Effects of tai chi chuan on psychobiological indicators of anxiety and sleep qual

描述(申请人提供)：本研究的长期目标是调查太极拳对青少年焦虑症状和睡眠质量的影响。据估计，焦虑症在一生中影响着25%的人口，并与巨大的个人、社会和经济代价有关。睡眠质量差的人患焦虑症的可能性是1.97到6.3倍，患精神障碍的可能性是一般人的4.0倍(Taylor，Lichstein，&Durence，2003)。青春期和青春期是焦虑症早期迹象发展的关键时期。认知行为干预和药物干预可用于治疗焦虑，但精神疾病的诊断带有耻辱，使许多年轻人远离这些标准治疗。锻炼是一种前景看好的低成本干预措施，负面副作用最小，是治疗焦虑和睡眠质量差的替代疗法。最近的一项荟萃分析 研究发现，体育锻炼干预对焦虑症状的影响程度适中，但锻炼产生这些影响的方式在很大程度上仍不清楚(Wipfli，Rethorst，&Landers，2008)。[特别是对于太极拳，最近的另一项荟萃分析发现，对焦虑症状的影响程度适中(Wang等人，2010年)。]Brosscht，Gerin和Thayer(2006)假设，持之以恒的认知可以缓和应激源的健康后果，因为它可以延长与应激相关的情感和生理激活。他们将持之以恒的认知定义为包含一个或多个心理压力源的重复性思维。基于他们的理论，我们提出了太极拳练习可以通过两个过程来改善压力和焦虑症状：(1)认知上通过减少持之以恒的认知和改善心理功能；(2)在生理上通过减少慢性生理唤醒。[我们提出了一项随机对照试验，比较太极拳和压力管理教育组在焦虑和睡眠质量方面的变化。这项研究的主要目的是确定一个方案的可行性，以比较这两个组的效果，包括我们的招募、筛选、随机、保留和测量方法。这项研究的第二个目的是阐明与焦虑症状的减少和睡眠质量的改善相关的心理生物学过程。目标生物标记物是唾液皮质醇、唾液α-淀粉酶和心脏自主神经调节。有关太极拳对焦虑和睡眠质量的反应的信息将对制定年轻人的治疗建议很有价值。 公共卫生相关性：青春期和青春期是焦虑症早期迹象发展的关键时期。认知-行为和药物干预可用于治疗焦虑，但精神疾病的诊断需要 这是一种耻辱，让许多年轻人远离这些标准治疗，药物干预可能会产生负面副作用。关于谁对太极拳做出反应的信息将对制定治疗建议非常有价值，这些建议适用于患有焦虑症状和伴随而来的睡眠质量较差的年轻人。

DESCRIPTION (provided by applicant): The long-term objective of this research is to investigate the effects of tai chi chuan on symptoms of anxiety and sleep quality in young adults. Anxiety disorders are estimated to affect 25% of the population over the lifetime and are associated with significant personal, social and economic costs. People with poor sleep quality are 1.97 to 6.3 times more likely to develop anxiety disorders and 4.0 times more likely to develop psychiatric disorders in general (Taylor, Lichstein, & Durrence, 2003). Adolescence and young adulthood are key times for development of early signs of anxiety disorders. Cognitive-behavioral and pharmacological interventions are available for treatment of anxiety, but the diagnosis of a mental illness carries a stigma that keeps many young people away from these standard treatments. Exercise is a promising low-cost intervention with minimal negative side effects that is an alternative treatment for anxiety and poor sleep quality. A recent meta-analysis found moderate effect sizes for physical exercise interventions on symptoms of anxiety, but the means by which exercise has these effects remains largely unknown (Wipfli, Rethorst, & Landers, 2008). [Specifically for tai chi chuan, another recent meta-analysis found moderate effect sizes on symptoms of anxiety (Wang et al., 2010).] Brosschot, Gerin, and Thayer (2006) hypothesized that perseverative cognition moderates the health consequences of stressors because it can prolong stress-related affective and physiological activation. They define perseverative cognition as repetitive thoughts containing a representation of one or more psychological stressors. Based on their theory, we propose two processes through which the mindful exercise practice of tai chi chuan may ameliorate the effects of stress and symptoms of anxiety: (1) cognitively by reducing perseverative cognition and improving psychological functioning, and (2) physiologically by reducing chronic physiological arousal. [We propose a randomized controlled trial comparing tai chi chuan with a stress management education group on changes in anxiety and sleep quality. The primary aim of this study is to determine the feasibility of a protocol to compare the effects of these two groups including our recruitment, screening, randomization, retention, and measurement methods. The secondary aim of this study is to elucidate psychobiological processes associated with reductions in symptoms of anxiety and improvements in sleep quality. Targeted biomarkers are salivary cortisol, salivary alpha-amylase, and cardiac autonomic modulation. Information about the response of anxiety and sleep quality to tai chi chuan will be valuable in formulating treatment recommendations for young adults. PUBLIC HEALTH RELEVANCE: Adolescence and young adulthood are key times for development of early signs of anxiety disorders. Cognitive-behavioral and pharmacological interventions are available for treatment of anxiety, but the diagnosis of a mental illness carries a stigma that keeps many young people away from these standard treatments, and pharmacological interventions can have negative side effects. Information about who responds to tai chi chuan will be valuable in formulating treatment recommendations for young adults with symptoms of anxiety and attendant poor sleep quality.