A Systematic Review on the Adult Alpha Brainwave Activity After Essential Oil Inhalation.

Aroma extracts from plant species have been utilized since ancient times for a variety of discomforting circumstances. Aromatherapy is a recognized complementary therapeutic treatment performed in various ways such as massage or dermal application, with its main uses involving relaxation, pain relief, and stress management. Several studies have outlined that inhalation of fragrance may influence the brain function since their components can cross the blood-brain barrier and interact with central nervous system receptors. The aim of this review was to systematically present findings regarding alpha brain wave activity reported exclusively by electroencephalography. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed and Scopus databases were screened for relevant papers, based on specific eligibility criteria. The final step of the process resulted in 13 studies published between 1998 and 2021, using different essential oils. Most of the studies revealed the increase of alpha brainwave activity post-essential oil inhalation. Given the proven positive outcomes of increased alpha wave activity on several domains such as cognitive performance and better mental state, further research on the impact of essential oil inhalation is warranted.

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.

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.

Psychiatric Disorders and Obesity in Childhood and Adolescence-A Systematic Review of Cross-Sectional Studies.

Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this study was to systematically review the evidence regarding the relation of obesity and psychiatric disorders in childhood and adolescence. This review, based on the PRISMA guidelines, included cross-sectional studies published within the last decade, pertaining to the relation between psychiatric disorders and obesity in children and adolescents up to the age of 19 years. Studies on eating disorders were excluded. A total of 14 studies of 23,442 children and adolescents that investigated the relation of obesity with anxiety, mood disorders, and psychosis were included in this systematic review. Nine of the included studies reported a significant relationship between the psychiatric disorder under investigation and obesity. Understanding the nexus between obesity and psychiatric disorders in children and adolescents is of great importance, given the alarming increase in both conditions in youth. Such findings could facilitate the development and implementation of targeted interventions.

Measuring Adolescent Chronic Stress: A Review of Established Biomarkers and Psychometric Instruments.

Adolescence is a period of stressful physiological and psychosocial changes. Exposure to chronic stress can cause specific structural and functional changes in an organism, which can be appraised objectively. Some of these alterations are an expected reaction of the body in its attempt to adapt to a stressful situation, while others are signs of possible disease development. The aim of this review was to present the most widely used methods of stress evaluation in adolescence research. Primary biomarkers associated with different biological systems, such as the stress hormones glucocorticoids, and catecholamines, as well as the available methods of extraction and assessment of each biomarker, are presented. This work also includes secondary outcomes, which can also provide an estimation of an individual's stress level. Also, most available psychometric instruments of stress, constructed to address specifically this period of life, are presented and discussed. In addition, this paper addresses possible confounding factors that may affect stress measurements, which should be taken under consideration when conducting stress research. To objectively evaluate stress, it is of great importance for a researcher to be familiar with the condition under examination and its representative stress indices. Adequate evaluation of adolescents with the selection of proper psychometric tests and biological markers can help design targeted interventions aiming to prevent or reverse the effects of physical and mental stressors that occur during adolescence, effects that can be carried into adulthood with detrimental consequences.

Validation of the Eating Habits Questionnaire in Greek adults.

Healthy eating has gained ground in people's daily lives in modern society. However, an overwhelming preoccupation with healthy eating can lead to a pathological form setting the ground for orthorexia nervosa. This study aimed to validate the Greek version of the Eating Habits Questionnaire (EHQ) in adults 18 to 65 years old. The EHQ evaluates orthorexia nervosa traits. An online survey was conducted among adults of the general Greek population by administrating a battery of self-report instruments. The IPIP Big-Five personality questionnaire, Beck's Depression Inventory, the Obsessive-Compulsive Inventory-Revised, the Bulimic Investigatory Test, the Edinburg BITE, and the Eating Attitudes Test-13 were used. Internal consistency, test-retest reliability, and convergent and criterion validity were examined. A total of 551 adults (92.2% females) voluntarily participated in the study. Results suggest that the Greek version of the instrument has good psychometric properties. Analysis revealed a 3-factor model explaining 48.20% of the total variance. Cronbach's alphas ranged between 0.80 to 0.82, indicating good internal consistency. The test-retest reliability analysis showed no statistically significant difference between the measurements of the first and the post-2 weeks. Correlations with other eating disorder-related constructs were found to be weak to moderate. Body mass index was not significantly correlated with neither of the three EHQ subscales. The Greek version of EHQ is a robust instrument that could be used in clinical practice and research in the field of eating disorders in Greece.

