Abstract
Background: The impact of stress on the nation’s physical and mental health is considerable. Exercise is considered to have beneficial effects on mental health and the capacity for coping with stress. The purpose of this study is to verify the effects of fitness dance intervention on female Ph.D. candidates’ stress, and compare it with the intervention effects of MBSR. Method: A repeated measurement experimental design was used to evaluate the effects of fitness dance and MBSR on Chinese female Ph.D. candidates’ stress. Results: Twelve weeks of fitness dance and MBSR can reduce participants’ stress from severe to moderate. Eight weeks of fitness dance can reduce the tension from perceived stress (p = 0.019) and loss of control from perceived stress (p = 0.043). Twelve weeks of fitness dance can reduce the tension from perceived stress (p < 0.000), loss of control from perceived stress (p = 0.002) and perceived stress (p = 0.001). Fitness dance and MBSR affect emotion regulation, thereby affecting stress. Fitness dance reduced participants’ stress by improving their cognitive reappraisal ability. MBSR reduced participants’ stress by improving their cognitive reappraisal ability and expression suppression ability. Conclusions: Fitness dance, as a method of exercise intervention, is suitable for reducing Chinese female Ph.D. candidates’ stress.
Keywords: fitness dance, MBSR, female Ph.D. candidates, stress alleviating, exercise
1. Introduction
The impact of stress on the nation’s physical and mental health has been considerable [1,2]. Recent years have focused a considerable amount of public and professional interest on the relationship between stress and physical and mental health. The relationship between stress and health is well documented, with exposure to stressful events linked to depression [3,4], cardiovascular disease [5,6], mortality [1], and numerous other negative affections (e.g., symptoms of anxiety and depression) [7]. Stress is inevitable. Compared with other professions or occupations, sources of stress, anxiety, apprehension, or exhaustion in academia are more prominent [8]. Scholars have classified the stress of Ph.D. candidates into five categories: academic stress, economic stress, social stress, family stress, and daily life stress [9,10]. Among them, the stress of female Ph.D. candidates mainly comes from academic stress and family stress [11]. Previous studies have shown that the academic stress of female Ph.D. candidates mainly comes from doing experiments, writing a doctoral thesis, and publishing doctoral qualification papers [9,10,11]. Furthermore, the family stress of female Ph.D. candidates is related to the role conflict caused by women’s multiple identities [12]. Some studies show that stress also potentiates anxiety and impairs emotion regulation [13,14,15]. The survey by Mao Yupeng et al. (2022) showed that the stress faced by Chinese female Ph.D. candidates made them more anxious [16]. A study by Yukihiro Suzuki et al. (2021) revealed an important mechanism of emotion regulation in response to stress, which reflects the level of modulation induced by a stressor [17]. Many studies show that successful regulation of emotions is essential to cope properly with stress [7,10,17].
Exercise has been considered to have beneficial effects on mental health and the capacity to cope with stress. Indeed, exercise as a moderator of stress levels has been previously investigated in university student populations [18,19]. Moreover, these results suggest an appraisal of exercise in order to reduce psychological distress among students. Aerobic exercise has been thought to influence emotion in a dose-dependent manner [20,21]. Scholar Brown et al. (1988) pointed out that physical exercise as a healthy lifestyle may be a valuable resource to combat stress [22]. Salmon (2001) pointed out that physical exercise can effectively combat anxiety and depression and prevent the adverse effects of stress [23]. Silja et al. (2013) found that physical activity can promote children’s mental health by regulating their neuroendocrine response to stress [24]. Some research results showed that there is a negative correlation between college students’ physical activities and academic stress [25]. Therefore, some scholars believed that students can take part in physical activities as an effective way to manage academic stress [26]. Among them, exercise that is combined with music has a better effect on mental health promotion [27,28,29,30]. Music, with slow or fast rhythm cadences, can control and pace the motions of the body [31]. Engaging with music has benefits for the cognitive, emotional, physiological, and social wellbeing of an individual [32]. Fitness dance is a type of sport that promotes health, advances aesthetic appreciation, and enriches social and cultural life by using gymnastic motions with dance elements with the accompaniment of music. A previous study showed that positive experiences such as vitality, social connection, and positive emotion presented in fitness dance may be important factors to promote mental health [33]. In terms of exercise dose, it has been pointed out that for stressed individuals, moderate-intensity physical activity of more than 30 min three times a week can help alleviate stress [34,35]. In addition, some scholars pointed out that participating in moderate-intensity fitness dance more than twice a week exhibits good compliance [36,37,38].
Research on stress relief in the field of psychology mainly focus on mindfulness-related exercises. Mindfulness-related exercises are mainly carried out in groups. Many studies designed mindfulness-based exercise programs as: having a frequency of once per week, an intervention time of generally no less than 4 weeks and no more than 12 weeks, and an exercise time of 1–2.5 h each session [39,40,41]. Cheng K P et al. (2016) conducted a prospective study using a four-week short-term Mindfulness Cognitive Therapy program, and conducted a mindfulness intervention study on 135 medical students at the Malaysian University. The results showed that the students’ perceived stress was significantly reduced [42]. Mindfulness has been shown to mediate the effect of meditation programs on stress in a variety of populations [43,44,45]. In a recent narrative synthesis of studies on the effects of mindfulness on stress in college students, 16 of the 22 studies reported significant decreases in self-reported stress [46]. However, the stress-reducing effects in female Ph.D. candidates is less clear. More research is needed to understand what aspects of mindfulness interventions may be working to reduce stress in female Ph.D. candidates. One of the most popular mindfulness-based interventions is Mindfulness-Based Stress Reduction (MBSR) [47,48]. Research in psychology has supported the use of MBSR to alleviate the anxiety of different groups by reducing stress, managing emotions, and regulating physical and mental states [49,50]. A study found that mindfulness-based intervention is effective for patients with depression and anxiety, besides improving physical health [51].
Existing research holds a positive attitude towards the use of fitness dance and MBSR to alleviate stress. The perspective of this study is that fitness dance can be taken as a type of exercise to promote female Ph.D. candidates to develop a healthy lifestyle. This study speculates that in the process of promoting female Ph.D. candidates to develop a healthy lifestyle, the positive emotions generated by participating in fitness dance are conducive to reducing their stress. At the same time, MBSR has been widely used to alleviate stress, but this use has not been confirmed among female Ph.D. candidates. In this paper, the hypothesis is that fitness dance and MBSR affect emotion regulation, thereby affecting stress. To examine this hypothesis, a randomized controlled experiment with fitness dance as the exercise intervention and MBSR as the psychological intervention was designed to explore effects of these two interventions on female Ph.D. candidates’ stress. This study refers to the design of the existing mindfulness-based stress reduction interventions and fitness dance interventions which were used to alleviate stress. The fitness dance intervention was designed as two weekly moderate-intensity sessions of 40 min each. The MBSR intervention was designed as one weekly session of 60 min. They both took place for 12 weeks. The Chinese Perceived Stress Scale was used to investigate the stress of participants. The Emotion Regulation Questionnaire was used to investigate the emotion regulation of participants. Methods, effects, and differences of the two interventions were reported in this study.
