Enhancing Mental Health Awareness in Adolescent Girls through the Application of Complementary Therapies: A Quasi-Experimental Study
DOI:
https://doi.org/10.56294/hl2025919Keywords:
Journaling, Yoga Pranayama, Self-Hypnosis, Mental health awareness, Adolescent girlsAbstract
Introduction: mental health awareness is an important concept for adolescent girls. In general, adolescent girls have a higher prevalence of anxiety and depression than boys. The problem-solving method used in this study provided interventions through complementary therapies such as journaling, yoga pranayama, and self-hypnosis. Therefore, this study aimed to determine the application of Journaling, Yoga Pranayama, and Self-hypnosis in increasing mental health awareness in adolescent girls within Badung Regency, Bali.
Method: a quasi-experimental method was used to evaluate the application of journaling, yoga pranayama, and self-hypnosis in increasing mental health awareness. The respondents were adolescent girls divided into three different groups, given Journaling, Yoga Pranayama, and Self-Hypnosis methods, respectively. Before and after the intervention, the respondents were tested using the Depression Anxiety and Stress Scales Youth version (DASS-Y) to determine anxiety, stress, and depression.
Results: the Wilcoxon test showed significant reductions across all interventions: journaling reduced depression (p = 0,005), anxiety (p = 0,008), and stress (p = 0,018); yoga pranayama reduced depression (p = 0,022), anxiety (p = 0,018), and stress (p = 0,048); and self-hypnosis reduced depression (p = 0,001), anxiety (p = 0,001), and stress (p = 0,003). The Kruskal–Wallis test revealed no significant differences between the three interventions for depression (p = 0,417), anxiety (p = 0,539), or stress (p = 0,109).
Conclusion: Journaling, yoga pranayama, and self-hypnosis interventions can reduce anxiety, stress, and depression in adolescent girls.
References
1. Binagwaho A, Senga J. Children and Adolescent Mental Health in a Time of COVID-19: A Forgotten Priority. Ann Glob Heal. 2021 Jun;87(1):57. DOI: https://doi.org/10.5334/aogh.3330
2. Widyawati. Kemenkes Beberkan Masalah Permasalahan Kesehatan Jiwa di Indonesia – Sehat Negeriku. Kementerian Kesehatan Republik Indonesia. 2021.
3. Campbell OLK, Bann D, Patalay P. The gender gap in adolescent mental health : A cross-national investigation of 566 , 829 adolescents across 73 countries. SSM - Popul Heal. 2021;13(January). DOI: https://doi.org/10.1016/j.ssmph.2021.100742
4. Amirah Ellyza Wahdi, Setyawan A, Putri YA, Wilopo SA, Erskine HE, Wallis K, et al. National Adolescent Mental Health Survey (I-NAMHS). 1st ed. Wahdi AE, Kuntoro AA, editors. Yogyakarta: Pusat Kesehatan Reproduksi; 2022.
5. Suardana IW, Yusuf A, Hargono R, Juanamasta IG, Sudiantara K, Gama IK, et al. Spiritual coping “tri hita karana” and depression prevention behavior among the elderly during the Covid-19 pandemic. Healthc Low-resource Settings [Internet]. 2024 Sep 9; Available from: https://www.pagepressjournals.org/hls/article/view/13025 DOI: https://doi.org/10.4081/hls.2024.13025
6. Suardana IW, Yusuf A, Hargono R, Juanamasta IG. Spiritual Coping “Tri Hita Karana” among Older Adults during Pandemic COVID-19: A Perspective of Balinese Culture. Univers J Public Heal [Internet]. 2023 Jun;11(3):297–304. Available from: http://www.hrpub.org/journals/article_info.php?aid=13268 DOI: https://doi.org/10.13189/ujph.2023.110303