Difference in Hair Cortisol Concentrations between Obese and Non-Obese Children and Adolescents: A Systematic Review.

Childhood obesity has been linked to physical and psychological comorbidities that can be carried into adulthood. A bidirectional link between body weight and the stress system appears to exist, as cortisol may affect the regulation of appetite, while adiposity can affect cortisol secretion. Among the biological tissues used to evaluate cortisol concentrations, scalp hair can provide retrospective measures. The aim of this systematic review was to investigate the difference in hair cortisol concentrations between obese and non-obese minors ≤ 19 years of age. Children and adolescents with genetic, somatic or psychiatric comorbidities were excluded. The work was conducted following the PRISMA guidelines, using prespecified search terms in the Pubmed database. The initial search yielded 56 studies, while the last step of the screening procedure concluded in 9 observational studies. Among them, the results could be characterized as inconclusive. Five of them demonstrated significantly higher hair cortisol concentrations in obese children and adolescents than normal weight subjects. On the contrary, the remaining four found no statistically significant differences in hair cortisol concentrations between obese and non-obese subjects. Different methodologies applied, and confounding factors could explain the inconsistency in the findings. Further research is needed to provide more solid results.

Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis.

Implemented social distancing measures may have forestalled the spread of COVID-19, yet they suppressed the natural human need for contact. The aim of this systematic review was to explore the impact of the COVID-19 pandemic on adult sexual wellbeing and sexual behavior. An extensive search in Pubmed, Scopus, and PsycInfo databases based on PRISMA guidelines was conducted. After applying specific eligibility criteria, screening resulted in 38 studies. Results were drawn from 31,911 subjects and outlined the negative effect of the pandemic in sexual frequency, function, satisfaction, and the behavioral changes regarding masturbation and internet-based practices. Meta-analyses of the drawn data on 1,343 female, and 1,372 male subjects quantified the degree of sexual function change during the COVID-19 pandemic vs. prior the pandemic. A random effects model revealed the significant negative impact of the pandemic on female sexual function (SMD: 0.76, 95% CI:0.74 to 1.59), while no significant change was found for the males (SMD: 0.25, 95% Cl: -0.03 to 0.52). Significant heterogeneity was identified across included studies (p < 0.00001, I2 = 97%, I2 = 90% for females and males, respectively). As part of the global health, sexual wellbeing should be on the focus of clinicians and researchers.

Validation of the Greek version of the Bergen Social Media Addiction Scale in Undergraduate Students.

Social Networking Sites (SNSs) number at least 3.81 billion users worldwide, while in Greece, 74.7% of internet users resort to SNSs. However, there is no instrument adapted to the Greek language that assesses addiction to SNSs. The Bergen Social Media Addiction Scale is a short 6-item questionnaire that assesses social media addiction. This study aimed to evaluate the psychometric properties of the Greek version of the Bergen Social Media Addiction Scale. The sample consisted of 325 University students (mean age 21.6 years, SD=5.26). Confirmatory factor analysis was performed that supported the one-factor model. The reliability of the tool was tested with various indicators and was found to be satisfactory. The regression analysis identified gender, time of SNSs use, number of SNSs held by an individual and stress as statistically significant predictors of SNSs addiction. Positive correlations were found between SNSs addiction and stress, depression, anxiety and loneliness, while negative correlations were observed between SNSs addiction, self-esteem and age. Stress fully mediated the relationship between depression and SNSs addiction. The findings of the present study indicate that the Greek version of the Bergen Social Media Addiction Scale is a valid and reliable instrument for assessing SNSs addiction. The relationship between SNSs addiction and the biopsychosocial model was confirmed.