2. Methods
2.1. Participants
Participants were recruited between March and April 2022 via social media and the Northeastern University student affairs office. Interested female Ph.D. candidates were sent the Chinese Perceived Stress Scale (CPSS). Participants were eligible for the study if they were current full-time female Ph.D. candidates and (1) scored ≥14 points on the Chinese Perceived Stress Scale (CPSS), (2) were willing to be randomized, and (3) did not take drugs. Participants were excluded if they had a current fitness dance practice or mindfulness practice. Eighty-five female Ph.D. candidates from Northeastern University were the participants for this study. Their age was 28.43 ± 3.71 years. There were 43 participants in the fitness dance group and 42 participants in the MBSR group. Table 1 is the specific information. This paper follows the following ethical principles in the implementation of the experiment. Before the start of the research, the participants were introduced in detail to the purpose, methods, and possible risks in the process of the research. They were told that they could voluntarily decide whether to participate or not on the basis of fully understanding the research process. They were also informed that they had the right to withdraw freely at any time, and filled in the informed consent form after consent was given. (2) The personal information and research data of the participants are strictly confidential. (3) During the research, we took various measures to ensure the personal safety of the participants. The approval number of this research is “No.:202203-15”.
Table 1.
Comparison of demographic data balance between two groups of female Ph.D. candidates (n = 85).
| Essential Information |
Classification Criteria | Frequency (n = 85) |
Fitness Dance Group (n = 43) |
MBSR (n = 42) |
χ2 | p |
|---|---|---|---|---|---|---|
| Age | 20–25 years old | 9 | 4 (9.30%) | 5 (11.91%) | 0.162 | 0.983 |
| 26–30 years old | 51 | 28 (65.11%) | 23 (54.76%) | |||
| 31–35 years old | 23 | 10 (23.26%) | 13 (30.95%) | |||
| 36–40 years old | 2 | 1 (2.33%) | 1 (2.38%) | |||
| Marital status | Unmarried | 68 | 37 (86.04%) | 31 (73.81%) | 0.647 | 0.828 |
| Married | 17 | 6 (13.96%) | 11 (26.19%) | |||
| Motherhood | No | 77 | 41 (95.34%) | 36 (85.71%) | 0.531 | 0.972 |
| Yes | 8 | 2 (4.66%) | 6 (14.29%) | |||
| Grade | Grade 1 | 19 | 10 (23.26%) | 9 (21.43%) | 0.041 | 0.391 |
| Grade 2 | 22 | 11 (25.58%) | 11 (26.19%) | |||
| Grade 3 | 24 | 12 (27.91%) | 12 (28.57%) | |||
| Grade 4 | 20 | 10 (23.26%) | 10 (23.81%) |
χ2: Variation level between the two groups of samples. p: Significance level of samples’ variation between the two groups.
2.2. Instruments
The Chinese Perceived Stress Scale (CPSS) (Yang Tingzhong, China) was used to investigate the stress of Chinese female Ph.D. candidates. The Perceived Stress Scale includes three versions: PSS-14, PSS-10, and PSS-4. Yang Tingzhong et al. first adapted PSS-14 for a Chinese context, and introduced it to China in 2003 [50]. The Cronbach’s alpha of the Chinese version of the PSS (CPSS) is 0.78, and the correlation coefficient between each item and the total score is 0.37–0.53, which means the scale has good credibility. The scale has two dimensions, namely tension and sense of loss of control, and rates on a five-point Likert scale ranging from 1 (“Never”) to 5 (“Always”). Many studies have shown that the CPSS has good reliability and validity [52,53,54,55]. Given the preestablished psychometric properties of the survey tools, construct validity and reliability diagnostics were not performed for this study.
The Emotion Regulation Questionnaire (ERQ) was used to investigate the emotion regulation of Chinese female Ph.D. candidates. The Emotion Regulation Questionnaire was designed to assess individual differences in the habitual use of two emotion regulation strategies: cognitive reappraisal and expressive suppression [56]. The ERQ comprises 10 items and rates on a seven-point Likert scale ranging from 1 (“strongly disagree”), to 4 (“neutral”), to 7 (“strongly agree”). Participants were asked to rate the statements according to how they reappraised or suppressed the expression of emotions. The validity, reliability, and factor structure of this questionnaire has been demonstrated [56], and replicated consistently [57,58,59,60].
2.3. Procedures
From May to July in 2022, the fitness dance group received two weekly sessions of 40 min of moderate-intensity fitness dance exercise for 12 weeks. The MBSR group received one weekly session of 60 min of MBSR for 12 weeks. Both of the two groups completed the exercise in a group environment. The participants in the fitness dance group were organized in one group to practice, and their course was taught by a female doctor who majored in physical education and training. The participants in the MBSR group were organized into two groups to practice, and their course was taught by a female doctor who majored in positive psychology. Both of the two groups were administered the testing instruments at baseline (before starting the 12-week exercise program), the 8th week, and the 12th week, to assess perceived stress and emotion regulation. The instruments were the Chinese Perceived Stress Scale (CPSS) and Emotion Regulation Questionnaire (ERQ).
2.4. Statistical Analysis
SPSS 21.0 statistical software (IBM, Armonk, NY, USA) was used for descriptive statistics, analysis of variance, correlation analysis, and regression analysis.
3. Results
3.1. Basic Information of Participants
The grouping results showed that there were 43 participants in the fitness dance group and 42 participants in the MBSR group. Chi-square test showed that there was no difference in age, marital status, motherhood, and grade between the two groups (p > 0.05, Age = 0.983, Marital status = 0.828, Motherhood = 0.972, Grade = 0.391). The two groups were comparable. Table 1 is the specific information. After interventions, there were 38 participants in the fitness dance group and 38 participants in the MBSR group. The reasons for the loss of nine participants include: poor compliance (5), business trip (1), heavy learning task, and withdrawal from practice (3).
3.2. Comparison of Baseline Balance of Perceived Stress and Emotion Regulation between Two Groups of Participants
Table 2 is the baseline perceived stress and emotion regulation of female Ph.D. candidates in the fitness dance group and the MBSR group. The result of variance analysis showed that there was no difference between the two groups in the variables of “CPSS-Tension”, “CPSS-Loss of control”, “CPSS”, “ERQ-Cognitive reappraisal”, “ERQ-Expressive suppression” (p > 0.05). The two groups were comparable.
Table 2.
Comparison of baseline balance of perceived stress and emotion regulation between two groups of participants (M ± SD).
| Variable | Fitness Dance Group (n = 43) |
MBSR (n = 42) |
F | p |
|---|---|---|---|---|
| CPSS-Tension | 24.84 ± 2.05 | 24.29 ± 1.47 | 2.028 | 0.158 |
| CPSS-Loss of control | 28.23 ± 1.76 | 28.33 ± 1.95 | 0.063 | 0.803 |
| CPSS | 53.07 ± 2.89 | 52.62 ± 2.69 | 0.554 | 0.459 |
| ERQ-Cognitive reappraisal | 19.00 ± 3.14 | 18.90 ± 3.40 | 0.018 | 0.894 |
| ERQ-Expressive suppression | 18.37 ± 2.57 | 17.83 ± 2.76 | 0.868 | 0.354 |
F: The ratio of samples’ variance between the two groups. p: Significance level of samples’ variance between the two groups.
3.3. Effects of Fitness Dance and MBSR on Female Ph.D. Candidates’ Perceived Stress and Emotion Regulation
As shown in Table 3, the results showed that the time main effect of “CPSS-Tension” of the two groups at different time points was significant (F = 1.039, p = 0.008, η2p = 0.829). The main effect of group was significant (F = 0.702, p = 0.038, η2p = 0.122). The interaction between time and group was significant (F = 0.893, p = 0.026, η2p = 0.171). Table 4 shows further simple effect analysis found that it was significant at the 8th week (p = 0.043) and 12th week (p = 0.032).
Table 3.
