variables between three different programs and a control group. The first program included training in deep breathing, relaxation response, meditation, and guided imagery techniques (RRGI). The second program included training in cognitive behavioral techniques (CB). The third program included both RRGI and CB (RRGICB). Setting. The study was conducted at Buenos Aires University. Subjects. Participants (N = 52) were undergraduate students. Measures. Anxiety, anger, hopelessness, neuroticism, respiration rate, and salivary cortisol levels were assessed. Analysis. Wilcoxon signed rank test was used to investigate differences in pre and post variables. Results. Subjects in the RRGI group showed significantly lower levels of anxiety (p < .011), anger (p < .012), neuroticism (p < .01), respiratory rate (p < .002), hopelessness (p < .01), and salivary cortisol (p < .002) after the treatment. Subjects in the CB group showed significantly lower levels of anxiety (p < .018), anger (p < .037), and neuroticism (p < .03) after the treatment. Subjects in the RRGICB group showed significantly lower levels of anxiety (p < .001), anger (p < .001), neuroticism (p < .008), hopelessness (p < .01), respiratory rate (p < .001), and salivary cortisol (p < .002) after the treatment. Subjects in the control group showed only one variable modification, a significant increase in cortisol levels (p < .004). Conclusions. The combination of deep breathing, relaxation response, meditation, and guided imagery techniques with CB seems to be effective at helping people to deal with stress.

[1]  A. Stone,et al.  Development of common cold symptoms following experimental rhinovirus infection is related to prior stressful life events. , 1992, Behavioral medicine.

[2]  Z. Segal,et al.  Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. , 2000, Journal of consulting and clinical psychology.

[3]  T. Barnhofer,et al.  Cognitive reactivity mediates the relationship between neuroticism and depression , 2010, Behaviour research and therapy.

[4]  E. Adam,et al.  Day-to-day dynamics of experience–cortisol associations in a population-based sample of older adults , 2006, Proceedings of the National Academy of Sciences.

[5]  S. Scuri,et al.  Diaphragmatic Breathing Reduces Exercise-Induced Oxidative Stress , 2011, Evidence-based complementary and alternative medicine : eCAM.

[6]  G. Elkins,et al.  Mind–Body Therapies in Integrative Oncology , 2010, Current treatment options in oncology.

[7]  A. Noone,et al.  Stress Biomarkers in Medical Students Participating in a Mind Body Medicine Skills Program , 2011, Evidence-based complementary and alternative medicine : eCAM.

[8]  Wayne Katon,et al.  Anxiety disorders and comorbid medical illness. , 2008, General hospital psychiatry.

[9]  Nakia S. Gordon,et al.  The effects of brief mindfulness meditation training on experimentally induced pain. , 2010, The journal of pain : official journal of the American Pain Society.

[10]  I. Wilhelm,et al.  Is the cortisol awakening rise a response to awakening? , 2007, Psychoneuroendocrinology.

[11]  Sebastián Eduardo Piemontesi,et al.  Relaciones entre la ansiedad frente a los exámenes, estrategias de afrontamiento, autoeficacia para el aprendizaje autorregulado y rendimiento académico , 2011 .

[12]  M. Posner,et al.  Short-term meditation training improves attention and self-regulation , 2007, Proceedings of the National Academy of Sciences.

[13]  Noriah Mohd Ishak,et al.  Improving Mental Health and Academic Performance through Multiple Stress Management Intervention: Implication For Diverse Learners , 2010 .

[14]  F. Zitman,et al.  Salivary Cortisol Levels in Persons With and Without Different Anxiety Disorders , 2010, Psychosomatic medicine.

[15]  C. Reynolds,et al.  Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder , 2008, Psychoneuroendocrinology.

[16]  A. Childress,et al.  The basics of cognitive therapy. , 1981, Psychosomatics.

[17]  Katherine M. Richardson,et al.  Effects of occupational stress management intervention programs: a meta-analysis. , 2008, Journal of occupational health psychology.

[18]  P. P. Heppner,et al.  Use of different sources of stress to predict hopelessness and suicide ideation in a college population. , 1992 .

[19]  H. Bogner,et al.  Resident physician burnout: is there hope? , 2008, Family medicine.

[20]  D. Meichenbaum.  Stress inoculation training , 1985 .

[21]  G. D. Jacobs,et al.  Topographic EEG mapping of the relaxation response , 1996, Biofeedback and self-regulation.

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

[23]  Muhamad Saiful,et al.  Effects Of A Brief Stress Reduction Intervention On Medical Students’ Depression, Anxiety And Stress Level During Stressful Period. , 2011 .

[24]  Wolff Schlotz,et al.  Perceived Work Overload and Chronic Worrying Predict Weekend–Weekday Differences in the Cortisol Awakening Response , 2004, Psychosomatic medicine.

[25]  G. Fricchione,et al.  The relaxation response: reducing stress and improving cognition in healthy aging adults. , 2006, Complementary therapies in clinical practice.

[26]  Mario Beauregard,et al.  Quantum physics in neuroscience and psychology: a neurophysical model of mind–brain interaction , 2004, Philosophical Transactions of the Royal Society B: Biological Sciences.

[27]  Naomi I. Eisenberger,et al.  Anger and fear responses to stress have different biological profiles , 2010, Brain, Behavior, and Immunity.

[28]  Nancy L Pedersen,et al.  Personality and major depression: a Swedish longitudinal, population-based twin study. , 2006, Archives of general psychiatry.

[29]  M Frankenhaeuser,et al.  Pituitary-adrenal and sympathetic-adrenal correlates of distress and effort. , 1980, Journal of psychosomatic research.

