Mindfulness and Academic Performance of College and University Students: A Systematic Review.

Higher education's expectations place demands on students' attainment, leading them to experience stress and anxiety, which negatively affect their academic improvement and life satisfaction. The aim of this systematic review was to investigate (a) if mindfulness as an inner ability is related to academic attainment, through dependent variables, including compassion, engagement, stress or anxiety state, depression, self-efficacy, mindfulness's facets (non-reactivity, acting with awareness) and (b) if mindfulness-based interventions positively affect the academic performance of college and university students. The systematic review was conducted in accordance with the PRISMA statement. PubMed, Web of Science, and Cochrane Library Wiley were screened to identify studies published relevant to the topic. In total, 568 papers were retrieved in the initial search. Five papers met the eligibility criteria and were included in the systematic review: a randomized controlled trial, a non-randomized controlled trial, a quasi-experimental study, a quantitative exploratory pilot study, and a longitudinal randomized controlled study. Most interventional studies revealed a non-significant direct effect of practicing mindfulness technique on academic attainment. Further research, especially randomized controlled trials are necessary to clarify the effect of mindfulness on academic performance of college and university students.

How Does Meditation Affect the Default Mode Network: A Systematic Review.

This article provides a systematic review of studies evaluating the effect of meditation on the Default Mode Network (DMN). The review was conducted according to PRISMA guidelines. A literature search of PubMed, Scopus, and Embase was conducted up to June 2020. Search terms included default mode network or DMN and meditation.A total of 306 articles were identified, of which 16 controlled trials with a total of 853 experienced (in Mindfulness, Samatha, Raja Yoga, Transcendental Meditation, Vipassana, Insight meditation Theravada tradition) and non-experienced mediators were finally included in this systematic review. The results showed that meditative interventions affect the operation of DMN and there are differences in functional connectivity between networks. Further research should be undertaken to establish meditation as an effective intervention strategy for well-being.

Post-traumatic Stress Disorder as a Risk Factor for the Development of Risky Behavior Among Adolescent Offenders: A Systematic Review.

The purpose of this research study was to obtain greater insight into the associations of post-traumatic stress disorder (PTSD) and trauma-exposed experiences with the development of offending behavior in adolescents. Using the PubMed and Scopus databases, we performed a systematic review of recent cross-sectional studies between 2016 and 2022, investigating the associations of PTSD and trauma with the social and mental behavior of adolescents. Fifty-three articles were initially identified. Due to duplication, eight articles were excluded, leaving 45 remaining articles. In addition, 34 articles were excluded due to year of publication, review, abstract, or irrelevant title. Seven articles were included in this systematic review after excluding the remaining due to different study types or samples. Included studies primarily examined the associations of PTSD symptomatology and expression of externalizing symptoms with risky behavior and the commission of a crime. The strongest outcomes were increased levels of violent behavior, violent delinquency, and total risk in correlation with PTSD symptoms, emotional numbing, use of drugs, and in some cases maltreatment. The results of the systematic review suggest that PTSD symptoms and risky behavior, which can be also fueled by maltreatment activities in the family circle, are associated with criminal behavior. Future research is needed to confirm these findings.

Burnout in General Surgeons. A Systematic Review.

Occupational burnout is particularly widespread amongst surgical professionals. During the past 10 years, both the awareness and the ability to reliably measure and classify "burnout" in medical professionals have increased. The purpose of this systematic review was to summarize the current evidence on the burnout levels of general surgeons. Online searches were carried out using the scientific search engines PubMed, Embase, Cinahl, and Google scholar, from 2010 to 2020, before the COVID-19 pandemic. Articles that met the inclusion criteria were critically evaluated using the critical appraisal skills programme (CASP) tool. Five studies pertaining to 669 subjects were included in this review. As expected, "burnout syndrome" was mainly due to the exhaustive and demanding conditions of working life and was strongly observed in general surgeons. The incidence of the burnout syndrome increased with their years of service, compromised their quality of life, and had detrimental effects on their mental and physical health. Personal achievements and emotional satisfaction were protective for the occurrence of the syndrome. We conclude that valid recognition and prevention of the burnout syndrome are necessary. Further research is needed to manage this phenomenon within the healthcare settings and the surgical departments.

Brain Activity of Professional Dancers During Audiovisual Stimuli Exposure: A Systematic Review.