Comparison of perceived stress and emotion regulation changes between the two groups before and after intervention (M ± SD).
| CPSS-Tension | CPSS-Loss of Control | CPSS | ERQ-Cognitive Reappraisal | ERQ-Expressive Suppression | ||
|---|---|---|---|---|---|---|
| Fitness dance group (n = 38) | Baseline | 24.84 ± 2.02 | 28.34 ± 1.81 | 53.18 ± 2.99 | 18.92 ± 3.20 | 18.34 ± 2.44 |
| 8th week | 21.66 ± 1.81 | 27.32 ± 1.32 | 48.97 ± 2.35 | 22.47 ± 2.63 | 17.61 ± 1.73 | |
| 12th week | 18.05 ± 1.33 | 22.66 ± 1.32 | 40.71 ± 2.04 | 24.92 ± 2.36 | 16.05 ± 1.89 | |
| MBSR group (n = 38) | Baseline | 24.26 ± 1.45 | 28.21 ± 1.89 | 52.47 ± 2.60 | 18.95 ± 3.51 | 17.74 ± 2.87 |
| 8th week | 23.18 ± 1.59 | 25.61 ± 1.28 | 48.79 ± 2.13 | 21.71 ± 3.00 | 15.42 ± 2.04 | |
| 12th week | 19.53 ± 1.20 | 21.00 ± 2.14 | 40.53 ± 2.64 | 23.37 ± 2.79 | 14.87 ± 1.89 | |
| Time | F | 1.039 | 2.232 | 2.07 | 1.019 | 1.897 |
| p | 0.008 ** | 0.021 * | 0.009 ** | 0.042 * | 0.027 * | |
| η2p | 0.829 | 0.862 | 0.918 | 0.644 | 0.425 | |
| Group | F | 0.702 | 2.013 | 0.002 | 0.917 | 0.521 |
| p | 0.038 * | 0.027 * | 0.528 | 0.052 | 0.732 | |
| η2p | 0.122 | 0.224 | 0.016 | 0.09 | 0.152 | |
| Time × Group | F | 0.893 | 3.965 | 0.012 | 0.537 | 1.02 |
| p | 0.026 * | 0.005 ** | 0.473 | 0.067 | 0.041 * | |
| η2p | 0.171 | 0.102 | 0.006 | 0.088 | 0.07 | |
* p < 0.05, ** p < 0.01. F: The ratio of samples’ variance between the two groups. p: Significance level of samples’ variance between the two groups. η2p: Effect size. 0.04 = small, 0.25 = medium, 0.64 = large [61].
Table 4.
The simple effect analysis of Time× Group of “Fitness dance—MBSR”.
| Fitness Dance—MBSR | CPSS-Tension | CPSS-Loss of Control | ERQ-Expressive Suppression | |||
|---|---|---|---|---|---|---|
| t | p | t | p | t | p | |
| 8th week | −5.695 | 0.043 * | 7.976 | 0.018 * | 7.853 | 0.034 * |
| 12th week | −7.121 | 0.032 * | 6.151 | 0.044 * | 2.583 | 0.122 |
* p < 0.05.
The time main effect of “CPSS-Loss of control” of the two groups at different time points was significant (F = 2.232, p = 0.021, η2p = 0.918). The main effect of group was significant (F = 2.013, p = 0.027, η2p = 0.224). The interaction between time and group was significant (F = 3.965, p = 0.005, η2p = 0.102). Table 4 shows further simple effect analysis found that it was significant at the 8th week (p = 0.018) and the 12th week (p = 0.044).
The time main effect of “CPSS” of the two groups at different time points was significant (F = 2.07, p = 0.009, η2p = 0.829). The main effect of group was not significant (F = 0.002, p = 0.528, η2p = 0.016). The interaction between time and group was not significant (F = 0.012, p = 0.473, η2p = 0.006).
The time main effect of “ERQ-Cognitive reappraisal” of the two groups at different time points was significant (F = 1.019, p = 0.042, η2p = 0.644). The main effect of group was not significant (F = 0.917, p = 0.052, η2p = 0.09). The interaction between time and group was not significant (F = 0.537, p = 0.067, η2p = 0.088).
The time main effect of “ERQ-Expressive suppression” of the two groups at different time points was significant (F = 1.897, p = 0.027, η2p = 0.425). The main effect of group was not significant (F = 0.521, p = 0.732, η2p = 0.152). The interaction between time and group was significant (F = 1.02, p = 0.041, η2p = 0.07). Table 4 shows further simple effect analysis found that it was significant at the 8th week (p = 0.034), but it was not significant at the 12th week (p = 0.122).
The results of perceived stress of the two groups at the 8th and 12th week showed (Table 5) that, after 8 weeks of intervention, the participants’ “CPSS-Tension” and “CPSS-Loss of control” in the fitness dance group were significant (p = 0.019, p = 0.043), but their “CPSS” was not significant (p = 0.051). In the MBSR group, the participants’ “CPSS-Loss of control” and “CPSS” were significant (p < 0.000, p < 0.000), but their “CPSS-Tension” was not significant (p = 0.231). After 12 weeks of intervention, the participants’ “CPSS-Tension”, “CPSS-Loss of control”, and “CPSS” in the fitness dance group were significant (p < 0.000, p = 0.002, p = 0.001). In the MBSR group, the participants’ “CPSS-Tension”, “CPSS-Loss of control”, and “CPSS” were also significant (p = 0.021, p < 0.000, p < 0.000). The results of differences between the 8th week and 12th week showed that the participants’ “CPSS-Tension”, “CPSS-Loss of control”, and “CPSS” in the fitness dance group were significant (p = 0.008, p = 0.01, p = 0.012). In the MBSR group, the participants’ “CPSS-Loss of control” and “CPSS” was significant (p < 0.000, p = 0.009).
Table 5.
Comparison of perceived stress and emotion regulation between the two groups at the 8th and 12th week.
| Group | Variable | Baseline–8th Week | Baseline–12th Week | 8th Week–12th Week | |||
|---|---|---|---|---|---|---|---|
| t | p | t | p | t | p | ||
| Fitness dance group (n = 38) | CPSS-Tension | −2.461 | 0.019 * | −6.151 | <0.000 ** | −3.882 | 0.008 ** |
| CPSS-Loss of control | −1.868 | 0.043 * | −4.199 | 0.002 ** | −3.395 | 0.01 * | |
| CPSS | −1.065 | 0.051 | −4.478 | 0.001 ** | −3.219 | 0.012 * | |
| ERQ-Cognitive reappraisal | 6.823 | <0.000 ** | 7.26 | <0.000 ** | 5.329 | 0.006 ** | |
| ERQ-Expressive suppression | −0.504 | 0.102 | −1.19 | 0.051 | −1.69 | 0.047 * | |
| MBSR group (n = 38) | CPSS-Tension | −0.892 | 0.231 | −2.081 | 0.021 * | −1.036 | 0.68 |
| CPSS-Loss of control | −5.337 | <0.000 ** | −6.833 | <0.000 ** | −5.916 | <0.000 ** | |
| CPSS | −5.05 | <0.000 ** | −6.27 | <0.000 ** | −3.785 | 0.009 ** | |
| ERQ-Cognitive reappraisal | 5.629 | <0.000 ** | 5.684 | <0.000 ** | 4.15 | 0.002 ** | |
| ERQ-Expressive suppression | −1.279 | 0.049 * | −1.71 | 0.047 * | −0.029 | 0.254 | |
* p < 0.05, ** p < 0.01. t: Variation within group. p: Significance level of samples’ variance between the two groups.