7. Winurini S. Penanganan Kesehatan Mental. Vol. XV, Pusat Penelitian Badan Keahlian DPR RI. 2023.
8. Sudarmi SLP, Widiastini LP, Karuniadi IGAM. Yoga Pranayama Reduce Anxiety Facing Labor In Pregnant Women Trimester III at PMB in the work area of the Abiansemal I Health Center. J Kesehat Pasak Bumi Kalimantan. 2022;5(2):162–6. DOI: https://doi.org/10.30872/j.kes.pasmi.kal.v5i2.8563
9. Sohal M, Singh P, Dhillon BS, Gill HS. Efficacy of journaling in the management of mental illness : a systematic review and meta- analysis. Fam Med Community Heal. 2022;10:1–7. DOI: https://doi.org/10.1136/fmch-2021-001154
10. Sawni A, Breuner CC. Clinical Hypnosis , an Effective Mind – Body Modality for Adolescents with Behavioral and Physical Complaints. Children. 2017;4(16):1–12. DOI: https://doi.org/10.3390/children4040019
11. Juanamasta IG. Pengaruh Hipnoterapi terhadap Peningkatan Kualitas Tidur [Internet]. STIKes Wira Medika Bali; 2012. Available from: https://www.academia.edu/13229581/Pengaruh_Hipnoterapi_terhadap_Peningkatan_Kualitas_Tidur
12. Alexiou E, Kotsoni A, Stalikas A. The Effectiveness of an Online Positive Psychology Intervention among Healthcare Professionals with Depression , Anxiety or Stress Symptoms and Burnout. Psychology. 2021;12:392–408. DOI: https://doi.org/10.4236/psych.2021.123025
13. Kawitri AZ, Rahmawati BD, Arruum R, Rahmatika R. Self-Compassion and Resilience among Adolescents Living at Social Shelters. J Psikogenes. 2019;7(1):76–83. DOI: https://doi.org/10.24854/jps.v7i1.879
14. Fekete EM, Deichert NT. A Brief Gratitude Writing Intervention Decreased Stress and Negative Affect During the COVID‑19 Pandemic. J Happiness Stud. 2022;23(6):2427–48. DOI: https://doi.org/10.1007/s10902-022-00505-6
15. Gupta MK, Singh AR. Exploring the Therapeutic Effect of Yoga to Enhance Psychological Well-being among Adolescent Girl Students. J Educ Soc Behav Sci. 2022;35(2):13–9. DOI: https://doi.org/10.9734/jesbs/2022/v35i230402
16. Widiastini LP, Karuniadi IGAM, Saraswati PAD. Penyuluhan dan Yoga Suryanamaskar Menurunkan Tingkat Stress serta Dismenore pada Remaja Putri. Gemakes J Pengabdi Kpd Masy. 2023;3(2):203–9. DOI: https://doi.org/10.36082/gemakes.v3i2.1294
17. Juanamasta IG, Priastana IKA. Yoga affect to system immune: A systematic review. In: Proceeding ICON 3, International Conference on Nursing. Malang: Universitas Brawijaya; 2017. p. 206–17.
18. Lestari TR, Wati NMN, Juanamasta IG, Thrisnadewi NLP, Sintya NKA. Pengaruh Terapi Yoga (Paschimottanasana dan Adho Mukha Padmasana) terhadap Intensitas Nyeri pada Remaja Putri yang Mengalami Dismenore Primer. J Heal Sci Prev. 2019;3(2):94–100. DOI: https://doi.org/10.29080/jhsp.v3i2.221
19. Juanamasta IG, Wati NMN, Widana AAGOGO. Covid-19: A balinese viewpoint. Belitung Nurs J. 2020;6(4):143–4. DOI: https://doi.org/10.33546/bnj.1133
20. Eliyawati, Susanti NY, Hikmah R. Penyuluhan dan Pelatihan Self Hypnosis pada Remaja Putri Untuk Mengurangi Kecemasan Psikologis Menuju Dewasa Awal. J ALTIFANI. 2024;4(1):51–8. DOI: https://doi.org/10.59395/altifani.v4i1.515
21. Szabo M, Lovibond PF. Development and Psychometric Properties of the DASS-Youth ( DASS-Y ): An Extension of the Depression Anxiety Stress Scales (DASS) to Adolescents and Children. Front Psycology. 2022;13(April):1–16. DOI: https://doi.org/10.3389/fpsyg.2022.766890
22. Galderisi S. The need for a consensual definition of mental health. World Psychiatry. 2024 Feb;23(1):52–3. DOI: https://doi.org/10.1002/wps.21150
23. World Health Organization (WHO). Adolescent mental health. World Health Organization; 2024.
24. Grogans SE, Bliss-Moreau E, Buss KA, Clark LA, Fox AS, Keltner D, et al. The nature and neurobiology of fear and anxiety: State of the science and opportunities for accelerating discovery. Neurosci Biobehav Rev. 2023 Aug;151:105237. DOI: https://doi.org/10.1016/j.neubiorev.2023.105237
25. Suhr M, Risch AK, Wilz G. Maintaining Mental Health Through Positive Writing : Effects of a Resource Diary on Depression and Emotion Regulation. J Clin Psychol. 2017;00(0):1–13. DOI: https://doi.org/10.1002/jclp.22463
26. Smyth JM, Johnson JA, Auer BJ, Lehman E, Talamo G, Sciamanna CN. Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial. JMIR Ment Heal. 2018 Dec;5(4):e11290. DOI: https://doi.org/10.2196/11290
27. MacIsaac A, Mushquash AR, Wekerle C. Writing Yourself Well : Dispositional Self-Reflection Moderates the Effect of a Smartphone App-Based Journaling Intervention on Psychological Wellbeing across Time. Behav Chang. 2023;40(March):297–313. DOI: https://doi.org/10.1017/bec.2022.24
