I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
,
p
p
.
76
0
~
77
2
I
SS
N:
2
2
5
2
-
8
8
0
6
,
DOI
: 1
0
.
1
1
5
9
1
/ijp
h
s
.
v
1
4
i
2
.
2
5
2
2
4
760
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//
ijp
h
s
.
ia
esco
r
e.
co
m
Electroencep
ha
lo
g
ra
phy
and hea
rt
rate va
ria
bility p
ro
g
no
stics
in mental
hea
lth
t
hera
pies for Ma
la
y
sia
n
w
o
rkers
Nurna
dia
h Z
a
m
ri
1
,
Sa
m
ha
ni I
s
m
a
il
2
,
Azim
a
h Is
m
a
il
3
,
No
rsu
ha
ily
Abu
B
a
k
a
r
4
,
Siti
Nura
ni H
a
s
s
a
n
5
,
T
ua
n Sha
ri
pa
h
T
ua
n H
a
di
6
,
Am
ir
Z
ulh
ilm
i Y
a
ha
y
a
6
,
Cho
ng
Siew
K
o
o
n
7
,
No
r
Azm
i
Abu B
a
k
a
r
1
1
F
a
c
u
l
t
y
o
f
I
n
f
o
r
m
a
t
i
c
s
a
n
d
C
o
mp
u
t
i
n
g
,
U
n
i
v
e
r
s
i
t
i
S
u
l
t
a
n
Z
a
i
n
a
l
A
b
i
d
i
n
,
B
e
su
t
C
a
mp
u
s,
Te
r
e
n
g
g
a
n
u
,
M
a
l
a
y
si
a
2
F
a
c
u
l
t
y
o
f
M
e
d
i
c
i
n
e
,
U
n
i
v
e
r
s
i
t
i
S
u
l
t
a
n
Z
a
i
n
a
l
A
b
i
d
i
n
,
M
e
d
i
c
a
l
C
a
m
p
u
s,
Te
r
e
n
g
g
a
n
u
,
M
a
l
a
y
s
i
a
3
F
a
c
u
l
t
y
o
f
D
e
si
g
n
,
I
n
n
o
v
a
t
i
v
e
a
n
d
Te
c
h
n
o
l
o
g
y
,
U
n
i
v
e
r
si
t
i
S
u
l
t
a
n
Z
a
i
n
a
l
A
b
i
d
i
n
,
G
o
n
g
B
a
d
a
k
C
a
m
p
u
s,
Te
r
e
n
g
g
a
n
u
,
M
a
l
a
y
si
a
4
F
a
c
u
l
t
y
o
f
A
p
p
l
i
e
d
S
o
c
i
a
l
S
c
i
e
n
c
e
s
,
U
n
i
v
e
r
si
t
i
S
u
l
t
a
n
Za
i
n
a
l
A
b
i
d
i
n
,
G
o
n
g
B
a
d
a
k
C
a
m
p
u
s
,
T
e
r
e
n
g
g
a
n
u
,
M
a
l
a
y
si
a
5
N
a
t
i
o
n
a
l
I
n
st
i
t
u
t
e
o
f
O
c
c
u
p
a
t
i
o
n
a
l
S
a
f
e
t
y
a
n
d
H
e
a
l
t
h
,
B
a
n
d
a
r
B
a
r
u
B
a
n
g
i
,
S
e
l
a
n
g
o
r
,
M
a
l
a
y
s
i
a
6
D
e
p
a
r
t
me
n
t
o
f
P
sy
c
h
i
a
t
r
y
a
n
d
M
e
n
t
a
l
H
e
a
l
t
h
,
H
o
s
p
i
t
a
l
S
u
l
t
a
n
a
h
N
u
r
Z
a
h
i
r
a
h
,
K
u
a
l
a
T
e
r
e
n
g
g
a
n
u
,
M
a
l
a
y
si
a
7
D
e
p
a
r
t
me
n
t
o
f
P
sy
c
h
i
a
t
r
y
a
n
d
M
e
n
t
a
l
H
e
a
l
t
h
,
H
o
s
p
i
t
a
l
K
u
a
l
a
Lu
m
p
u
r
,
J
a
l
a
n
P
a
h
a
n
g
,
K
u
a
l
a
Lu
mp
u
r
,
M
a
l
a
y
s
i
a
Art
icle
I
nfo
AB
S
T
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
Ma
y
2
7
,
2
0
2
4
R
ev
is
ed
Oct
1
5
,
2
0
2
4
Acc
ep
ted
Oct
30
,
2
0
2
4
G
lo
b
a
ll
y
,
o
v
e
r
a
m
il
li
o
n
in
d
i
v
i
d
u
a
ls
su
c
c
u
m
b
t
o
su
ici
d
e
a
n
n
u
a
ll
y
,
wit
h
d
e
p
re
ss
io
n
c
o
n
tri
b
u
t
in
g
to
6
.
7
%
o
f
th
e
se
trag
ic
d
e
a
th
s.
S
u
c
h
c
rise
s
o
ften
ste
m
fro
m
li
fe
-
i
n
d
u
c
e
d
p
re
ss
u
re
s,
e
sc
a
latin
g
in
t
o
se
v
e
re
m
e
n
tal
h
e
a
lt
h
issu
e
s.