The results of emotion regulation of the two groups at the 8th and 12th week showed (Table 5) that, after 8 weeks of intervention, the participants’ “ERQ-Cognitive reappraisal” in the fitness dance group was significant (p < 0.000), but their “ERQ-Expressive suppression” was not significant (p = 0.102). In the MBSR group, the participants’ “ERQ-Cognitive reappraisal” and “ERQ-Expressive suppression” were both significant (p < 0.000, p = 0.049). After 12 weeks of intervention, the participants’ “ERQ-Cognitive reappraisal” in the fitness dance group was significant (p < 0.000), but their “ERQ-Expressive suppression” was not significant (p = 0.051). In the MBSR group, the participants’ “ERQ-Cognitive reappraisal” and “ERQ-Expressive suppression” were both significant (p < 0.000, p = 0.047). The results of differences between the 8th week and 12th week showed that the participants’ “ERQ-Cognitive reappraisal” and “ERQ-Expressive suppression” in the fitness dance group were significant (p = 0.006, p = 0.047). In the MBSR group, the participants’ “ERQ-Cognitive reappraisal” was significant (p = 0.002).
3.4. Correlation between Perceived Stress and Emotion Regulation in the Two Groups
As shown in Table 6, the results showed that perceived stress in the two groups (the fitness dance group and the MBSR group) was positively correlated with grade, CPSS-tension, CPSS-loss of control, ERQ-expressive suppression, and negatively correlated with ERQ cognitive reappraisal.
Table 6.
Correlation analysis of perceived stress and emotion regulation in the two groups.
| Group | Variable | CPSS | ||
|---|---|---|---|---|
| Baseline | 8th Week | 12th Week | ||
| Fitness dance group (n = 38) | Grade | 0.126 * | 0.076 | 0.045 |
| CPSS-Tension | 0.669 ** | 0.919 ** | 0.696 ** | |
| CPSS-Loss of control | 0.504 ** | 0.372 * | 0.108 * | |
| ERQ-Cognitive reappraisal | 0.998 ** | 0.606 ** | 0.402 ** | |
| ERQ-Expressive suppression | 0.916 ** | 0.770 * | 0.307 | |
| MBSR group (n = 38) | Grade | 0.134 * | 0.105 * | 0.029 |
| CPSS-Tension | 0.742 ** | 0.515 * | 0.334 * | |
| CPSS-Loss of control | 0.559 ** | 0.642 ** | 0.617 ** | |
| ERQ-Cognitive reappraisal | 0.954 ** | 0.656 ** | 0.967 ** | |
| ERQ-Expressive suppression | 0.992 ** | 0.825 ** | 0.513 ** | |
* p < 0.05, ** p < 0.01.
Based on the correlation analysis, perceived stress was taken as the dependent variable. The grade, tension, loss of control, cognitive reappraisal and expressive suppression were taken as the independent variables in the stepwise regression analysis. The results of the fitness dance group (Table 7) showed that the grade did not affect perceived stress at the 8th and 12th week. The tension and loss of control significantly positively predicted the score of perceived stress at the 8th and 12th week. The cognitive reappraisal significantly negatively predicted the score of perceived stress at the 8th and 12th week. The expressive suppression positively predicted the score of perceived stress at the 8th week.
Table 7.
Stepwise regression analysis results of fitness dance group.
| Variable | Baseline | 8th Week | 12th Week |
|---|---|---|---|
| Grade | 0.786 * (0.923) | — | — |
| CPSS-Tension | 2.543 ** (2.310) | 1.093 ** (1.575) | 1.855 ** (1.083) |
| CPSS-Loss of control | 1.087 * (7.394) | 0.389 * (3.614) | 0.056 * (0.768) |
| ERQ-Cognitive reappraisal | −5.654 ** (−3.276) | −9.011 ** (−0.190) | −3.865 * (−0.098) |
| ERQ-Expressive suppression | 0.647 * (0.812) | 0.753 * (0.967) | — |
| R2 | 0.821 | 0.886 | 0.601 |
| Adjusted R2 | 0.818 | 0.880 | 0.578 |
| F | 27.824 ** | 36.625 ** | 26.349 ** |
Dependent variable: Perceived stress, * p < 0.05, ** p < 0.01.
The results of the MBSR group (Table 8) showed that the grade positively predicted perceived stress at the 8th week. The tension, loss of control, and expressive suppression significantly positively predicted the score of perceived stress at the 8th and 12th week. The cognitive reappraisal negatively predicted the score of perceived stress at the 8th and 12th week.
Table 8.
Stepwise regression analysis results of MBSR group.
| Variable | Baseline | 8th Week | 12th Week |
|---|---|---|---|
| Grade | 0.886 * (1.023) | 0.629 * (0.574) | — |
| CPSS-Tension | 2.675 ** (2.468) | 0.859 * (1.293) | 1.039 * (0.765) |
| CPSS-Loss of control | 1.001 * (7.165) | 5.674 ** (3.574) | 4.267 ** (2.765) |
| ERQ-Cognitive reappraisal | −5.473 ** (−3.126) | −7.246 ** (−5.825) | −0.846 * (−1.506) |
| ERQ-Expressive suppression | 0.573 ** (0.801) | 2.708 ** (3.812) | 3.676 ** (5.670) |
| R2 | 0.768 | 0.765 | 0.945 |
| Adjusted R2 | 0.761 | 0.745 | 0.942 |
| F | 34.786 ** | 36.966 ** | 30.892 ** |
Dependent variable: Perceived stress, * p < 0.05, ** p < 0.01.
4. Discussion
This study showed that fitness dance and MBSR can reduce Chinese female Ph.D. candidates’ stress from severe to moderate. Specifically, fitness dance alleviated stress by reducing the tension of participants’ perceived stress and improving their cognitive reappraisal ability. Compared with fitness dance, MBSR mainly reduced the loss of control aspect of perceived stress on participants, and reduced the use of expressive suppression strategies to reduce stress. Cognitive reappraisal involves an attempt to generate a positive interpretation of a traumatizing event to reduce excessive emotionality. Expressive suppression names the attempt to modulate negative emotions by hiding, inhibiting, or reducing the behavioral response to a stressful event. Cognitive reappraisal, but not expressive suppression, is effective in reducing physiological arousal and negative emotions [62,63], and is associated with beneficial physiological and psychological outcomes [64,65]. This study also indicated that within the context of stress, expressive suppression is associated with higher levels of stress.
This study also aimed to compare the effects of fitness dance and MBSR on perceived stress and emotion regulation in Chinese female Ph.D. candidates. From the perspective of intervention time, participants reported that fitness dance reduced the tension score of participants’ perceived stress at the 8th week. MBSR reduced the participants’ sense of loss of control of perceived stress at the 8th week. At the 12th week, the two interventions both significantly reduced the total perceived stress score of the participants. From the influence of fitness dance and MBSR on the perceived stress of Chinese female Ph.D. candidates, fitness dance showed a better function of reducing the tension of perceived stress, and the reduction of perceived stress begins at the 12th week. Compared with fitness dance, MBSR reduced perceived stress at the 8th week, mainly by reducing the sense of losing control attributed to perceived stress of Chinese female Ph.D. candidates.
