Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.
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The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (N = 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0-100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as "all injuries" (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and "substantial injuries" (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann-Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March, p < 0.05), and in 5 months for substantial injuries (September, October, November, December, April, p < 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries [F(1.87,216.49) = 3.10, p = 0.051] and substantial injuries [F(2,138) = 4.16, p = 0.018]. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.
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Abstract Objectives The aim of this review is to establish the effectiveness of psychological relapse prevention interventions, as stand-alone interventions and in combination with maintenance antidepressant treatment (M-ADM) or antidepressant medication (ADM) discontinuation for patients with remitted anxiety disorders or major depressive disorders (MDD). Methods A systematic review and a meta-analysis were conducted. A literature search was conducted in PubMed, PsycINFO and Embase for randomised controlled trials (RCTs) comparing psychological relapse prevention interventions to treatment as usual (TAU), with the proportion of relapse/recurrence and/or time to relapse/recurrence as outcome measure. Results Thirty-six RCTs were included. During a 24-month period, psychological interventions significantly reduced risk of relapse/recurrence for patients with remitted MDD (RR 0.76, 95% CI: 0.68–0.86, p<0.001). This effect persisted with longer follow-up periods, although these results were less robust. Also, psychological interventions combined with M-ADM significantly reduced relapse during a 24-month period (RR 0.76, 95% CI: 0.62–0.94, p = 0.010), but this effect was not significant for longer follow-up periods. No meta-analysis could be performed on relapse prevention in anxiety disorders, as only two studies focused on relapse prevention in anxiety disorders. Conclusions In patients with remitted MDD, psychological relapse prevention interventions substantially reduce risk of relapse/recurrence. It is recommended to offer these interventions to remitted MDD patients. Studies on anxiety disorders are needed.
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