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Forest ecosystems have been acknowledged as a viable intervention for mitigating mental stress. However, there is a scarcity of research investigating the impact of forest environments on sleep. This study primarily investigated the physiological and psychological effects of sleep in a forest environment. It included a sample of 50 Chinese young adult students. A comparative analysis was conducted to examine the impact of sleeping in a forest environment as opposed to a controlled room setting (control). The researchers collected data on blood pressure, electroencephalography (EEG), and psychological markers. There was a statistically significant decrease in systolic blood pressure after the participants slept in a forest environment compared to when they slept in a room (control). Moreover, a notable increase in alpha- and beta-wave frequencies was detected in the forest environment. A more pronounced reduction in anxiety scores was observed in those exposed to a forest environment compared to those in the control group. The physiological and psychological data presented in this study demonstrate that engaging in forest leisure positively affects both physical and mental relaxation in young adults., Competing Interests: Declaration of Competing Interests The authors assert that they possess no conflicting interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Worry increases risk for long-term health issues by prolonging the physiological stress response. In contrast, relaxation may ameliorate the psychological and physiological burden resulting from worry. This study examined the impact of experimentally induced worry and relaxation on cortisol, heart rate variability (HRV), and inflammation., Method: Participants (N = 80) completed both a worry and relaxation induction (presented in a fixed order) while HRV was collected continuously. Three blood samples were taken (at baseline, after the worry induction, and after the relaxation induction) to measure IL-6, IFN-γ, TNF-α and serum cortisol., Results: There were significant changes in IL-6 (p < 0.001), IFN-γ (p < 0.01), HRV (p < .001), and cortisol (p <  .001) but not in TNF-α (p = 0.65) across conditions. HRV decreased significantly from baseline to worry and then increased following relaxation. IL-6 was higher during relaxation compared to worry and baseline. Cortisol decreased significantly across conditions. Several patterns of covariance between inflammation and HRV and/or cortisol also emerged., Conclusions: These findings offer novel insight into how worry influences the immune system and emphasize the utility of a multi-methods approach to understanding the impact of worry on physical health., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

High stress and anxiety in healthy individuals may lead to use different pharmacological and non-pharmacological therapies. The study aimed to investigate the effect of different genres of music on anxiety and relaxation in healthy participants. This study was a randomized controlled trial with a cross-over design. Forty-six healthy undergraduates participated in the study and randomly received different genres of music (Pop, Rock, Western Classical, and Persian Traditional) and silence for five consecutive days between February and June 2018. Each participant was her/his own control. Relaxation and the State Anxiety were checked with Smith Relaxation States Inventory 3 and The State Anxiety Inventory before and after listening to 15 min of music or laying down in silence. None of the five procedures were preferred for a more relaxing effect (P > 0.05). Also, none of the interventions were preferred for reduction of the state anxiety (P > 0.05). Although different genres of music, i.e., Pop, Rock, Western Classical, Persian Traditional, could reduce state anxiety and improve relaxation, they had no extra effect compared to Silence., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The Contrast Avoidance Model postulates that individuals with generalized anxiety disorder (GAD) fear a sharp spike in negative emotion, and thus, prefer to worry to maintain their negative affect rather than being in a more euthymic state, such as relaxation. Relaxation induced anxiety (RIA) is a paradoxical phenomenon wherein people experience a spike in their anxiety during relaxation training. Because these phenomena may be related and may also operate among individuals with major depressive disorder (MDD), we attempted to test whether negative contrast sensitivity was a mediator of GAD or MDD in the prediction of RIA., Methods: Individuals with GAD (n = 32), MDD (n = 34), and healthy controls (n = 30) were exposed to a negative emotional contrast by engaging with relaxation practice and then watching a negative emotional video. This was followed by the assessment of their negative contrast sensitivity. After this, participants engaged again with relaxation and RIA was measured. We examined mediation effects of negative contrast on the relationship between diagnostic status and RIA., Results: Negative contrast sensitivity fully mediated GAD and partially mediated MDD in predicting RIA., Conclusions: Our findings support the hypotheses that negative contrast sensitivity is the mediator of both GAD and MDD in predicting RIA. This may have implications for assessment and treatment of GAD and MDD., (Copyright © 2019. Published by Elsevier B.V.)