[30]  L. Alloy,et al.  Stress generation in depression: A systematic review of the empirical literature and recommendations for future study. , 2010, Clinical psychology review.

[31]  H. Houshyar,et al.  From Malthus to motive: How the HPA axis engineers the phenotype, yoking needs to wants , 2006, Progress in Neurobiology.

[32]  L. R. Goldberg.  The structure of phenotypic personality traits. , 1993, The American psychologist.

[33]  F. Patacchioli,et al.  Anti‐stress effect of yoga‐type breathing: modification of salivary cortisol, heart rate and blood pressure following a step‐climbing exercise , 2002 .

[34]  Andrew Steptoe,et al.  Differences in cortisol awakening response on work days and weekends in women and men from the Whitehall II cohort , 2004, Psychoneuroendocrinology.

[35]  B. Lahey,et al.  Public health significance of neuroticism. , 2009, The American psychologist.

[36]  Sari A Acra,et al.  Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial , 2006, BMC pediatrics.

[37]  Dirk H. Hellhammer,et al.  The cortisol awakening response - normal values and confounds. , 2000, Noise & health.

[38]  E. Isometsä,et al.  The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population , 2006, Depression and anxiety.

[39]  É. Labbé,et al.  Psychosocial Factors and Prediction of Headaches in College Adults , 1997, Headache.

[40]  Stefan Wüst,et al.  Human models in acute and chronic stress: Assessing determinants of individual hypothalamus–pituitary–adrenal axis activity and reactivity , 2010, Stress.

[41]  T. Skinner,et al.  A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. , 2007, Journal of psychosomatic research.

[42]  C. Kirschbaum,et al.  Salivary cortisol in psychobiological research: an overview. , 1989, Neuropsychobiology.

[43]  C. Smart,et al.  Mindfulness-based cognitive therapy for generalized anxiety disorder. , 2008, Journal of anxiety disorders.

[44]  C. Spielberger,et al.  Manual for the State-Trait Anxiety Inventory , 1970 .

[45]  S. Guinjoan,et al.  Burnout, Perceived Stress, and Depression Among Cardiology Residents in Argentina , 2009, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry.

[46]  U. Ehlert,et al.  Randomized controlled evaluation of the effects of cognitive–behavioral stress management on cortisol responses to acute stress in healthy subjects , 2003, Psychoneuroendocrinology.

[47]  B. Kudielka,et al.  Salivary cortisol as a biomarker in stress research , 2009, Psychoneuroendocrinology.

[48]  Charles D. Spielberger,et al.  Assessment of Emotions: Anxiety, Anger, Depression, and Curiosity , 2009 .

[49]  Sebastián Eduardo Piemontesi,et al.  Estrategias de aprendizaje y ansiedad ante los exámenes en estudiantes universitarios , 2009 .

[50]  P. Niemi,et al.  Medical students’ distress – quality, continuity and gender differences during a six-year medical programme , 2006, Medical teacher.

[51]  C. Segrin.  Social Skills, Stressful Life Events, and the Development of Psychosocial Problems , 1999 .

[52]  Rachel Leproult,et al.  Alterations of Circadian Rhythmicity and Sleep in Aging: Endocrine Consequences , 1998, Hormone Research in Paediatrics.

[53]  B. Kudielka,et al.  Circadian cortisol profiles and psychological self-reports in shift workers with and without recent change in the shift rotation system , 2007, Biological Psychology.

[54]  F. Smit,et al.  Predictors of first incidence of DSM‐III‐R psychiatric disorders in the general population: findings from the Netherlands Mental Health Survey and Incidence Study , 2002, Acta psychiatrica Scandinavica.

[55]  J. Dusek,et al.  The Evaluation of a Mind/Body Intervention to Reduce Psychological Distress and Perceived Stress in College Students , 2002, Journal of American college health : J of ACH.

[56]  F. Hucklebridge,et al.  Exploration of the awakening cortisol response in relation to diurnal cortisol secretory activity. , 2001, Life sciences.

[57]  D. Shapiro,et al.  Stress Management in Medical Education: A Review of the Literature , 2000, Academic medicine : journal of the Association of American Medical Colleges.

[58]  A. Ellis.  Reason and emotion in psychotherapy , 1962 .

[59]  M. Desimone,et al.  A study on the effectiveness of a stress management programme for College students , 2005 .

[60]  R. Friedberg,et al.  Cognitive Developmental Therapy With Children , 1997, Journal of Cognitive Psychotherapy.

[61]  F. Shanahan,et al.  The stress response and the hypothalamic-pituitary-adrenal axis: from molecule to melancholia. , 2000, QJM : monthly journal of the Association of Physicians.

[62]  B. Kudielka,et al.  Salivary cortisol sampling compliance: comparison of patients and healthy volunteers , 2004, Psychoneuroendocrinology.

[63]  A. Perski,et al.  The morning salivary cortisol response in burnout. , 2004, Journal of psychosomatic research.

[64]  C. Kirschbaum,et al.  Increased free cortisol secretion after awakening in chronically stressed individuals due to work overload , 1998 .

[65]  S. Weisman,et al.  Complementary therapies for acute pediatric pain management. , 2000, Pediatric clinics of North America.

[66]  Dejian Mind-Body Intervention Improves the Cognitive Functions of a Child with Autism , 2011, Evidence-based complementary and alternative medicine : eCAM.

[67]  T. Theorell,et al.  The demand control model and circadian saliva cortisol variations in a Swedish population based sample (The PART study) , 2006, BMC public health.

[68]  J. Born,et al.  Nocturnal adrenocorticotropin and cortisol secretion depends on sleep duration and decreases in association with spontaneous awakening in the morning. , 1992, The Journal of clinical endocrinology and metabolism.