28. Norman ED. Express Yourself : A Study on Expressive Writing and State Anxiety. Andrews University; 2020.
29. R P, Kumar AP, Dhamodhini K S, Venugopal V, Silambanan S, K M, et al. Role of yoga in stress management and implications in major depression disorder. J Ayurveda Integr Med. 2023 Sep;14(5):100767. DOI: https://doi.org/10.1016/j.jaim.2023.100767
30. Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017 Dec;86:152–68. DOI: https://doi.org/10.1016/j.psyneuen.2017.08.008
31. Novaes MM, Palhano-Fontes F, Onias H, Andrade KC, Lobão-Soares B, Arruda-Sanchez T, et al. Effects of Yoga Respiratory Practice (Bhastrika pranayama) on Anxiety, Affect, and Brain Functional Connectivity and Activity : A Randomized Controlled Trial. Front Psychiatry. 2020;11(May):1–13. DOI: https://doi.org/10.3389/fpsyt.2020.00467
32. Yadav P. A Review of Bhramari Pranayama’s Impact on Mental Health. Int Res J Ayurveda Yoga. 2023;6(5):43–6. DOI: https://doi.org/10.47223/IRJAY.2023.6507
33. Kuppusamy M, Kamaldeen D, Pitani R, Amaldas J. Effects of Bhramari Pranayama on health e A systematic review. J Tradit Complement Med. 2018;8(1):11–6. DOI: https://doi.org/10.1016/j.jtcme.2017.02.003
34. Prakash P, Boominathan P, Mahalingam S. Acoustic Description of Bhramari Pranayama. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(S3):4738–47. DOI: https://doi.org/10.1007/s12070-021-03054-1
35. Shah MR, Kothari PH. Effects of Nadi- Shodhana Pranayama on Depression, Anxiety, Stress and Peak Expiratory Flow Rate in Post CABG Patients : Experimental Study. Int J Heal Sci Res Orig Res. 2019;9(October):40–6.
36. Ojas A, Pandey P, Dalal S. Effects of nadi-shodhan pranayama and yoga-nidra on emotional maturity and mental health of young adults. Int J Indian Psychol. 2020;8(4).
37. Madaan L, Basavaraddi I V, Jain K. Comparative effect of Yogasana and pranayama on depression , anxiety and stress levels in adults practitioners. Int J Indian Psychol. 2020;8(3).
38. Wan J, Pang V, Subramaniam P, Amit N, Wahab S, Moustafa AA, et al. Hypnotherapy as Treatment for Depression : A Scoping Review Hypnotherapy as Treatment for Depression : A Scoping Review. Int J Clin Exp Hypn. 2024;72(2):155–88. DOI: https://doi.org/10.1080/00207144.2024.2317193
39. Lynn SJ, Green JP, Polizzi CP, Ellenberg S, Gautam A, Aksen D. Hypnosis, Hypnotic Phenomena, and Hypnotic Responsiveness : Clinical and Research Foundations — A 40-Year Perspective. Int J Clin Exp Hypn. 2019;67(4):475–511. DOI: https://doi.org/10.1080/00207144.2019.1649541
40. Valentine KE, Milling LS, Clark LJ, Moriarty CL. The Efficacy of Hypnosis as a Treatment for Anxiety : A Meta-Analysis. Int J Clin Exp Hypn. 2019;67(3):336–63. DOI: https://doi.org/10.1080/00207144.2019.1613863
41. Pachaiappan S, Tee MY, Low WY. Effect of Self-Hypnosis on Test Anxiety among Secondary School Students in Malaysia. Int J Clin Exp Hypn. 2023;71(4):338–49. DOI: https://doi.org/10.1080/00207144.2023.2246512
42. Latt CML, Alldredge CT, Williams S, Vinson M, Moris JS, Elkins GR. Mindful Self-Hypnosis Combined with Resistance Training to Reduce Perceived Stress and Improve Other Psychological Factors in Female College Students. Int J Clin Exp Hypn. 2024;72(3):254–73. DOI: https://doi.org/10.1080/00207144.2024.2346609
43. Olendzki N, Elkins GR, Slonena E, Hung J, Rhodes JR. Mindful Hypnotherapy to Reduce Stress and Increase Mindfulness : A Randomized Controlled Pilot Study. Int J Clin Exp Hypn. 2020;68(2):151–66. DOI: https://doi.org/10.1080/00207144.2020.1722028
44. Fisch S, Trivakovi S, Roll S, Keller T, Binting S, Cree M, et al. Group hypnosis for stress reduction and improved stress coping : a multicenter randomized controlled trial. BMC Complement Med Ther. 2020;6:1–14. DOI: https://doi.org/10.1186/s12906-020-03129-6
45. Souza FL, Moura MS, Silva JVA, Elkins G. Hypnosis for depression: Systematic review of randomized clinical trials with meta-analysis. Complement Ther Clin Pract. 2024;57(November). DOI: https://doi.org/10.1016/j.ctcp.2024.101913
46. Karrasch S, Bongartz W, Behnke A, Matits L, Kolassa IT. The Effects of a Single Relaxation Hypnosis Session on Mental Stress in Chronically Stressed Individuals. Z Klin Psychol Psychother. 2022;51:247–62. DOI: https://doi.org/10.1026/1616-3443/a000679
47. Reynaud D, Bruneau L. Feasibility and acceptance of self- hypnosis to reduce chronic stress levels on family in- home caregivers of elderly people : protocol for the POSSAID pilot , list controlled trial. BMJ J. 2022;12(12):1–8. DOI: https://doi.org/10.1136/bmjopen-2022-066749
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