Background: Observing plants can induce neurophysiological responses that can alleviate stress and reduce anxiety. However, few studies have examined such effects in older adults., Methods: The physiological and psychological effects of observing nature (visual observation of a money plant) on 50 older Chinese women (age range: 58-90 years, SD: 8.5 years) were investigated. The participants observed a healthy money plant in a planter for 5 min; the lack of presence of a plant was used as a control. Physiological measurements were assessed using electroencephalography, and the STAI was used as a psychological assessment., Results: After a 5-min observation of a money plant as compared with the control condition, systolic blood pressure significantly decreased, variations in both high alpha and high beta brainwaves were found, and psychological measurements revealed lower anxiety scores., Conclusions: Our findings indicate that viewing a money plant for 5 min may enhance both psychological and physiological relaxation in older adults., (© 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.)

Background: Nonpharmacological interventions appear to benefit many patients and do not have the side effects commonly associated with medications. Music-based experiences may benefit critical care patients., Objective: To examine the effect of an active music therapy intervention on physiological parameters and self-reported pain and anxiety levels of patients in the intensive care unit., Methods: A study was conducted using a pretest-posttest, within-subject, single-group design. The study population consisted of a convenience sample of 52 patients. Study participants received a 30-minute music therapy session consisting of either a relaxation intervention or a "song choice" intervention. The music therapist recorded the patients' vital signs before and after the intervention, and patients completed self-assessments of their pain and anxiety levels before and after the intervention., Results: After the intervention, significant decreases (all P < .001) were found in respiratory rate (mean difference, 3.7 [95% CI, 2.6-4.7] breaths per minute), heart rate (5.9 [4.0-7.8] beats per minute), and self-reported pain (1.2 [0.8-1.6] points) and anxiety levels (2.7 [2.2-3.3] points). No significant change in oxygen saturation level was observed. Outcomes differed between the 2 intervention groups: patients receiving the relaxation intervention often fell asleep., Conclusions: The results of this study support active music therapy as a nonpharmacological intervention in intensive care units. This study may lay the groundwork for future research on music therapy in critical care units using larger, more diverse samples., (©2019 American Association of Critical-Care Nurses.)

Worry is associated with inflexibility in cognitive, emotional, and physiological functioning. In addition, worry's negative valence and abstract level of construal are rigid characteristics that contribute to its nonadaptive consequences. Relaxation and cognitive therapy aim to increase flexibility in chronic worriers, and may have greater efficacy when administered in combination. We examined the extent to which relaxation enhances and/or worry inhibits cognitive flexibility during a cognitive restructuring exercise in which participants generated alternative predictions for their worries. Participants ( n = 189) were randomly assigned to engage in relaxation, worry, or neutral thinking prior to cognitive restructuring. We measured the number and perceived likelihood of alternative predictions generated by participants, and coded those alternative predictions for their degree of positive valence, negative valence, and level of construal (abstractness to concreteness). Worry and relaxation did not lead to different numbers or perceived likelihood of alternative predictions. However, compared with participants with minimal symptoms of generalized anxiety disorder (GAD), those with elevated symptoms of GAD who engaged in prior worry generated alternative predictions characterized by greater negative valence and more abstractness (i.e., less concreteness). We also found that greater negative valence of alternative predictions was associated with more abstractness, whereas greater positive valence of alternative predictions was associated with more concreteness. These findings suggest that after engaging in worry, individuals with GAD may be less able to flexibly shift from the use of nonadaptive characteristics (negative valence, abstractness) associated with feared outcomes to the use of more adaptive characteristics (positive valence, concreteness) when considering alternative predictions.

Background: Worry is a key component of anxiety and may be an effective target for therapeutic intervention. We compared two psychological processes (attention and acceptance) on the frequency of intrusive worrying thoughts in an experimental worry task., Method: 77 participants were randomised across three groups and completed either a 10 min attention or acceptance-based psychological exercise, or progressive muscle relaxation control. We subsequently measured anxiety, and the content and frequency of intrusive thoughts before and after a 'worry induction task'., Results: Groups did not differ in baseline worry, anxiety or thought intrusions. Both attention and acceptance-based groups experienced fewer negative thought intrusions (post-worry) compared to the relaxation control group. The acceptance exercise had the largest effect, preventing 'worry induction'. Increases in negative intrusive thoughts predicted subjective anxiety., Discussion: We provide evidence that acceptance and attention psychological exercises may reduce anxiety by reducing the negative thought intrusions that characterise worry., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This paper studies the effect of stress/anxiety states on EEG signals during video sessions. The levels of arousal and valence that are induced to each subject while watching each video are self rated. These levels are mapped in stress and relaxed states and subjects that fufill criteria of adequate anxiety/stress scale were chosen leading to a subset of 18 subjects. Then, temporal, spectral and non linear EEG features are evaluated for being able to represent accurately states under investigation. Feature selection schemes choose the most significant of them in order to provide increased discrimination ability between relaxed and anxiety/stress states.