Is there a relation between major depression and hair cortisol? A systematic review and meta-analysis.

Literature supports a causal role of stress in major depressive disorder (MDD). Hair cortisol concentration (HCC) has been widely used as a measure of long-term stress. Although elevated HCC has been observed in healthy people experiencing chronic stress, findings regarding individuals with mental disorders have been complicated. This review attempts to systematically present all the published research on major depression and HCC. An extensive search of databases was performed to identify articles that investigated this question. The initial search retrieved 142 studies, of which, 16 original articles were included in this review. Results were contradictory; most of the studies showed no significant HCC differences between MDD patients and controls, while others indicated either higher or lower HCC in MDD patients than controls. Higher HCC was reported in first depressive episode compared to recurrent MDD and controls; patients with comorbid MDD and anxiety disorder had higher HCC than controls. No significant HCC difference was found between patients with melancholic or atypical depression and controls. Findings concerning HCC in postpartum depression were inconsistent. A meta-analysis of the data extracted from seven studies of the sample was performed to quantify the degree of cortisol change in MDD patients vs. controls. A random effects model revealed no significant hair cortisol concentrations difference between depressed patients and healthy controls (SMD: -0.02, 95% CI: -0.36 to 0.32). Significant heterogeneity was identified across included studies (P = 0.002, I2 = 71%). The disagreement among studies' results indicates that there is room for improvement in this research field. Confounding factors independent of depression should be taken into consideration.

Validation of the Instagram Addiction Scale in Greek Youth.

Instagram is one of the fastest growing social networking platforms. A body of evidence suggests that Instagram problematic use and addiction have negative effects on the psychological well-being of young people. The Instagram Addiction Scale, a self-report tool assessing Instagram problematic use and addiction, has been developed recently. The aim of the present study was to validate the Instagram Addiction Scale in the Greek language and to assess its psychometric properties. An online and on-print self-report survey was conducted among Greek youth, aged between 18 and 24 years. The survey included the Instagram Addiction Scale, the Rosenberg Self-esteem Scale, the Perceived Stress Scale, and the Big Five Inventory. A total of 967 respondents participated in the study. The analysis suggested that the Greek version of the Instagram Addiction Scale has good psychometric properties. The principal component factor analysis for construct validity generated two subscales as the original instrument: social effect and impulsion. Internal consistency for the two subscales and the scale's total score was satisfactory, with Cronbach's α at 0.76, 0.85 and 0.88, respectively. Correlation analyses revealed positive associations between the perceived stress scale and social effect, and the Instagram Addiction Scale's total score (p<0.0001 and p=0.002 respectively). This is the first study validating the Instagram Addiction Scale in Greek youth, which can be used by researchers and practitioners for the evaluation of youth problematic use of Instagram.

Validation of the Cosmetic Procedure Screening (COPS) Questionnaire in the Greek language.

Practitioners in cosmetic and aesthetic treatment practices are likely to unknowingly work with patients with Body Dysmorphic Disorder (BDD). Screening questionnaires to identify the disorder in Greece are lacking. The purpose of this study was to validate a Greek version of the Cosmetic Procedure Screening (COPS) questionnaire, a self-report measure of how the respondents feel about their appearance, before an aesthetic intervention. The COPS was translated into Greek and was completed by 216 adult females from several areas of Attica (four private beauty centers, three dermatology clinics, five plastic surgery clinics, and Thriasio General Hospital of Elefsina) who pursued a cosmetic procedure. Participants also completed the Perceived Stress Scale (PSS-14). The Greek version of the COPS questionnaire demonstrated high internal consistency (Cronbach's α of 0.856) with corrected item's total range 0.468 to 0.687. Two of the factors explained 58.98% of total variance. Twenty (9.26%) women had a possible diagnosis of BDD (80% were unmarried, 95% had no children, 80% had university education). An increase in perceived stress levels was associated with an increase in the likelihood of being diagnosed with BDD (Pearson's r=0.726). The Greek version of the COPS questionnaire is a valid instrument that can be used by professionals to screen adult women for BDD.