The important finding of this study was that the emotional regulation produced by fitness dance and MBSR has a certain mediating effect on the relationship between Chinese female Ph.D. candidates and stress. Specifically, fitness dance reduced the perceived stress of participants by improving their cognitive reappraisal ability. MBSR alleviates the perceived stress of participants by improving their cognitive reappraisal ability and expression suppression ability. The initial hypothesis of this study was that fitness dance and MBSR affect emotion regulation, thereby affecting stress, and the results confirmed the primary hypothesis. The perceived stress of the participants in the fitness dance group and the MBSR group was positively correlated with expressive suppression and negatively correlated with cognitive reappraisal. The following analysis of MBSR and fitness dance functions may provide preliminary support for the results. Existing studies have consistently shown that MBSR is a kind of psychological education, and its impact on individual cognitive reappraisal strategies and expression suppression strategies is conducive to reducing stress [56,66,67]. A systematic review with a meta-analysis indicated that psychoeducation is effective in both reducing stress and in helping people to manage stress due to trauma [68]. Fitness dance is a form of exercise intervention. The literature suggests that square dance intervention [69], aerobic dance [70], and African dance [71] are effective in reducing stress, depression, and anxiety. The findings of this study provided preliminary support for the view that fitness dance possibly reduces stress through a mechanism different from that employed in MBSR. The music contained in fitness dance has the ability to regulate emotional state and promote physical and mental interaction, and has been widely used for relaxation in medical care [72,73]. The motions of fitness dance make body and spirit perceive each other, which is the process of sensory information inside the body being transmitted and communicated to the brain and other body structures that occurs with or without conscious attention [74]. Interoception acts as a distractor to shift the individual’s attention away from the negative emotions and replace them with positive thoughts [75]. This shifting of attention serves as one of the emotion-focused coping strategies allowing individuals to cope with stress. As a result, stress and negative emotions could be healed [75]. Moreover, fitness dance is a collective sport. Research supporting the physical and mental health contributions of exercise has identified mediators such as organizational practices and the role of seeing other people who are similar to you becoming and being active, which are significant determinants of exercise engagement [76]. The evidence by Louise Mansfield et al. (2018) suggested that peer-supported delivery mechanisms in sport and dance programs may support wellbeing enhancement for young people [77]. In addition, a previous study showed that the “vitality”, “social connection”, “positive emotion”, and other positive subjective experiences contained in fitness dance are related to the improvement of cognitive reappraisal ability [33]. According to emotion regulation theory, emotion regulation can be controlled consciously and diligently, or it can be carried out automatically without consciousness and effort [61]. In the process of practicing fitness dance, female Ph.D. candidates pay attention to fitness dance practice. Many studies have shown that transference of attention can effectively regulate emotions [78,79,80], reduce stress, and reduce the level of anxiety [81,82,83]. Furthermore, fitness dance’s elements of music and body motion stimulate interoception and act as distractors to shift the individual’s attention away from negative emotions and stress and replace them with positive thoughts [7,84,85]. In the research on exercise intervention similar to fitness dance, Gao et al. (2016) showed that square dance intervention for 3 months could significantly reduce the depressive symptoms of perimenopausal women [69]. Studies pointed out that aerobic dance is popular among middle-aged women because it can help reduce stress, depression, and anxiety [70,86,87].
The results also indicated that the stress of female Chinese Ph.D. candidates is related to their grades. Performing experiments, writing a doctoral thesis, and publishing doctoral qualification papers require considerable time, energy, and financial resources [12]. With the increase of grades, if Ph.D. candidates want to graduate on time, they will have less time to complete their studies and more stress in the face of graduation and employment. As such, grade positively affects the stress score of female Chinese Ph.D. candidates.
Although the findings in this study are promising regarding the efficacy of fitness dance and MBSR interventions to reduce stress among Chinese female Ph.D. candidates, several limitations must be noted. First, the sample comprised Chinese female Ph.D. candidates; therefore, the generalizability of our findings may be limited. In future interventions, it is important to explore efficacy in more diverse samples. Second, all data collected in this study relied on self-report, which may lead to social desirability or response bias where participants respond in what they believe is a more favorable manner. Future studies warrant determining the best control condition.
5. Conclusions
The findings in this study showed that 12 weeks of fitness dance and MBSR can reduce Chinese female Ph.D. candidates’ stress from severe to moderate. Fitness dance mainly reduces Chinese female Ph.D. candidates’ stress by improving their cognitive reappraisal ability of emotion regulation. As a type of exercise intervention, fitness dance is suitable for reducing Chinese female Ph.D. candidates’ stress. MBSR, as has been shown in previous studies, can reduce Chinese female Ph.D. candidates’ stress by improving their cognitive reappraisal ability and expression suppression ability of emotion regulation in short period of time (8 weeks). It is worth noting that grade has an impact on female Ph.D. candidates’ perceived stress, which should be included in the analysis of variables in future research. This study indicates that fitness dance, as a method of exercise intervention, is suitable for reducing Chinese female Ph.D. candidates’ stress. Future research should be expanded to combine fitness dance with psychological education, such as MBSR and CBT (Cognitive Behavioral Therapy).
This study enlightens us that exercise intervention and psychological intervention are both ways to counteract stress. They are the methods aimed at promoting a healthy lifestyle. Intervention programs to relieve stress for different people should be formulated according to their physical and mental characteristics and sources of stress.
Author Contributions
D.L., B.L. and Y.M. designed the study and revised the manuscript. B.L. developed the research and collected the data. F.S. analyzed the data and created the tables and figures. Y.Z. and C.J. drafted the manuscript. All authors have read and agreed to the published version of the manuscript.
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data presented in this study are available on request from the corresponding author.
Conflicts of Interest
The authors declare no conflict of interest.
Funding Statement
This research was funded by the Planning Project of Liaoning Sports Science Association (2022LTXH082).