The Contrast Avoidance model (Newman & Llera, 2011) proposes that individuals with generalized anxiety disorder (GAD) are hypersensitive to sharp upward shifts in negative emotion that typically accompany negative events, and use worry to maintain sustained intrapersonal negativity in an attempt to avoid these shifts. Although research shows that worry increases negative emotionality and mutes further emotional reactivity to a stressor when compared to the worry period (e.g., Llera & Newman, 2010), no study has tracked changes in negative emotionality from baseline to worry inductions followed by a range of emotional exposures. Further, no study has yet assessed participants' subjective appraisals of prior worry on helping to cope with such exposures. The present study tested the main tenets of the Contrast Avoidance model by randomly assigning participants with GAD (n=48) and nonanxious controls (n=47) to experience worry, relaxation, and neutral inductions prior to sequential exposure to fearful, sad, and humorous film clips. Both physiological (nonspecific skin conductance responses [NS-SCRs]) and self-reported emotional changes were observed. Results indicated that worry boosted negative emotionality from baseline, which was sustained across negative exposures, whereas low negative emotionality during relaxation and neutral inductions allowed for sharp increases in response to exposures. Furthermore, GAD participants found worry to be more helpful than other conditions in coping with exposures, whereas control participants reported the opposite pattern. Results provide preliminary support for the Contrast Avoidance model. This suggests that treatment should focus on underlying avoidance patterns before attempting to reduce worry behavior., (Copyright © 2014. Published by Elsevier Ltd.)

Nurses at a Belfast hospital have eased the anxiety of cardiac patients attending for day procedures by introducing reclining chairs and a relaxing waiting area. A nurse-led care pathway has also removed delays in care and provided consistency from admission to discharge.

Objective: To explore gender differences in physical and mental relaxation in subjects who watched a forest relaxation video., Methods: The subjects were 12 males and 12 females in their 20's, with an average age of 21.67 ± 1.00 and 21.42 ± 1.56, respectively. They rested for 5 minutes, and then watched either a forest relaxation video or control video (grey screen, no sound). After the video session, they rested again for 5 minutes. Thus, the total experimental duration was 20 minutes. Before and after the video session, subjects completed visual analog scales (VAS) on mood and Profile of Mood States (POMS) questionnaires. Subjects also pointed out the most comfortable scenes on the video. In addition, we measured their heart rates. Analyses were based on the semantic differential (SD) technique., Results: The heart rate of male subjects decreased just after watching the relaxation video (p<0.05-0.01), and the LnHF increased (p<0.05-0.01), indicating significant activation of the parasympathetic nervous system. Regarding VAS scales, the "refreshment" score increased in male subjects (p<0.01). In females, all three scores for "pleasantness", "calmness", and "refreshment" increased after watching the relaxation video (p<0.05-0.001). In addition, the "tension-anxiety" score of the POMS decreased after watching the video (p<0.05)., Conclusions: Both male and female subjects felt relaxed after the forest relaxation video. Especially, heart rate changes suggested that male subjects experienced relaxation after the video, whereas female subjects experienced mental relaxation.

This paper is a review of studies published during the last several years on exercise effects on overweight, growth, chronic illnesses, depression and anxiety in children and adolescents. Although the lion's share of the research involves aerobic exercise, studies on yoga and tai chi are also reviewed. Following exercise, body mass index and lipid profiles have improved in overweight children, and those with asthma, diabetes and depression have also benefited from exercise. The yoga studies reviewed here focused on ADHD and anxiety, and the tai chi studies involved children with ADHD and asthma. A potential underlying mechanism for the positive effects of exercise, yoga and tai chi may be the stimulation of pressure receptors leading to increased vagal activity, decreased stress hormones and increased production of anti-pain and antidepressant neurotransmitters such as serotonin. Further studies are needed using convergent behavioral, physiological and biochemical measures. Nonetheless, the current literature highlights the importance of adding exercise programs to clinics, schools and families for the physical and psychological well-being of children and adolescents., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The purpose of this investigation was to determine the characteristics of relaxing music for anxiety control. Undergraduate students (N=84) were instructed to imagine themselves in an anxiety producing situation while listening to a selection of 30 music compositions. For each composition, level of relaxation, the factors that either enhanced or detracted from its relaxing potential and the emotional labels attached were assessed. Participants were also asked to state which music components (e.g., tempo, melody) were most conducive to relaxation. Additional information was obtained through the use of a focus group of 6 undergraduate music students. This paper presents details on the characteristics of relaxing-music for anxiety control and emotional labels attached to the relaxing compositions. Furthermore, an importance value has been attached to each of the music components under scrutiny, thus providing an indication of which music components should receive greatest attention when selecting music for anxiety control.