Exploring the Effects of Problematic Internet Use on Adolescent Sleep: A Systematic Review.

Adolescent suse internet via several devices to gather information or communicate. Sleep, as a key factor of adolescents' development, contributes to their physical and mental health. Over the past decades insufficient sleep among adolescents has been wide spread, and one of its attributing factors is the increased availability of technology. This review aims to investigate the body of evidence regarding the impact of problematic internet use on adolescent sleep. Extensive search of databases was performed according to PRISMA guidelines for studies published within the last decade, regarding subjects aged 10-19. The final step of the search yielded 12 original studies. The quality of extracted data was evaluated with the AXIS tool, in order to estimate the risk of bias. All studies showed a negative correlation between adolescent sleep and problematic internet use. It was found to affect sleep quality and quantity and provoke insomnia symptoms. Interestingly, adolescent's sex, parental educational level, type of family and use for leisure or academic reasons appeared as affecting factors of the problematic internet use-sleep relationship. Problematic internet use has several effects on adolescents' sleep. Results of relevant studies should be embedded in educational interventions addressed to adolescents as well as parents, to eliminate the negative outcomes of problematic internet use on sleep and adolescence's health in general.

Stress among pediatric oncology staff. A systematic review.

Cancer is considered one of the dominant life-threatening diseases in children. Working in the field of pediatric oncology, although rewarding, can be a source of stress and emotional burden for health care providers. The aim of this systematic review was to summarise the evidence regarding the occupational stress of health care providers working with pediatric cancer patients. Extensive search of the Pubmed and Scopus databases was performed to identify studies relevant to the topic. Initial search retrieved 657 studies. The reviewing investigators, after applying the inclusion/exclusion criteria, extracted data to critically appraise the quality of evidence. The final step of search concluded in 23 studies of heterogeneous design. Results revealed two main domains of which occupational stress derived from i) the interaction of the health care provider with the patient and the family, and ii) several organisational factors, such as hierarchical structures, experience, workload, and low organisational support. Literature on the stress of pediatric oncology staff is limited. The rather small sample sizes of the studies, the heterogeneity of methodological design, the lack of assessment from a sociological point of view, as well as the limited psychometric instruments adapted to pediatric oncology staff, make the validity of the results questionable. Further research is warranted to obtain a more accurate view of the field, to identify a cause-effect relation between work-related stress and pediatric oncology staff, and, more importantly, to guide future recommendations on support systems and stress management training within pediatric oncology settings.

Stress Management in Elementary School Students: a Pilot Randomised Controlled Trial.

Research has shown that stress experiences begin in early stages of life. Stress management techniques have appeared to be beneficial for the development or enhancement of stress coping skills. The aim of this pilot randomised controlled trial was to assess the effect of a 12-week intervention, comprising training in diaphragmatic breathing and progressive muscular relaxation, on elementary school students' stress levels. Outcomes on the quality of life and behavioural aspects of the students were also assessed. Standardised questionnaires were administered at baseline and after the 12-week intervention program. Fifty-two children aged 10 to 11 years were randomly assigned to intervention (n=24) and control groups (n=28). Children of the intervention group demonstrated lower levels of stress (in all three subscales of lack of well-being, distress, and lack of social support) and improved aspects of quality of life (physical, emotional, and school functioning). No significant differences were observed regarding the examined behavioural dimensions, in the intervention group. Larger randomised controlled trials with follow-up evaluations are needed to ascertain the positive outcomes of such programs on elementary school children.

Pythagorean Self Awareness Intervention in Caregivers of Patients with Motor Disabilities.