Footnotes
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Vasunilashorn S., Lynch S.M., Glei D.A., Weinstein M., Goldman N. Exposure to Stressors and Trajectories of Perceived Stress among Older Adults. J. Gerontol. B Psychol. 2015;70:329–337. doi: 10.1093/geronb/gbu065. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Kugelmass H., Lynch S.M. Types of stressors. In: Cockerham W.C., Dingwall R., Quah S., editors. Encyclopedia of Health, Illness, Behavior, and Society. Wiley & Sons; Chichester, UK: 2014. [DOI] [Google Scholar]
- 3.Hammen C. Stress and depression. Annu. Rev. Clin. Psychol. 2005;1:293–319. doi: 10.1146/annurev.clinpsy.1.102803.143938. [DOI] [PubMed] [Google Scholar]
- 4.Mazure C.M. Life stressors as risk factors in depression. Clin. Psychol. Sci. Pract. 1998;5:291–313. doi: 10.1111/j.1468-2850.1998.tb00151.x. [DOI] [Google Scholar]
- 5.Rasul F., Stansfeld S.A., Hart C.L., Smith G.D. Psychological distress, physical illness, and risk of coronary heart disease. J. Epidemiol. Commun. Health. 2005;59:140–145. doi: 10.1136/jech.2004.019786. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Stansfeld S.A., Fuhrer R., Shipley M.J., Marmot M. Psychological distress as a risk factor for coronary heart disease in the Whitehall II Study. Int. J. Epidemiol. 2002;31:248–255. doi: 10.1093/ije/31.1.248. [DOI] [PubMed] [Google Scholar]
- 7.Daviu N., Bruchas M.R., Moghaddam B., Sandi C., Beyeler A. Neurobiological links between stress and anxiety. Neurobiol. Stress. 2019;11:100191. doi: 10.1016/j.ynstr.2019.100191. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Kinman G., Jones F., Kinman R. The well-being of the UK academy, 1998–2004. Qual. High. Educ. 2006;12:15–27. doi: 10.1080/13538320600685081. [DOI] [Google Scholar]
- 9.Brougham R.R., Zail C.M., Mendoza C.M., Miller J.R. Stress, Sex Differences, and Coping Strategies Among College Students. Curr. Psychol. 2009;28:85–97. doi: 10.1007/s12144-009-9047-0. [DOI] [Google Scholar]
- 10.Levecque K., Anseel F., De Beuckelaer A., Van der Heyden J., Gisle L. Work organization and mental health problems in PhD students. Res. Policy. 2017;46:868–879. doi: 10.1016/j.respol.2017.02.008. [DOI] [Google Scholar]
- 11.Tang F., Byrne M., Qin P. Psychological distress and risk for suicidal behavior among university students in contemporary China. J. Affect. Disord. 2018;228:101–108. doi: 10.1016/j.jad.2017.12.005. [DOI] [PubMed] [Google Scholar]
- 12.Yuan J., Luo Y., Yan J.H., Meng X., Yu F., Li H. Neural correlates of the females’ susceptibility to negative emotions: An insight into gender-related prevalence of affective disturbances. Hum. Brain Mapp. 2009;30:3676–3686. doi: 10.1002/hbm.20796. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Grillon C., Duncko R., Covington M.F., Kopperman L., Kling M.A. Acute Stress Potentiates Anxiety in Humans. Biol. Psychiatry. 2007;62:1183–1186. doi: 10.1016/j.biopsych.2007.06.007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Fox E., Cahill S., Zougkou K. Preconscious Processing Biases Predict Emotional Reactivity to Stress. Biol. Psychiatry. 2010;67:371–377. doi: 10.1016/j.biopsych.2009.11.018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Raio C.M., Orederu T.A., Palazzolo L., Shurick A.A., Phelps E.A. Cognitive emotion regulation fails the stress test. Proc. Natl. Acad. Sci. USA. 2013;110:15139–15144. doi: 10.1073/pnas.1305706110. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Mao Y., Zhu Y., Jia C., Sun F., Chen S., Liu B. Anxiety Status of Female Chinese Ph.D. Candidates and Its Association with Sports. Healthcare. 2022;10:1203. doi: 10.3390/healthcare10071203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Suzuki Y., Tanaka S.C. Functions of the ventromedial prefrontal cortex in emotion regulation under stress. Sci. Rep. 2021;11:18225. doi: 10.1038/s41598-021-97751-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Chiauzzi E., Green T.C., Lord S., Thum C., Goldstein M. My student body: A high-risk drinking prevention Web site for college students. J. Am. Coll. Health. 2006;54:371. doi: 10.3200/JACH.53.6.263-274. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Neveu D., Doron J., Visier L., Boiché J., Trouillet R., Dujols P., Ninot G. Students perceived stress in academic programs: Consequences for its management. Rev. Epidemiol. Sante. 2012;60:255–264. doi: 10.1016/j.respe.2012.01.008. [DOI] [PubMed] [Google Scholar]
- 20.Dietrich A. Transient hypofrontality as a mechanism for the psychological effects of exercise. Psychiatry Res. 2006;145:79–83. doi: 10.1016/j.psychres.2005.07.033. [DOI] [PubMed] [Google Scholar]
- 21.Ekkekakis P., Acevedo E.O. Psychobiology of Physical Activity. American Psychological Association; Washington, DC, USA: 2006. Affective responses to acute exercise: Toward a psychobiological dose-response model; pp. 91–109. [Google Scholar]
- 22.Brown J.D., Siegel J.M. Exercise as a buffer of life stress: A prospective study of adolescent health. Health Psychol. 1988;7:341–353. doi: 10.1037/0278-6133.7.4.341. [DOI] [PubMed] [Google Scholar]
- 23.Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: A unifying theory. Clin. Psychol. Rev. 2001;21:33–61. doi: 10.1016/S0272-7358(99)00032-X. [DOI] [PubMed] [Google Scholar]
- 24.Martikainen S., Pesonen A.-K., Lahti J., Heinonen K., Feldt K., Pyhälä R., Tammelin T., Kajantie E., Eriksson J., Strandberg T., et al. Higher Levels of Physical Activity Are Associated With Lower Hypothalamic-Pituitary-Adrenocortical Axis Reactivity to Psychosocial Stress in Children. J. Clin. Endocrinol. Metab. 2013;98:E619–E627. doi: 10.1210/jc.2012-3745. [DOI] [PubMed] [Google Scholar]
- 25.Lines R.L.J., Ducker K.J., Ntoumanis N., Thogersen-Ntoumani C., Fletcher D., Gucciardi D.F. Stress, physical activity, sedentary behavior, and resilience-The effects of naturalistic periods of elevated stress: A measurement-burst study. Psychophysiology. 2021;58:e13846. doi: 10.1111/psyp.13846. [DOI] [PubMed] [Google Scholar]
- 26.Cruz S.Y., Fabián C., Pagán I., Ríos J.L., González A.M., Betancourt J., González M.J., Rivera-Soto W.T., Palacios C. Physical activity and its associations with sociodemographic characteristics, dietary patterns, and perceived academic stress in students attending college in Puerto Rico. Puerto Rico Health Sci. J. 2013;32:44–50. [PubMed] [Google Scholar]
- 27.Alessandri E., Rose D., Wasley D. Health and Wellbeing in Higher Education: A Comparison of Music and Sport Students through the Framework of Self Determination Theory. Front. Psychol. 2020;11:566307. doi: 10.3389/fpsyg.2020.566307. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Carretti G., Mirandola D., Sgambati E., Manetti M., Marini M. Survey on Psychological Well-Being and Quality of Life in Visually Impaired Individuals: Dancesport vs. Other Sound Input-Based Sports. Int. J. Environ. Res. Public Health. 2022;19:4438. doi: 10.3390/ijerph19084438. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Terry P.C., Karageorghis C.I., Curran M.L., Martin O.V., Parsons-Smith R.L. Effects of music in exercise and sport: A meta-analytic review. Psychol. Bull. 2020;146:91–117. doi: 10.1037/bul0000216. [DOI] [PubMed] [Google Scholar]