Many studies have shown the ability of media--television, movies, and virtual reality (VR) experiences--to elicit emotions. Nevertheless, it is still unclear how the different factors involved--user related and medium related--play a role in producing an emotional response during a VR experience. We investigate this issue, analyzing the role played by the cultural and technological backgrounds of the users in the emotional responses to VR. Specifically, we use the "core affect" model of emotions developed by Russell (2003) to explore how these factors influence the way in which participants experience virtual worlds. Our sample includes 20 Mexican participants: 8 living in El Tepeyac, a small rural and isolated Mexican village characterized by a very primitive culture, and 12 high civilized inhabitants of Mexico City. The "Green Valley," a noninteractive, relaxing immersive environment showing a mountain landscape around a calm lake, was used to induce relaxation in the two groups during an ambulatory surgical operation. To investigate the effects of VR on the relaxation process, we measured participants' physiological (heart rate) and emotional (VAS-A) responses before, during, and after the operation. The results show that VR significantly modified the core affect (reduced arousal) in all participants but that the final emotional response produced by this change was influenced by the attribution process: the civilized inhabitants of Mexico City, who were able to attribute the reduced arousal to the VR experience, reported a significant reduction in the self-reported level of anxiety, while people from El Tepeyac showed a reduction in their physiological reactions but not in their perceived anxiety.

This study investigated heart rate variability (HRV) in healthy volunteers that were selected for extreme scores of trait anxiety (TA), during two opposite psychophysiological conditions of mental stress, and relaxation induced by autogenic training. R-R intervals, HF and LF powers, and LF/HF ratios were derived from short-term electrocardiographic recordings made during mental stress and relaxation by autogenic training, with respiratory rate and skin conductance being controlled for in all the analyses. The main finding was that high TA was associated with reduced R-R intervals and HF power across conditions. In comparison to mental stress, autogenic training increased HRV and facilitated the vagal control of the heart. There were no significant effects of TA or the psychophysiological conditions on LF power, or LF/HF ratio. These results support the view that TA, which is an important risk factor for anxiety disorders and predictor of cardiovascular morbidity and mortality, is associated with autonomic dysfunction that seems likely to play a pathogenetic role in the long term.

This controlled study compared immediate effects of two relaxation techniques on state anxiety and sustained attention in healthy subjects. 86 volunteers (56 men and 30 women) were divided into two groups: the first 43 volunteers (age range 18 to 64) practiced 20 minutes of yoga-based Deep Relaxation Technique (DRT), while the second group of 43 volunteers (same age range), practiced 20 minutes Supine Rest (SR). State anxiety was assessed using the State Trait Anxiety Inventory (STAI A-State), and sustained attention was assessed using the Six Letter Cancellation (SLC) and Digit Letter Substitution (DLS) tests. All tests were administered immediately before, and immediately after, practice. A significant reduction in State Anxiety score (P < 0.001) was observed for the group practicing DRT, but not for the group practicing SR. For the sustained attention tests, however, there were significant increases in scores by both DRT and SR groups (P < 0.001). The results suggest that both interventions improve attention, but that only DRT reduces State Anxiety.

This study examined the relationship between basic psychological skills usage (i.e., goal-setting, imagery, self-talk, and relaxation) and the intensity and directional dimensions of competitive anxiety. Semistructured interviews were used on a sample of 15 elite athletes (M age = 24.3 years, SD = 4.2) from a variety of team and individual sports. Findings revealed that the participants maintained the intensity of their anxiety response prior to competition and could deploy goal-setting, imagery, or self-talk to enable facilitative interpretations of anxiety-related symptoms to performance. Higher levels of self-confidence and an optimistic outlook toward forthcoming competition were also expressed. The underlying mechanisms perceived to be responsible for these effects included effort and motivation, attentional focus, and perceived control over the anxiety response.

