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Zhang Y, Yang XX, Luo JY, Liang M, Li N, Tao Q, Ma LJ, Li XM. Randomized trial estimating effects of hypnosis versus progressive muscle relaxation on medical students' test anxiety and attentional bias. World J Psychiatry 2022; 12:801-813. [PMID: 35978973 PMCID: PMC9258271 DOI: 10.5498/wjp.v12.i6.801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/26/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance. Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals. AIM To evaluate whether hypnosis and progressive muscle relaxation (PMR) could modify medical college students' test anxiety and attentional bias. METHODS A total of 598 medical students were screened. The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale (TAS). Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group. Another 45 students with low TAS score were included, forming a baseline control group. The intervention was conducted weekly for 6 wk, and each session lasted approximately 30 min. The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal. Data were collected at the pretest, posttest, and 2-mo follow-up. RESULTS Hypnosis group participants had a significantly lower TAS score at posttest (t = -21.827, P < 0.001) and at follow-up (t = -14.824, P < 0.001), compared to that at pretest. PMR group participants also had a significantly lower TAS score at posttest (t = -10.777, P < 0.001) and at follow-up (t = -7.444, P < 0.001), compared to that at pretest. At the posttest level, the hypnosis group had a significantly lower TAS score than the PMR group (t = -3.664, P < 0.001). At the follow-up level, the hypnosis group also had a significantly lower TAS score than the PMR group (t = -2.943, P = 0.004). Clinically significant improvement was found in both the hypnosis and PMR groups (hypnosis = 64.0%; PMR = 62.22%). Hypnosis was more effective than PMR in reducing test anxiety among medical college students. Hypnosis could modify attentional bias toward threatening stimuli, but PMR could not. CONCLUSION These results suggest that attentional bias plays an important role in test anxiety treatment.
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Affiliation(s)
- Yang Zhang
- Affiliated Psychological Hospital, Anhui Medical University, Hefei 230032, Anhui Province, China
- The Fourth People’s Hospital, Hefei 230032, Anhui Province, China
- Anhui Mental Health Center, Hefei 230032, Anhui Province, China
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Xin-Xin Yang
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Jing-Yi Luo
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Meng Liang
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Ni Li
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Qian Tao
- Department of Psychology, School of Basic Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Li-Jun Ma
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
- Department of Psychology, Anqing Normal University, Anqing 246011, Anhui Province, China
| | - Xiao-Ming Li
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
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Tze V, Parker P, Sukovieff A. Control-Value Theory of Achievement Emotions and Its Relevance to School Psychology. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2021. [DOI: 10.1177/08295735211053962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The control-value theory (CVT) of achievement emotions is a well-established theoretical framework which delineates the predictive relationships among distal and proximal antecedents, academic emotions, and student engagement and achievement. Although most research anchored in CVT is conducted by educational psychologists, the theory is arguably applicable to the field of school psychology. In this article, we first provide a brief overview of the theory, with a specific focus on the proximal antecedents (i.e., cognitive appraisals), as well as academic emotions and performance. Given that school psychologists are often consulted with strategies regarding students’ emotional challenges exhibited in the classroom, we then discuss empirical evidence of control- and value-based interventions (e.g., attributional retraining, utility-value), both of which can be posited to address the cognitive appraisals of achievement emotions. Lastly, we discuss the implications of CVT and control- and value-based interventions to school psychologists’ work.
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Feldman O, Goldstien E, Rolnik B, Ganz AB, Lev-Ari S. Inquiry Based Stress Reduction (IBSR) Improves Overall Stuttering Experience among Adults Who Stutter: A Randomized Controlled Trial. J Clin Med 2021; 10:2187. [PMID: 34070161 PMCID: PMC8158472 DOI: 10.3390/jcm10102187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022] Open
Abstract
Stuttering is a speech disorder that can cause disturbances in the timing and flow of speech. In addition to being a communication disorder, stuttering is often accompanied by a reduction in the quality of life and has impacts on social status, mental well-being, self-acceptance, and the chances of integration into the labor market. The Inquiry Based Stress Reduction (IBSR) program, developed in the United States by Byron Katie in 1986, is the clinical application of "The Work" method (Thework.com) and represents an emerging mindfulness and cognitive-reframing method. IBSR has been demonstrated to improve mental health and well-being in adults and may alleviate psychological and psychosocial symptoms of stuttering. The purpose of this trial was to examine the effect of a 12-week IBSR intervention on the overall stuttering experience and indicators of anxiety, psychological flexibility, and well-being among adults who stutter (AWS). This study was a randomized controlled clinical trial. Participants were randomized to IBSR (n = 28) and control (n = 28) groups. Validated questionnaires of overall stuttering experience (OASES-A), anxiety (STAI), psychological flexibility (PFQ), and satisfaction with life (SWLS) were completed before, after, and one month after the intervention. An intention-to-treat approach was implemented for analysis. Our results show that participants in the IBSR intervention group exhibited a greater improvement in their overall stuttering experience as compared to the control group, as well as in general information on stuttering awareness and perception, reactions to stuttering, communication in daily situations, and quality of life. In addition, we found a greater reduction in anxiety levels and an increase in satisfaction-with-life scores in the IBSR group. These results indicate that IBSR can improve the overall stuttering experience.