Many studies have shown the effect of dance to the brain. It seems that long-term practice modulates brain plasticity and visuomotor skills, as it activates the Action Observation Network (AON). The aim of this systematic review was to evaluate potential differences in the brain activity (visuomotor skills) between professional dancers and non-dancer adults, measured by electroencephalography (EEG), during the observation of an individual who is dancing (video dance stimuli). This literature search was conducted from February to June 2022, according to the PRISMA guidelines, in the PubMed database using advanced search, mesh terms, and extensive manual search. The included articles were published in English. Specifically, case-control studies were selected, which used healthy adults, professional dancers, and non-dancers as participants, who were exposed to video dance clips and measured by EEG. The articles were excluded if they were based on different type of study, unhealthy population, control group with athletic background, different type of stimuli (rhythmic), or different type of task and procedure. The ratings of quality of evidence were conducted using the Joanna Briggs Institute's (JBI) critical appraisal tool. Five case-control studies were included with 193 participants in total, 87% females. The participating groups of professional dancers (n = 12-25) had mean age 25.14 years, with at least 9-19 years of professional training, whereas control groups had the same sample size, mean age of 24.14 years, and no experience in dancing. Most of the studies presented high methodological quality. All studies showed significant differences in dancers' brain activity, especially regarding the visuomotor skills. The results showed faster activation of AON demonstrated by higher P300 at the frontocentral regions and increased sensitivity of the occipital temporal cortex. Dancers could cope easier with familiar-unfamiliar and effortful-effortless movements. They also demonstrated faster alpha band peak frequency, stronger synchrony over the bands theta, beta, gamma during the audiovisual stimuli, and the ability to encode faster the visual information. The results demonstrate that dancers had better visuomotor skills suggesting dance-enhanced neuroplasticity, as professional dancers processed their actions easier. Dance, which includes visuomotor tasks, could help in prevention, therapy, and rehabilitation of neurodegenerative diseases or movement disorders.

The Effect of Pythagorean Self-Awareness Intervention on Stress and Mental Health Characteristics of Civil Servants in Crete, Greece.

Evidence is limited regarding the effects of holistic programs on work-related stress, anxiety, and depressive symptomatology. This study aimed to evaluate the effects of the Pythagorean Self-Awareness Intervention (PSAI) on stress and mental health characteristics of civil servants in Crete, Greece. This was a single arm interventional study with PSAI outcome evaluation. Validated, self-reported scales were used to assess stress and mental health characteristics (PSS, DASS, UCLA, RSE, and STAXI). Hair samples were obtained to measure cortisol concentrations as a biological stress marker. Paired-samples t-test or Wilcoxon tests were used to evaluate pre- and post-intervention measures. Overall, 48 civil servants (56.3% women, mean age 51 years) participated in the study. Statistically significant reductions were observed in all self-reported stress scales (p < 0.05). Although hair cortisol decreased, this difference was not statistically significant (p = 0.109). Statistically significant improvements were also observed on depressive symptomatology (p < 0.001), self-esteem (p < 0.001), loneliness (p < 0.001), self-efficacy (p = 0.002), and anger (p = 0.017). The PSAI appeared beneficial with respect to all self-reported outcomes. Larger studies including control groups and further follow-up evaluations are needed to ascertain these findings.

Validation of the Greek Version of the State Shame and Guilt Scale (SSGS).

Both shame and guilt are self-conscious negative emotions claiming self-representations and self-awareness. Growing evidence indicates that these pessimistic emotions are associated to stress and stress-related disorders. The aim of this study was to translate and investigate the validity and reliability of the State Shame and Guilt Scale (SSGS) in a Greek adult population sample. A total of 181 adults (63% women) participated in the study. To validate the SSGS, correlations with the Depression Anxiety Stress Scales (DASS) and the Perceived Stress Scale (PSS) were also examined. Exploratory factor analysis was used to examine the factors of the Greek version of the SSGS. In addition, for greater validity, comparisons were made according to sex, marital status and level of education. The reliability assessment revealed that the index of internal consistency (Cronbach's alpha) was above the acceptable margin (0.7) for the three subscales (shame; 0.717, guilt; 0.770, pride; 0.874). The Greek version of the 15-item State Shame and Guilt Scale (SSGS) demonstrated good psychometric properties and could be proven useful for the assessment of shame, guilt, and pride.

Pythagorean Self-Awareness Intervention Promoted Healthy Dietary Patterns, Controlled Body Mass Index, and Reduced Self-Reported Stress Levels of Primary School Children: Α One-Arm Pilot Study.