Aim: This paper is a report of a study to determine the effectiveness of jaw and total body relaxation for postoperative pain, anxiety and level of relaxation, and to determine any patient expectancy effects., Background: Relaxation is increasingly suggested as a pain control technique that can be used by nurses in daily practice. A systematic review of the effectiveness of relaxation for postoperative pain relief revealed many poorly designed studies and only some weak evidence supporting the use of relaxation for postoperative pain., Method: A randomized controlled trial (n = 118) was conducted between 2002 and 2003 to compare total body relaxation, jaw relaxation, attention control and usual care. Consenting patients admitted for elective orthopaedic surgery aged 18 or over, able to speak English and able to tense and relax more than two muscle groups were included. Pain at rest and on movement, anxiety and relaxation were assessed at pre-admission clinic, pre-intervention, immediately post-intervention and 1, 2, 3 and 4 hours later. However, the trial was under-powered., Findings: There were statistically significant reductions in pain at rest from pre- to post-intervention for both the relaxation groups and the attention control group. The usual care group had a small increase in pain, whilst the other three groups had similar small decreases in pain. There was no statistically significant difference in anxiety or relaxation scores pre- to post-intervention between groups., Conclusion: Jaw relaxation could give these orthopaedic patients a small, very short-lasting additional amount of pain relief, and it may be that staff and patients feel this small benefit to be worthwhile.

Music therapy is a method which takes the adventage of therapeutic influence of musie on psychological and somatic sphere of the human body. Its therapeutic properties are more and more used. Current scientific research have proved its modifying influence on vegetative, circulatory, respiratory and endocrine systems. Works devoted to the effects of musie on the patients' psychological sphere have also confirmed that it reduces psychopathologic symptoms (anxiety and depression), improves self-rating, influences quality and disorders of sleep, reduces pain, improves moral immunity and patients' openness, readiness, co-operation in treatment process. Music therapy is treated as a method which complements conventional treatment and makes up part of an integral whole together with physiotherapy, kinesitherapy and recuperation.

The purpose of this study was to investigate the differences of experimentally induced anxiety levels reached by subjects listening to no music (n = 30), subjects listening to music selected by the experimenter from the subject's preferred genre or artist listed as relaxing (n = 30), and subjects listening to a specific song they listed as relaxing (n = 30). Subjects consisted of 90 individuals, male and female, randomly assigned to one of the three groups mentioned above. Subjects in either music group filled out a questionnaire prior to participating in the study indicating their preference of music used for relaxation purposes. Subjects in Experimental Group 1 marked their preferred genres and/or artists, and Experimental Group 2 marked specific songs used for relaxation purposes. While the experimenter hypothesized subjects in Experimental Group 2 would show less anxiety than both the control group and Experimental Group 1, there were no significant differences found between the 2 music groups in anxiety levels reached. However, there was a statistically significant difference between the no music control group and both music groups in the anxiety level reached by subjects. Subjects listening to music, both songs chosen by the experimenter and subject selected songs, showed significantly less anxiety than subjects not listening to music.

This study investigated whether relaxation training would increase caregivers' self-efficacy for controlling anxiety associated with difficult behaviors by care recipients. Thirty-six individuals caring for relatives with Alzheimer's disease were taught four types of relaxation techniques. Caregivers' self-efficacy increased following the intervention. Length of time spent in the caregiving role and duration of time since care recipients' diagnosis were significantly related to caregiver self-efficacy before the intervention, but became non-significant following the intervention. An insignificant decrease in incidence of reported behavioral problems occurred following the intervention.

It has been argued that surgery is a form of psychological stress, and that the response to it should therefore be modifiable by psychological means. To test this hypothesis, we assessed the effect of preoperative relaxation instructions on endocrine, cardiovascular, and subjective responses in 21 patients undergoing minor abdominal surgery. Controls (N = 19) received general procedural information. In the relaxation group only, there was a significant increase in cortisol and adrenaline concentration from immediately before induction of anesthesia to immediately after surgery. Noradrenaline values were unaffected by relaxation. In contrast, relaxation reduced state-anxiety on the preoperative day and the two postoperative days; maximal peroperative systolic and diastolic blood pressures were also reduced. The results are consistent with previous evidence that adrenaline and cortisol responses to surgery are greater in less anxious patients.

Immediately before they underwent femoral angiography, 45 patients were given one of three types of audiotapes: a relaxation response tape recorded for this study, a tape of contemporary instrumental music, or a blank tape. All patients were instructed to listen to their audiotape during the entire angiographic procedure. Each audiotape was played through earphones. Radiologists were not told the group assignment or tape contents. The patients given the audiotape with instructions to elicit the relaxation response (n = 15) experienced significantly less anxiety (P less than .05) and pain (P less than .001) during the procedure, were observed by radiology nurses to exhibit significantly less pain (P less than .001) and anxiety (P less than .001), and requested significantly less fentanyl citrate (P less than .01) and diazepam (P less than .01) than patients given either the music (n = 14) or the blank (n = 16) control audiotapes. Elicitation of the relaxation response is a simple, inexpensive, efficacious, and practical method to reduce pain, anxiety, and medication during femoral angiography and may be useful in other invasive procedures.