- 30.Daley A.J., Maynard I.W. Preferred exercise mode and affective responses in physically active adults. Psychol. Sport Exerc. 2003;4:347–356. doi: 10.1016/S1469-0292(02)00018-3. [DOI] [Google Scholar]
- 31.Copeland B.L., Franks B.D. Effects of types and intensities of background music on treadmill endurance. J. Sport. Med. Phys. Fit. 1991;31:100–103. [PubMed] [Google Scholar]
- 32.Zatorre R., McGill J. Music, the food of neuroscience? Nature. 2005;434:312–315. doi: 10.1038/434312a. [DOI] [PubMed] [Google Scholar]
- 33.Dunlop W.L., Beauchamp M.R. En-Gendering Choice: Preferences for Exercising in Gender-Segregated and Gender-Integrated Groups and Consideration of Overweight Status. Int. J. Behav. Med. 2011;18:216–220. doi: 10.1007/s12529-010-9125-6. [DOI] [PubMed] [Google Scholar]
- 34.Ouyang Y., Wang K., Zhang T., Peng L., Song G., Luo J. The Influence of Sports Participation on Body Image, Self-Efficacy, and Self-Esteem in College Students. Front. Psychol. 2020;10:3039. doi: 10.3389/fpsyg.2019.03039. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Dimeo F., Bauer M., Varahram I., Proest G., Halter U. Benefits from aerobic exercise in patients with major depression: A pilot study. Br. J. Sports Med. 2001;35:114–117. doi: 10.1136/bjsm.35.2.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36.Octavianna Y., Sibarani R., Situmorang H., Hasibuan N.H. The impact of Marpaniaran ‘traditional dance of women’ of Toba Batak wedding ceremony for women’s physical and mental health. Gac. Sanit. 2021;35:S537–S539. doi: 10.1016/j.gaceta.2021.07.030. [DOI] [PubMed] [Google Scholar]
- 37.Millman L.S.M., Terhune D.B., Hunter E.C.M., Orgs G. Towards a neurocognitive approach to dance movement therapy for mental health: A systematic review. Clin. Psychol. Psychother. 2021;28:24–38. doi: 10.1002/cpp.2490. [DOI] [PubMed] [Google Scholar]
- 38.Ou K.-L., Wong M.Y.C., Chung P.K., Chui K.Y.K. Effect of Square Dance Interventions on Physical and Mental Health among Chinese Older Adults: A Systematic Review. Int. J. Environ. Res. Public Health. 2022;19:6181. doi: 10.3390/ijerph19106181. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 39.Clarke A.C., Chan J.M.Y., Stott J., Royan L., Spector A. An adapted mindfulness intervention for people with dementia in care homes: Feasibility pilot study. Int. J. Geriatr. Psychiatry. 2017;32:e123–e131. doi: 10.1002/gps.4669. [DOI] [PubMed] [Google Scholar]
- 40.Paller K.A., Creery J.D., Florczak S.M., Weintraub S., Mesulam M.-M., Reber P.J., Kiragu J., Rooks J., Safron A., Morhardt D., et al. Benefits of Mindfulness Training for Patients With Progressive Cognitive Decline and Their Caregivers. Am. J. Alzheimer’s Dis. Other Dementias®. 2015;30:257–267. doi: 10.1177/1533317514545377. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 41.Hölzel B.K., Lazar S.W., Gard T., Schuman-Olivier Z., Vago D.R., Ott U. How Does Mindfulness Meditation Work? Proposing Mechanisms of Action from a Conceptual and Neural Perspective. Perspect. Psychol. Sci. 2011;6:537–559. doi: 10.1177/1745691611419671. [DOI] [PubMed] [Google Scholar]
- 42.Phang C.K., Chiang K.C., Ng L.O., Keng S.-L., Oei T.P.S. Effects of Brief Group Mindfulness-based Cognitive Therapy for Stress Reduction among Medical Students in a Malaysian University. Mindfulness. 2016;7:189–197. doi: 10.1007/s12671-015-0399-2. [DOI] [Google Scholar]
- 43.Duarte J., Pinto-Gouveia J. Mindfulness, self-compassion and psychological inflexibility mediate the effects of a mindfulness-based intervention in a sample of oncology nurses. J. Context. Behav. Sci. 2017;6:125–133. doi: 10.1016/j.jcbs.2017.03.002. [DOI] [Google Scholar]
- 44.Baer R.A., Lykins E.L., Peters J. Mindfulness and self-compassion as predictors of psychological wellbeing in long-term meditators and matched nonmeditators. J. Posit. Psychol. 2012;7:230–238. doi: 10.1080/17439760.2012.674548. [DOI] [Google Scholar]
- 45.Bluth K., Blanton P.W. Mindfulness and Self-Compassion: Exploring Pathways to Adolescent Emotional Well-Being. J. Child Fam. Stud. 2014;23:1298–1309. doi: 10.1007/s10826-013-9830-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 46.Bamber M.D., Schneider J.K. Mindfulness-based meditation to decrease stress and anxiety in college students: A narrative synthesis of the research. Educ. Res. Rev. 2016;18:1–32. doi: 10.1016/j.edurev.2015.12.004. [DOI] [Google Scholar]
- 47.Kabat-Zinn J. Mindfulness-based stress reduction (MBSR) Constr. Hum. Sci. 2003;8:73–83. [Google Scholar]
- 48.Kazantzis N., Freeman A., Reinecke M., Dattilio F. Cognitive and Behavioral Theories in Clinical Practice. Volume 33. Guilford Press; New York, NY, USA: 2009. pp. 307–331. [Google Scholar]
- 49.Zernicke K.A., Campbell T.S., Blustein P.K., Fung T.S., Johnson J.A., Bacon S.L., Carlson L.E. Mindfulness-Based Stress Reduction for the Treatment of Irritable Bowel Syndrome Symptoms: A Randomized Wait-list Controlled Trial. Int. J. Behav. Med. 2013;20:385–396. doi: 10.1007/s12529-012-9241-6. [DOI] [PubMed] [Google Scholar]
- 50.Yang T., Huang H. An epidemiological study on the psychological pressure of urban residents in social transformation. Chin. J. Epidemiol. 2003;24:11–15. [Google Scholar]
- 51.Caldwell K., Harrison M., Adams M., Quin R.H., Greeson J. Developing Mindfulness in College Students through Movement-Based Courses: Effects on Self-Regulatory Self-Efficacy, Mood, Stress, and Sleep Quality. J. Am. Coll. Health. 2010;58:433–442. doi: 10.1080/07448480903540481. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 52.Grubic N., Badovinac S., Johri A.M. Student mental health in the midst of the COVID-19 pandemic: A call for further research and immediate solutions. Int. J. Soc. Psychiatry. 2020;66:517–518. doi: 10.1177/0020764020925108. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 53.Jiang H., Jin L.M., Qian X., Xiong X., La X.N., Chen W.Y., Yang X.G., Yang F.Y., Zhang X.W., Abudukelimu N., et al. Maternal Mental Health Status and Approaches for Accessing Antenatal Care Information During the COVID-19 Epidemic in China: Cross-Sectional Study. J. Med. Internet Res. 2021;23:e18722. doi: 10.2196/18722. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 54.Li J., Rose N. Urban social exclusion and mental health of China’s rural-urban migrants—A review and call for research. Health Place. 2017;48:20–30. doi: 10.1016/j.healthplace.2017.08.009. [DOI] [PubMed] [Google Scholar]
- 55.Yang T., Rockett I.R.H., Yang X., Xu X. Patterns and correlates of stress among rural Chinese males: A four-region study. Public Health. 2009;123:694–698. doi: 10.1016/j.puhe.2009.08.003. [DOI] [PubMed] [Google Scholar]
- 56.Gross J.J., John O.P. Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. J. Pers. Soc. Psychol. 2003;85:348–362. doi: 10.1037/0022-3514.85.2.348. [DOI] [PubMed] [Google Scholar]
- 57.Brandão T., Schulz M.S., Gross J.J., Matos P.M. The emotion regulation questionnaire in women with cancer: A psychometric evaluation and an item response theory analysis. Psycho Oncol. 2017;26:1647–1653. doi: 10.1002/pon.4356. [DOI] [PubMed] [Google Scholar]