Stress is common in childhood and an important factor that affects behavior later in adulthood. The aim of this study was to assess the effects of the Pythagorean Self-Awareness Intervention (PSAI), a holistic "cognitive reconstruction" technique to assess primary school children's stress levels, adherence to the Mediterranean diet, and body mass index. Secondary outcome measures included relations with peers, sleep, and hair cortisol concentrations. This one-arm pilot study took place in a primary school, from February to June 2019. Participants were 32 pupils attending the second grade of primary school who received the 8-week PSAI to adopt healthy behaviors and lifestyle. Self-report measures were applied for the evaluation of various variables at the beginning and the end of the eight-week intervention. There were statistically significant reductions in stress levels (p = 0.00), nightmares' frequency (p = 0.00), body mass index (p = 0.03), and bully scale (p = 0.00), and improvement in Mediterranean diet quality (p = 0.00). Hair cortisol concentrations increased (p = 0.02). The social scale significantly increased. Bedtime remained the same after the intervention. This pilot trial showed that the PSAI promoted healthy dietary patterns, controlled children's body mass index, and reduced their self-reported stress levels. Further research on the implementation of this holistic program on children is suggested, in well-powered randomized controlled trials.

Validation of the STOP-Bang Questionnaire in Greek Patients Suffering from Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a sleep disorder with high prevalence and significant health consequences. The aim of this study was to validate the STOP-Bang Questionnaire, a widely used screening tool for OSA besides polysomnography, in Greek patients. A hundred and two (102) patients with OSA, aged [mean (SD)] 59.16 (8.53) years, and 102 healthy adults, aged [mean (SD)] 54.67 (9.36) years, were assessed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for different cut-off values. The Epworth Sleepiness Scale (ESS) was also used to examine predictive validity. Patients with OSA showed higher scores than healthy controls (p < 0.001). The resulting specificity, sensitivity, PPV, and NPV were 98%, 60%, 71%, 97%, (cut-off 3), 96%, 81%, 84%, 95% (cut-off 4), and 86%, 97%, 97%, 88% (cut-off 5), respectively. This study has demonstrated that the Greek version of STOP-Bang can be used in the clinical setting to differentiate patients with OSA from healthy individuals with high accuracy and at low cost.

The Role of Pythagorean Self-Awareness Intervention in Obstructive Sleep Apnea. A Randomized Controlled Trial.

Obstructive sleep apnea (OSA) is a chronic disease causing daytime sleepiness and poor sleep and life quality. So far, its repercussions on psychological health have been poorly addressed in the available literature. The aim of this study was to investigate the effect of a cognitive-based stress management technique, called the Pythagorean Self-Awareness Intervention (PSAI), in patients with OSA. In this randomized controlled (parallel usual care group) trial with a 1:1 allocation ratio, patients in the intervention group (N = 30, 59.7 ± 9.4 years old, 15 females) received PSAI for 8 weeks along with continuous positive airway pressure (CPAP) treatment, while patients in the control group (N = 30, 58.9 ± 9.3, 22 females) received CPAP alone. The primary endpoint included OSA symptoms. Secondary endpoints were sleepiness, sleep quality, depression-anxiety-stress, and affect. All 30 patients in the intervention group showed 100% compliance with PSAI. There was a statistically significant reduction in OSA symptoms in the intervention group compared to the control group (p = 0.021). With regard to secondary endpoints, there were statistically significant improvements in sleep quality (p = 0.001) and positive (p = 0.001) and negative affects (p < 0.001) in the PSAI group versus controls. No side effects were reported by the patients. PSAI may be useful as a complementary tool for the management of patients suffering from OSA. Larger randomized controlled trials are required to validate the results of this study.

Event-Related Rumination Inventory: A Validation Process in the Greek Language.

Rumination has been identified as a negative psychological response of women diagnosed with breast cancer. The aim of the present study was to validate the Event-Related Rumination Inventory (ERRI) in Greek women with breast cancer. Sixty female patients with newly diagnosed breast cancer were included in the study. The ERRI questionnaire was translated with the back-forward procedure. Sociodemographic, anthropometric, and medical parameters were also assessed. The principal component analysis resulted in the following two-factor solution: (1) intrusive thoughts and (2) positive outcome. All subscales showed satisfactory internal consistency and variance, relative to theoretical score ranges. Subscale scores and the total score were significantly correlated with post-traumatic growth, distress, depression, and anxiety, demonstrating good criterion validity. Associations with patients' sociodemographic and medical characteristics, such as the stage of the disease and the type of treatment, were also identified. The Greek version of the ERRI provides valid and reliable measures of rumination when administered to women with breast cancer.