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Affiliation(s)
- Omrit Feldman
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (O.F.); (E.G.)
| | - Eran Goldstien
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (O.F.); (E.G.)
| | - Benjamin Rolnik
- Department of Genetics, Stanford University, Stanford, CA 94305, USA; (B.R.); (A.B.G.)
| | - Ariel B. Ganz
- Department of Genetics, Stanford University, Stanford, CA 94305, USA; (B.R.); (A.B.G.)
| | - Shahar Lev-Ari
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (O.F.); (E.G.)
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Effect of Inquiry-Based Stress Reduction (IBSR) Intervention on Well-Being, Resilience and Burnout of Teachers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073689. [PMID: 33916258 PMCID: PMC8037267 DOI: 10.3390/ijerph18073689] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 01/07/2023]
Abstract
Objective: The COVID-19 pandemic has had a major impact on teachers professional and personal lives. Our primary aim was to assess the effect of a blended Inquiry-Based Stress Reduction (IBSR), an emerging mindfulness and cognitive reframing intervention on teacher's well-being. Our secondary aims were to assess the effect of IBSR on resilience, burnout, mindfulness, and stress among teachers during the COVID-19 pandemic. Methods: The study was a prospective controlled trial with an intervention group (N = 35) and a comparison control group (N = 32). The intervention took place in the Jerusalem District throughout the school year from November 2019 to May 2020. The sessions were conducted in blended learning that included traditional learning (face-to-face) and online learning. Data was analyzed on an intention-to-treat basis. Results: IBSR blended intervention enhanced the resilience and improved the subjective and psychological well-being of teachers in spite of the breakout of the COVID-19 pandemic and the first lockdown in Israel. Simultaneously the control group suffered from enhanced burnout levels and a decline in psychological and subjective well-being. Conclusions: Implementation of IBSR blended intervention during the school year may benefit teachers' well-being and ability to flourish, even during stressful events such as the COVID-19 pandemic.
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Hook JN, Kim Penberthy J, Davis DE, Van Tongeren DR. Inquiry-based stress reduction: A systematic review of the empirical literature. J Clin Psychol 2021; 77:1280-1295. [PMID: 33538339 DOI: 10.1002/jclp.23120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/11/2020] [Accepted: 01/20/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This paper reviewed the empirical research on inquiry-based stress reduction (IBSR; also called "The Work"), which has similarities to third-wave cognitive behavioral approaches such as Acceptance and Commitment Therapy (ACT). Widely used as a self-help intervention, IBSR has only recently been subjected to empirical research. METHOD We reviewed empirical studies (published and unpublished) that examined IBSR. RESULTS We found 17 empirical studies (15 independent samples) that examined IBSR. Several studies reported positive changes on variables such as stress, anxiety, and well-being. However, only three studies evaluated IBSR using randomized clinical trials (RCTs). Concerns related to treatment feasibility and cost-effectiveness of IBSR are noted. CONCLUSIONS There are some promising initial findings on IBSR. However, additional research employing high-quality research designs is necessary to explore the efficacy and effectiveness of IBSR in various contexts.
