The Effect of Cognitive Behavior Therapy-Based “Forest Therapy” Program on Blood Pressure, Salivary Cortisol Level, and Quality of Life in Elderly Hypertensive Patients

Sung, Jidong; Woo, Jong Min; Kim, Won; Lim, Se Hun; Chung, Eun-Joo

doi:10.3109/10641963.2011.618195

Cited by 132 publications

(155 citation statements)

References 15 publications

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“…The significant reduction of cortisol levels in the CBT group is in agreement with several studies reporting the effects of CBT in cortisol levels in different populations (Matousek et al, 2011;Sharpley, 2010;Sung et al, 2012). However, our findings differ from those reported by Williams et al (2010) and Vedhara et al (2003), who did not find significant differences in cortisol levels after a CBT intervention for caregivers of patients with dementia.…”

Section: Discussionsupporting

confidence: 86%

“…An improvement of psychophysiological parameters of stress, with decreased secretion of cortisol after CBT was reported in studies with different clinical populations such as women presenting hypothalamic amenorrhea (Michopoulos, Mancini, Loucks, & Berga, 2013), patients with chronic medical conditions (Matousek, Pruessner, & Dobkin, 2011), hypertension (Sung, Woo, Kim, Lim, & Chung, 2012), specific phobia (Brand, Annen, Holsboer-Trachsler, & Blaser, 2011) and depression (Sharpley, 2010). Only two studies assessed changes in cortisol release in caregivers of dementia patients after a psychological intervention (Vedhara et al, 2003;Williams et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Cognitive–behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease

Aboulafia-Brakha¹,

Suchecki

Gouveia-Paulino

et al. 2014

Aging & Mental Health

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Background: Family caregivers of patients with dementia frequently experience psychological stress, depression and disturbed psychophysiological activity, with increased levels of diurnal cortisol secretion. Objectives: To compare the effects of a cognitive-behavioural group therapy (CBT) to a psychoeducation group programme (EDUC) on cortisol secretion in caregivers of patients with moderate Alzheimer's disease (AD). Method: Caregivers of AD outpatients were semi-randomly allocated to one of two intervention programmes (CBT or EDUC) consisting of eight weekly sessions. Twenty-six participants completed the study. Before and after intervention, salivary cortisol was collected at four different times of the day. Effects of the interventions were evaluated with selfreport psychological scales and questionnaires related to functional abilities and neuropsychiatric symptoms of the AD relative. Results: Only in the CBT group did salivary cortisol levels significantly decrease after intervention, with a large effect size and high achieved power. Both groups reported a reduction of neuropsychiatric symptoms of their AD relative after intervention. Conclusion: Psychoeducation for caregivers may contribute to a reduction of neuropsychiatric symptoms of AD patients while CBT additionally attenuates psychophysiological responses to stressful situations in caregivers, by reducing diurnal cortisol levels. This may lead to a positive impact in the general health of the caregiver, eventually resulting in better care of the AD patient.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Cognitive–behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease

Aboulafia-Brakha¹,

Suchecki

Gouveia-Paulino

et al. 2014

Aging & Mental Health

View full text Add to dashboard Cite

show abstract

“…Therefore, stress management strategies are frequently complex and need to be matched to the requirements of individual patients, beginning with the presumably positive diagnosis of a stress-induced disorder and continuing through rehabilitation and training to cope with distress. The use of validated saliva-based biomarkers as indicators of stress-induced body system vulnerability (allostatic overload) could support patients in improving their strategies to cope with challenging life events, through non-pharmacological approaches (11,58,86 –88). …”

Section: Discussionmentioning

confidence: 99%

Salivary cortisol and α-amylase: subclinical indicators of stress as cardiometabolic risk

Cozma

et al. 2017

Braz J Med Biol Res

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Currently, the potential for cardiovascular (CV) stress-induced risk is primarily based on the theoretical (obvious) side effects of stress on the CV system. Salivary cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response, are still not included in the routine evaluation of CV risk and require additional and definitive validation. Therefore, this article overviews studies published between 2010 and 2015, in which salivary cortisol and α-amylase were measured as stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk) clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science and Scopus electronic databases was performed, and 54 key articles related to the use of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR factors, including studies that emphasized methodological biases that could influence the accuracy of study outcomes, were ultimately identified. Overall, the biological impact of stress measured by salivary cortisol and α-amylase was associated with CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as potential diagnostic tools for detecting stress-induced cardiac diseases and especially to describe the mechanisms by which stress potentially contributes to the pathogenesis and outcomes of CV diseases.

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“…Recently, in Asian countries, such as China and Japan, forest bathing has received increasing attention due to its health-promoting effects, including enhancing immune functions and decreasing blood pressure in hypertension patients, as well as stress relief effects. Specifically, South Korea is a leading country applying forest therapy, e.g., the official designation of forests for human health, and quite a large number of studies about forest therapy on human health have been published from South Korea, such as providing physical relaxation, soothing anxiety, and even relieving pain in individuals with chronic widespread pain [13,14]. Our previous work indicated that forest bathing lowered the circulating endothelin-1 (ET-1) level in normal young subjects or old patients with hypertension [15,16], which is known as one of the most potent vasoconstrictors and is always recognized as a stimulator on cardiovascular diseases [17].…”

Section: Introductionmentioning

confidence: 99%

The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure

Mao

Cao

Wang

et al. 2017

IJERPH

121

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The aim of the current study was to test the hypothesis that forest bathing would be beneficial for elderly patients with chronic heart failure (CHF) as an adjunctive therapy. Two groups of participants with CHF were simultaneously sent to the forest or an urban control area for a four-day trip, respectively. Subjects exposed to the forest site showed a significant reduction of brain natriuretic peptide (BNP) in comparison to that of the city group and their own baseline levels. The values for the cardiovascular disease related pathological factors, including endothelin-1 (ET-1), and constituents of the renin-angiotensin system (RAS), including renin, angiotensinogen (AGT), angiotensin II (ANGII), and ANGII receptor type 1 or 2 (AT1 or AT2) in subjects exposed to the forest environment were lower than those in the urban control group. Obviously, a decreased level of inflammatory cytokines and improved antioxidant function was observed in the forest group rather than in the city group. The assessment of the profile of mood states (POMS) indicated that the negative emotional mood state was alleviated after forest bathing. As anticipated, a better air quality in the forest site was observed according to the detection of PM2.5 (particulate matter <2.5 μm) and negative ions. These results provided direct evidence that forest bathing has a beneficial effect on CHF patients, and thus may pave the way for potential development of forest bathing as an effective adjunctive therapy on cardiovascular disorders.

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The Effect of Cognitive Behavior Therapy-Based “Forest Therapy” Program on Blood Pressure, Salivary Cortisol Level, and Quality of Life in Elderly Hypertensive Patients

Abstract: The forest therapy program did not induce prolonged systolic blood pressure (SBP) reduction. However, considering the significant decrease in cortisol level and improvement in QoL measures, this may be a useful model of community hypertension management program.

Cited by 132 publications

References 15 publications

Cognitive–behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease

Cognitive–behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease

Salivary cortisol and α-amylase: subclinical indicators of stress as cardiometabolic risk

The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure

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