Effects of an 8-Week Stress Management Program in Women with Breast Cancer: A Randomized Controlled Trial.

Stress management programs have demonstrated benefits for patients with breast cancer, but their adoption in clinical practice is limited mainly due to the absence of necessary resources. The aim of this study was to investigate the effects of an 8-week stress management program, carried out by one psychologist, in women treated for breast cancer. In this randomized controlled trial, patients were allocated to two groups (control and intervention groups) that received standard care; women in the intervention group also participated in an 8-week stress management program. Intervention included stress- and diet-related psychoeducation, diaphragmatic breathing, guided imagery, progressive muscle relaxation, and cognitive reconstruction. Anthropometric and psychological measurements were carried out in both groups, pre- and post-intervention, using a battery of questionnaires. A total of 53 patients participated in the study, of whom 27 in the intervention group. Analysis revealed statistically significant differences between the two groups post-intervention in body mass index (P = 0.040) and quality of life, including global health status (P = 0.019), emotional functioning (P = 0.024), cognitive functioning (P = 0.041), and diarrhea (P = 0.012). There was a statistically significant effect of the type of surgery (partial or total mastectomy) to role functioning (P = 0.030), with major benefits identified in the subgroup of patients that had undergone mastectomy with immediate reconstruction. This stress management program, carried out by a single health professional, significantly improved some psychosomatic health parameters of patients with breast cancer. Short interventional programs can be successfully implemented with minimal resources to deliver quality care in these women.

Validation of the Greek Version of Hedonic, Eudaimonic, and Extrinsic Motives for Activities (HEEMA) Instrument.

Hedonia and eudaimonia are motivating forces through which individuals pursue well-being. The latter is a multidimensional concept, while hedonia and eudaimonia, both of which are realized through the reward system of the brain, are known to influence each other. Researchers have shown that specific extrinsic values (e.g., material wealth, power over other people, etc.) are associated with a sense of "good life" and may influence both hedonia and eudaimonia. The HEEMA (Hedonic, Eudaimonic, and Extrinsic Motives for Activities) scale was developed to evaluate all three ways of seeking well-being, hedonia, eudaimonia, and extrinsic values, in both a healthy and unhealthy fashion. The purpose of this study was to assess the psychometric properties of the HEEMA scale in a sample of 225 Greek individuals. Participants filled the HEEMA, SWLS, MLQ, Self-Esteem questionnaire, DASS-21, MHC-SF, and Big Five Inventory, anonymously. Reliability and validity indices of the scales were satisfactory (Cronbach's α were 0.734, 0.811, and 0.843 for the hedonic, eudaimonic, and extrinsic motives subscales, respectively). Indicatively, the study showed a positive correlation between aspects of well-being and positive emotions, satisfaction with life, sense of meaning and purpose, as well as with specific personality traits, while negative correlations were found between eudaimonic orientation and depression.

The Effects of Pythagorean Self-Awareness Intervention on Irritable Bowel Syndrome Patients: A Non-randomized Controlled Trial.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that affects a considerable percentage of the global population, mainly middle-aged women. IBS causes a constellation of symptoms with repercussions on patients' physical, psychological, and social well-being. Stress seems to play an important role in the pathogenesis of the disease as well as in its management. This study evaluated the effects of a novel non-pharmacological 8-week stress management intervention, the Pythagorean Self-Awareness Intervention (PSAI), in patients with IBS. In this non-randomized controlled trial, 60 IBS patients were assigned to an intervention and a control group. Self-reported questionnaires were used for the evaluation of IBS symptoms and a variety of biopsychological characteristics, pre- and post-intervention. All IBS-related symptoms were significantly reduced in the intervention group compared to the control group with 50% of the patients in the intervention group reporting less abdominal pain. The most potent effects of the intervention were observed in anger externalization, anger control, visuospatial memory, information processing speed, verbal memory, sense of coherence, stress, anxiety, and anger internalization. No side effects in the PSAI group were noted. In conclusion, PSAI was beneficial for patients suffering from IBS. Future research should expand and validate the results of this study.

Validation of the Greek Version of Social Media Disorder Scale.