- 58.Melka S.E., Lancaster S.L., Bryant A.R., Rodriguez B.F. Confirmatory factor and measurement invariance analyses of the emotion regulation questionnaire. J. Clin. Psychol. 2011;67:1283–1293. doi: 10.1002/jclp.20836. [DOI] [PubMed] [Google Scholar]
- 59.Moore S.A., Zoellner L.A., Mollenholt N. Are expressive suppression and cognitive reappraisal associated with stress-related symptoms? Behav. Res. Ther. 2008;46:993–1000. doi: 10.1016/j.brat.2008.05.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 60.Peng Y., Min H., Chen Y. An Item Response Theory Analysis of the Emotion Regulation Questionnaire. Gerontologist. 2016;56:281. [Google Scholar]
- 61.Ferguson C.J. An effect size primer: A guide for clinicians and researchers. Prof. Psychol. Res. Pract. 2009;40:532–538. doi: 10.1037/a0015808. [DOI] [Google Scholar]
- 62.Gross J.J. Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology. 2002;39:281–291. doi: 10.1017/S0048577201393198. [DOI] [PubMed] [Google Scholar]
- 63.Hagemann T., Levenson R.W., Gross J.J. Expressive suppression during an acoustic startle. Psychophysiology. 2006;43:104–112. doi: 10.1111/j.1469-8986.2006.00382.x. [DOI] [PubMed] [Google Scholar]
- 64.Aldao A., Nolen-Hoeksema S., Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clin. Psychol. Rev. 2010;30:217–237. doi: 10.1016/j.cpr.2009.11.004. [DOI] [PubMed] [Google Scholar]
- 65.John O.P., Gross J.J. Healthy and Unhealthy Emotion Regulation: Personality Processes, Individual Differences, and Life Span Development. J. Pers. 2004;72:1301–1334. doi: 10.1111/j.1467-6494.2004.00298.x. [DOI] [PubMed] [Google Scholar]
- 66.Lopez-Maya E., Olmstead R., Irwin M.R. Mindfulness meditation and improvement in depressive symptoms among Spanish- and English speaking adults: A randomized, controlled, comparative efficacy trial. PLoS ONE. 2019;14:e0219425. doi: 10.1371/journal.pone.0219425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 67.Proulx J., Croff R., Oken B., Aldwin C.M., Fleming C., Bergen-Cico D., Le T., Noorani M. Considerations for Research and Development of Culturally Relevant Mindfulness Interventions in American Minority Communities. Mindfulness. 2018;9:361–370. doi: 10.1007/s12671-017-0785-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 68.Van Daele T., Hermans D., Van Audenhove C., Van den Bergh O. Stress Reduction through Psychoeducation: A Meta-Analytic Review. Health Educ. Behav. 2012;39:474–485. doi: 10.1177/1090198111419202. [DOI] [PubMed] [Google Scholar]
- 69.Gao L., Zhang L., Qi H., Petridis L. Middle-aged Female Depression in Perimenopausal Period and Square Dance Intervention. Psychiatr. Danub. 2016;28:372–378. [PubMed] [Google Scholar]
- 70.Mastura J., Fauzee O.M.S., Bahaman A.S., Abd R.S., Somchit M.N. Effect of Low-Impact Aerobic Dance Exercise on Psychological Health (Stress) among Sedentary Women in Malaysia. Biol. Sport. 2012;29:63–69. [Google Scholar]
- 71.West J., Otte C., Geher K., Johnson J., Mohr D.C. Effects of hatha yoga and african dance on perceived stress, affect, and salivary cortisol. Ann. Behav. Med. 2004;28:114–118. doi: 10.1207/s15324796abm2802_6. [DOI] [PubMed] [Google Scholar]
- 72.Kattenstroth J.-C., Kalisch T., Holt S., Tegenthoff M., Dinse H.R. Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions. Front. Aging Neurosci. 2013;5:5. doi: 10.3389/fnagi.2013.00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 73.Kim S.-H., Kim M., Ahn Y.-B., Lim H.-K., Kang S.-G., Cho J.-H., Park S.-J., Song S.-W. Effect of dance exercise on cognitive function in elderly patients with metabolic syndrome: A pilot study. J. Sports Sci. Med. 2011;10:671–678. [PMC free article] [PubMed] [Google Scholar]
- 74.Hindi F.S. How Attention to Interoception Can Inform Dance/Movement Therapy. Am. J. Dance Ther. 2012;34:129–140. doi: 10.1007/s10465-012-9136-8. [DOI] [Google Scholar]
- 75.Dieterich-Hartwell R. Dance/movement therapy in the treatment of post traumatic stress: A reference model. Arts Psychother. 2017;54:38–46. doi: 10.1016/j.aip.2017.02.010. [DOI] [Google Scholar]
- 76.Bauman A.E., Reis R.S., Sallis J.F., Wells J.C., Loos R.J., Martin B.W. Correlates of physical activity: Why are some people physically active and others not? Lancet. 2012;380:258–271. doi: 10.1016/S0140-6736(12)60735-1. [DOI] [PubMed] [Google Scholar]
- 77.Mansfield L., Kay T., Meads C., Grigsby-Duffy L., Lane J., John A., Daykin N., Dolan P., Testoni S., Julier G., et al. Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: A systematic review. BMJ Open. 2018;8:e020959. doi: 10.1136/bmjopen-2017-020959. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 78.Beard C., Sawyer A.T., Hofmann S.G. Efficacy of Attention Bias Modification Using Threat and Appetitive Stimuli: A Meta-Analytic Review. Behav. Ther. 2012;43:724–740. doi: 10.1016/j.beth.2012.01.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 79.See J., MacLeod C., Bridle R. The reduction of anxiety vulnerability through the modification of attentional bias: A real-world study using a home-based cognitive bias modification procedure. J. Abnorm. Psychol. 2009;118:65–75. doi: 10.1037/a0014377. [DOI] [PubMed] [Google Scholar]
- 80.O’Toole L., Dennis T.A. Attention training and the threat bias: An ERP study. Brain Cogn. 2012;78:63–73. doi: 10.1016/j.bandc.2011.10.007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 81.Heeren A., Reese H.E., McNally R.J., Philippot P. Attention training toward and away from threat in social phobia: Effects on subjective, behavioral, and physiological measures of anxiety. Behav. Res. Ther. 2012;50:30–39. doi: 10.1016/j.brat.2011.10.005. [DOI] [PubMed] [Google Scholar]
- 82.Heeren A., Peschard V., Philippot P. The Causal Role of Attentional Bias for Threat Cues in Social Anxiety: A Test on a Cyber-Ostracism Task. Cogn. Ther. Res. 2012;36:512–521. doi: 10.1007/s10608-011-9394-7. [DOI] [Google Scholar]
- 83.Weber M., Schnorr T., Morat M., Morat T., Donath L. Effects of Mind–Body Interventions Involving Meditative Movements on Quality of Life, Depressive Symptoms, Fear of Falling and Sleep Quality in Older Adults: A Systematic Review with Meta-Analysis. Int. J. Environ. Res. Public Health. 2020;17:6556. doi: 10.3390/ijerph17186556. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 84.Bendel-Rozow T. Ph.D. Thesis. Lesley University; Cambridge, MA, USA: 2020. Recovery-Oriented Dance Movement Therapy: A Controlled Trial in Mental Health Rehabilitation. [Google Scholar]
- 85.Schmalzl L., Crane-Godreau M.A., Payne P. Movement-based embodied contemplative practices: Definitions and paradigms. Front. Hum. Neurosci. 2014;8:205. doi: 10.3389/fnhum.2014.00205. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 86.Park W., Park H.-Y. New Trend of Physical Activity and Exercise for Health Promotion and Functional Ability. Int. J. Environ. Res. Public Health. 2022;19:7939. doi: 10.3390/ijerph19137939. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 87.Cavazzatto T.G., Ronque E.R.V., Vieira E.R., Queiroga M.R., Junior H.S. Social-Ecological Correlates of Regular Leisure-Time Physical Activity Practice among Adults. Int. J. Environ. Res. Public Health. 2020;17:3619. doi: 10.3390/ijerph17103619. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data presented in this study are available on request from the corresponding author.