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Affiliation(s)
- Joshua N Hook
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Jennifer Kim Penberthy
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Don E Davis
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia, USA
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The Effect of Inquiry-Based Stress Reduction on Teacher Burnout: A Controlled Trial. Brain Sci 2020; 10:brainsci10070468. [PMID: 32708055 PMCID: PMC7407507 DOI: 10.3390/brainsci10070468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 12/03/2022] Open
Abstract
Burnout is a well-known phenomenon with significant social, biological and economic costs. In particular, teacher burnout is associated with unfavorable mental health outcomes and economic costs due to reduced hours and teacher turnover. This study investigated the effect of an Inquiry-Based Stress Reduction (IBSR) cognitive-reframing program on teacher burnout using a quasi-experimental design. Fifty-three teachers participated in a prospective intervention with a passive control group. The intervention group completed a 12-week IBSR program with 4.5 h of weekly engagement. Relative to control, teachers in the intervention group showed greater improvements in emotional exhaustion (18.8 ± 5.2 to 15.9 ± 5.7 vs. 16.0 ± 4.8 to 17.4 ± 4.8; p = 0.01) and personal accomplishment (21.8 ± 5.0 to 24.6 ± 4.3 vs. 21.9 ± 4.5 to 22.8 ± 4.3; p = 0.04). Significant correlations were found between change in emotional exhaustion and negative affect (positive correlation; r = 0.32; p = 0.034) and between personal accomplishment and perceived stress (negative correlation; r = −0.451; p = 0.002). This study demonstrates the potential of IBSR to improve teacher well-being. Future randomized studies are needed to evaluate the causality of IBSR in reducing burnout among teachers and other high-stress workplaces.
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Krispenz A, Gort C, Schültke L, Dickhäuser O. How to Reduce Test Anxiety and Academic Procrastination Through Inquiry of Cognitive Appraisals: A Pilot Study Investigating the Role of Academic Self-Efficacy. Front Psychol 2019; 10:1917. [PMID: 31481918 PMCID: PMC6710437 DOI: 10.3389/fpsyg.2019.01917] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Test anxiety can impair learning motivation and lead to procrastination. Control-value theory of achievement emotions (Pekrun, 2006) assumes test anxiety to be a result of students' appraisals of the testing situation and its outcomes. Modification of cognitive appraisals such as low self-efficacy beliefs is thus assumed to reduce test anxiety and subsequent procrastination. In the present study, we tested the effects of an inquiry-based stress reduction (IBSR) intervention on students' academic self-efficacy, their test anxiety, and subsequent procrastination in the final stages of an academic term. Design Longitudinal quasi-randomized intervention control trial. Methods University students identified worry thoughts regarding a specific and frightening testing situation. Intervention participants (n = 40) explored their worry thoughts with the IBSR method. Participants of an active waitlist control group (n = 31) received the intervention after the study was completed. Dependent variables were assessed before and after the intervention as well as at the end of the term. Results Data-analyses revealed that the IBSR intervention reduced test anxiety as well as subsequent academic procrastination in comparison to the control group. The effect on test anxiety was partly due to an enhancement of self-efficacy. Conclusion Our findings provide preliminary evidence that IBSR might help individuals to cope with their test anxiety and procrastination.
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Affiliation(s)
- Ann Krispenz
- Department of Psychology, University of Mannheim, Mannheim, Germany
| | - Cassandra Gort
- Department of Psychology, University of Mannheim, Mannheim, Germany
| | - Leonie Schültke
- Department of Psychology, University of Mannheim, Mannheim, Germany
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The dark side of perceived positive regard: When parents’ well-intended motivation strategies increase students’ test anxiety. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2019. [DOI: 10.1016/j.cedpsych.2018.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Krispenz A, Dickhäuser O. Reduction of Chronic Stress and Trait Anxiety by Inquiry of Cognitive Appraisals with the Inquiry-Based Stress Reduction (IBSR) Method. OPEN PSYCHOLOGY 2019. [DOI: 10.1515/psych-2018-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractBackground: Chronic stress and anxiety can impair individuals’ health. Appraisal theories assume that stress and anxiety are experienced if individuals appraise a situation as threatening for their well-being. Thus, the modification of cognitive appraisals can be expected to reduce stress and anxiety. A potentially effective method to modify individuals’ appraisals is inquiry-based stress reduction (IBSR; Mitchell & Mitchell, 2003).Aims: The present study assesses the effects of IBSR on chronic stress and trait anxiety in comparison to a matched control group.Method: We used a quasi-experimental repeated-measurement design and a non-clinical sample of N = 199. Participants’ chronic stress and anxiety levels were assessed before and three months after a nine-day IBSR training. To account for the consequences of missing randomization, propensity score matching was applied.Results: As expected, data analyses revealed that in the IBSR training group chronic stress and trait anxiety statistically significantly decreased over the course of three months whereas in the matched control group, the levels of chronic stress and trait anxiety did not statistically significantly change.Conclusions: IBSR seems to effectively reduce trait anxiety and chronic stress in a non-clinical sample.
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