Social media platforms have gained ground in the day-to-day life of the vast majority of people globally. Growing evidence suggests that social media overuse can take a pathological form, and users can exhibit behaviors similar to those appearing in several types of addiction. The aim of this study was to validate the Greek version of the Social Media Disorder Scale (SMDS) among young adults. An online survey was conducted among Greek adults, aged 18-29 years old. A total of 251 respondents voluntarily participated. Internal consistency, criterion, and construct validity were examined. Results suggest that the Greek version of SMDS shows good psychometric properties. Internal consistency was above the acceptable margin, with a satisfying Cronbach's α coefficient. Correlations with other addiction-related constructs were found to be moderate. Construct validity of the scale was evaluated with exploratory factor analysis. Exploratory factor analysis resulted in a single factor model, which explained almost half of the total variance. The Greek version of SMDS is a psychometrically sound and valid instrument, which researchers and practitioners can use to assess social media addiction in young adults.

The Rosenberg Self-Esteem Scale: Translation and Validation in the Greek Language in Adolescents.

Self-esteem constitutes a characteristic which can influence the person in many dimensions, depending on the perception positive or negative, which the individual has for himself/herself. The most usable tool for measuring self-esteem is the Rosenberg Self-Esteem Scale (RSES). In order to be validated in the Greek language in adolescents, the RSES was completed by 204 high school students, aged 12 to 18 years, at a private school in the suburbs of the region of Attica in Greece. Additional questionnaires were administered simultaneously, i.e., the Culture-Free Self-Esteem Inventories, Third Edition (CFSEI-3) and the Positive and Negative Affect Schedule (PANAS). The reliability and validity results of the RSES indicated satisfactory internal reliability index (Cronbach's a .89 and .80). The RSES showed good concurrent validity. Statistically significant relationships with academic performance and PANAS were observed. The Greek version of the RSES is short, easy to administer, and comprehensible by the teenagers and can be used for the measurement of self-esteem in adolescents in Greece.

The Kentucky Inventory of Mindfulness Skills in Greek Undergraduate and Postgraduate Students.

The Kentucky Inventory of Mindfulness Skills (KIMS) is a widely used multidimensional tool for assessing the tendency of the individual to be mindful in everyday life. The aim of the present study was to standardize a Greek version of KIMS and to explore its psychometric properties in the Greek population. A sample of 213 Greek undergraduate and postgraduate students from various educational institutions completed the questionnaires. The Mindful Attention and Awareness Scale (MAAS), Toronto Alexithymia Scale (TAS-20), and Perceived Stress Scale (PSS-14) were used to evaluate the criterion validity of KIMS. The Principal component analysis (PCA) resulted in a four-component solution, similar to the structure of the English version of the inventory: "Observing," "Describing," "Acting with awareness," and "Accepting without judgment." All components combined accounted for 45.79% of variance. The subscales had adequate internal consistency, and their scores were correlated with MAAS, TAS, and PSS scores, indicating satisfying criterion validity. Associations between the "Observing" subscale and demographic characteristics were also revealed. This version of KIMS can be safely utilized for assessing mindfulness skills and the efficacy of mindfulness-based interventions in Greek populations.

A review of psychosocial interventions targeting families of children with cancer.

OBJECTIVE: Psychosocial interventions in families of children with cancer are considered an effective way of empowering family members to tackle the complex hurdles they face. The ability of parents to develop adaptive coping strategies during the child's treatment is not only important to their own mental and physical health, but also to their child's well-being and long-term adjustment with the disease. METHODS: The aim of this review was to evaluate the existing literature for the period from 2009 to 2017 on psychosocial interventions targeting families of children with cancer. We searched the PubMed database using the following combination of keywords: "cancer AND children AND (intervention OR training) AND (mothers OR primary caregivers OR parents OR fathers OR siblings)." RESULTS: After careful evaluation of 995 papers, 17 full-text papers were found to match our criteria (12 randomized controlled trials and 5 quasi-experimental studies). The quality of the studies was assessed using the Delphi score questionnaire, and the score of the reviewed studies ranged from 3 to 5. The findings suggest that most interventions reduced distress and improved coping strategies among participants. Interventions, mainly cognitive behavioral therapy and problem-solving skills training targeting maternal distress, were associated with improved adjustment outcomes in mothers of children with cancer. SIGNIFICANCE OF RESULTS: Psychosocial interventions are helpful, and efforts should be made to promote them in a larger scale. Protocols should be implemented to ensure that all parents benefit. Computer-assisted methods may provide additional benefit by improving cancer-related knowledge and cancer-related communication.