Caregiving for disabled people is a strenuous task often provided by family members, with adverse repercussions on the caregivers' health. The aim of this study was to evaluate, for the first time, the effects of a novel cognitive-based stress management technique, the Pythagorean Self-Awareness Intervention (PSAI) on the stress levels and other cognitive and psychological characteristics of non-paid caregivers of patients with motor disability. In this quasi-experimental study, 59 caregivers of first-degree relatives with motor disabilities due to chronic neurological diseases, inpatients at a Rehabilitation Center, in Athens, Greece, were assigned to an intervention (PSAI, n=28) and a control group (received unstructured consultation, n=31). Psychological, cognitive, and sleep-related measurements (Zarit Burden Interview tool, Pittsburgh Sleep Quality Index, Self-Efficacy Scale, Depression, Anxiety and Stress Scale, Symbol Digit Modalities Test, California Verbal Learning Test-II, Brief Visuospatial Memory Test-Revised) were held at baseline and after 8 weeks (at completion of PSAI) in both groups. PSAI was found to decrease caregivers' stress, depressive symptoms and anxiety and improve their sleep quality, visual memory, self-efficacy, and cognitive speed processing. Future randomized controlled studies are needed to investigate the effects of this novel intervention in larger samples of caregivers.

Reliability and validity of the Peer Relation Questionnaire in a sample of Greek school children and adolescents.

Bullying among children and adolescents can have detrimental effects on their physical and mental health. The first step in the identification of bullying is the detection of relevant signs and behaviours, with the use of appropriate instruments. The widely used Peer Relation Questionnaire (PRQ)has been developed to measure bullying behaviour in children and adolescents. The aim of this study was to translate and validate this instrument in the Greek language in a school sample of children and adolescents. A sample of 193 students (mean age ± SD 11.44 ± 1.26 years, girls 49.7%), was recruited from elementary and junior high schools of the public and private sector, in the capital of Athens, Greece. Along with the Peer Relation Questionnaire, the Stress in Children questionnaire and a structured inquiry regarding satisfaction from various aspects of life were used to assess the criterion validity of the Peer Relation Questionnaire. Results revealed good psychometric properties of the questionnaire in the Greek language. The principal component analysis resulted in two subscales that demonstrated an adequate internal consistency and a significant correlation with stress and satisfaction parameters, suggesting satisfying criterion validity. Meaningful associations between demographic characteristics and the subscales were also found. The Greek version of the Peer Relation Questionnaire-short form can be used as a valid tool to measure bullying behaviour in children and adolescents.

The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece.

INTRODUCTION: Recent studies have reported that the quarantine imposed in several countries around the world due to Covid-19 affected the sexual function and relationship quality. On the March 23, 2020 the Greek government imposed a national quarantine to contain the spread of the pandemic. The impact of such conditions on sexual function and relationship quality of couples is unknown. AIM: To investigate sexual function and relationship quality of couples during the quarantine. METHODS: An online anonymous survey was conducted one month post-impose of the quarantine, between the April 21 and the May 3, 2020. Adult respondents in a relationship completed a questionnaire including sociodemographic characteristics, structured inquiries regarding sexual activity and quality of relationship, anxiety level, and mood during the quarantine, as well as the IIEF and FSFI indices. OUTCOMES: Sexual function was assessed using the Greek versions of the FSFI and IIEF for females and males respectively. Sexual activity using 5 statements regarding frequency of sexual thoughts, masturbation, and intercourse, quality of intercourse and general estimation of the level of sexual function. Participants graded their level of agreement. Relationship quality was assessed using 5 questions regarding communication, company, understanding, tension and general estimation of companionship. Participants graded their level of agreement. Two additional statements were used in order to evaluate mood and the level of anxiety. RESULTS: A sum of 299 adult heterosexual participants in a relationship participated. Little or no negative impact on sexual function was reported. Increased anxiety and deficient mood were reported only for those with no access to their partner. Being in a steady relationship and living with their partner, but only for couples without children, resulted in satisfaction by sexual activity and enhanced emotional security. CONCLUSION: Sexual function and relationship quality appeared as not affected by the quarantine and by the measures of social distancing. Sotiropoulou P, Ferenidou F, Owens D, et al. The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece. Sex Med 2021;9:100364.