Mental health in chronic disease patients during the COVID-19 quarantine in Greece.

OBJECTIVE: To investigate the effect of the time spent on quarantine on distress, anxiety, depression, and somatization of chronic disease patients during the COVID-19 quarantine in Greece and the differences in these parameters between healthy individuals and chronic disease patients. METHOD: The sample consisted of 943 healthy individuals and 163 patients (respiratory, autoimmune, cardiovascular, endocrine, patients with other diseases, and patients with more than one disease) completing sociodemographic assessments as well as the 4-Dimensional Symptom Questionnaire (4DSQ) during March 30, 2020 to May 3, 2020. Pearson's correlation was used to search for the association between time spent on quarantine and the 4DSQ subscales (distress, anxiety, depression, and somatization). Independent sample T-test and Glass's Δ were used for differences between healthy individuals and chronic disease patients in these subscales, an analysis also carried out between healthy individuals and all patient subgroups. RESULTS: No statistically significant correlations were noted between the 4DSQ subscales and the quarantine duration, both for the patient and the healthy individuals' group. Chronic disease patients had significantly higher levels of distress (p = 0.001, Δ = 0.28) and somatization (p = 0.000, Δ = 0.47), but not there were no significant differences in anxiety (p = 0.098, Δ = 0.14) and depression (p = 0.052, Δ = 0.19). Concerning head-to-head comparisons between the healthy individuals' group and each patient group, significantly higher scores in distress were found only for patients with respiratory diseases (p = 0.028, Δ = 0.42). Regarding somatization, significantly higher scores were noted for the healthy individuals' group compared with patients with autoimmune diseases (p = 0.010, Δ = 0.62), respiratory diseases (p = 0.027, Δ = 0.42), other diseases (p = 0.003, Δ = 0.55), and more than one disease (p = 0.012, Δ = 0.60). No statistically significant differences were found in anxiety and depression. SIGNIFICANCE OF RESULTS: The results of this study indicate that interventional programs for chronic disease patients during quarantine should focus on distress and somatization, not on anxiety and depression. Respiratory patients might have more supportive care needs compared with patients with other diseases.

Pythagorean self-awareness intervention: A novel cognitive stress management technique for body weight control.

BACKGROUND: Over the past decades, the prevalence of obesity has markedly increased worldwide. Stress is recognized as a substantial contributor to increased body weight; therefore, stress management interventions, especially cognitive behavioural, are becoming increasingly popular. The impact of stress management on stress- and obesity-related biomarkers (eg blood lipid profile, HBA1c, inflammatory biomarkers, such as CRP) has been scarcely studied. The aim of this study was to assess the effect of a novel cognitive behavioural stress management intervention, called 'Pythagorean Self-Awareness Intervention' (PSAI), in overweight/obese adults. MATERIALS AND METHODS: This was a two-armed 1:1 randomized, nonblind controlled study including overweight/obese individuals. The control group followed a personalized Mediterranean low-calorie diet, and the intervention group followed the same diet in addition to the PSAI intervention for 8 weeks. Measurements included demographic, anthropometric (ie BMI, waist-to-hip ratio), stress (ie perceived stress, salivary cortisol), dietary behaviour (ie emotional eating) and metabolic parameters (ie blood lipid profile, HBA1c, CRP, body composition in fat and water). Outcome per-protocol analysis was performed using mixed linear models adjusted for age and gender. RESULTS: A total of 49 of 62 eligible adults were analysed in the study (there were three dropouts in the intervention group and 10 dropouts in the control group); 28 were assigned to the intervention group (mean age 54.7 ± 11.9 years) and 21 to the control group (mean age 51.8 ± 11.9 years). The intervention group showed a statistically significant decrease in perceived stress, cortisol concentrations 30 minutes after awakening, cortisol's area under the curve, BMI, waist-to-hip ratio, restrained, emotional and external eating behaviour, fasting glucose, LDL, triglycerides, HbA1c and body and trunk fat, compared with the control group. Based on the observed effect sizes, clinically meaningful changes may be more evident in stress perception, restrained and external eating behaviour, Hb1ac and trunk fat. The compliance to the PSAI intervention reached 100%, and there were no adverse effects. CONCLUSIONS: The PSAI technique may be an effective stress management method for overweight/obese adults. Future and larger randomized controlled studies are needed to allow generalization of these findings.