Re
c
o
g
n
izin
g
t
h
e
se
e
a
rly
sig
n
s
is
p
iv
o
tal,
b
u
t
i
n
su
fficie
n
t
wit
h
o
u
t
e
ffe
c
ti
v
e
th
e
ra
p
e
u
ti
c
m
e
a
su
re
s.
Th
is
stu
d
y
e
n
d
e
a
v
o
rs
to
a
d
d
re
ss
th
e
se
c
h
a
l
len
g
e
s
b
y
e
x
p
lo
r
in
g
p
a
ti
e
n
t
re
sp
o
n
se
s
to
t
h
e
ra
p
y
u
si
n
g
e
lec
tro
e
n
c
e
p
h
a
lo
g
ra
m
(
EE
G
)
a
n
d
h
e
a
rt
ra
te
v
a
riab
il
it
y
(HRV
)
d
a
ta.
Co
n
d
u
c
ted
in
Ku
a
la
Tere
n
g
g
a
n
u
,
M
a
lay
sia
,
th
e
re
se
a
rc
h
i
n
v
o
lv
e
s
wo
rk
e
rs
a
n
d
e
m
p
lo
y
s
a
ro
m
a
th
e
ra
p
y
,
d
e
e
p
b
re
a
th
i
n
g
e
x
e
rc
ise
s,
a
n
d
ru
q
y
a
h
a
lo
n
g
si
d
e
a
c
o
n
tr
o
l
g
ro
u
p
.
EE
G
a
n
d
HR
V
sig
n
a
ls
m
o
n
it
o
r
b
ra
in
wa
v
e
p
a
tt
e
r
n
s
a
n
d
h
e
a
rt
rh
y
t
h
m
c
o
h
e
re
n
c
e
,
a
id
in
g
i
n
i
d
e
n
ti
f
y
in
g
d
e
p
re
ss
io
n
,
stre
ss
,
a
n
d
a
n
x
iet
y
in
d
ica
to
rs.
I
n
teg
ra
ti
n
g
q
u
e
sti
o
n
n
a
ire
d
a
ta
in
c
lu
d
in
g
t
h
e
d
e
p
re
ss
io
n
-
a
n
x
iet
y
-
stre
ss
-
sc
a
le
(DA
S
S
),
b
e
c
k
d
e
p
re
ss
io
n
in
v
e
n
to
r
y
(BDI),
b
e
c
k
a
n
x
iety
i
n
v
e
n
to
r
y
(BAI),
a
n
d
sta
ti
stica
l
a
n
a
ly
sis,
t
h
e
stu
d
y
a
ims
to
e
v
a
l
u
a
te
th
e
ra
p
e
u
t
ic
e
ffica
c
y
in
e
n
h
a
n
c
i
n
g
re
lax
a
ti
o
n
a
n
d
m
e
n
tal
we
ll
-
b
e
in
g
.
M
e
tri
c
s
li
k
e
HRV
c
o
h
e
re
n
c
e
ra
ti
o
a
n
d
EE
G
d
e
lt
a
wa
v
e
a
c
ti
v
it
y
o
ffe
r
in
si
g
h
ts
in
to
th
e
ra
p
y
o
p
ti
m
iza
ti
o
n
.
Re
su
l
ts
su
g
g
e
st
d
e
e
p
b
re
a
th
i
n
g
e
x
e
rc
ise
s a
n
d
a
ro
m
a
th
e
ra
p
y
a
s m
o
st effe
c
ti
v
e
i
n
i
n
d
u
c
in
g
c
a
lmn
e
ss
,
fo
l
lo
we
d
b
y
ru
q
y
a
h
.
B
y
tailo
r
in
g
t
h
e
ra
p
y
to
in
d
iv
id
u
a
l
n
e
e
d
s,
e
sp
e
c
ial
ly
a
m
o
n
g
wo
rk
e
rs,
th
e
stu
d
y
e
n
d
e
a
v
o
rs
to
fo
ste
r
m
e
n
tal
h
e
a
lt
h
re
sili
e
n
c
e
in
c
o
m
m
u
n
it
ies
,
p
a
v
in
g
t
h
e
p
a
t
h
t
o
wa
rd
s a
m
e
n
tally
h
e
a
lt
h
ier p
o
p
u
lac
e
.
K
ey
w
o
r
d
s
:
B
r
ain
wav
es
E
lectr
o
en
ce
p
h
al
o
g
r
am
Hea
r
t r
ate
v
ar
iab
ilit
y
Me
n
tal
h
ea
lth
T
h
er
ap
ies
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Nu
r
n
ad
iah
Z
am
r
i
Facu
lty
o
f
I
n
f
o
r
m
atics a
n
d
C
o
m
p
u
tin
g
,
Un
iv
er
s
iti Su
ltan
Z
ain
al
Ab
id
in
B
esu
t Cam
p
u
s
,
2
2
2
0
0
B
esu
t,
T
er
en
g
g
a
n
u
,
Ma
lay
s
ia
E
m
ail: n
ad
iah
za
m
r
i@
u
n
is
za
.
e
d
u
.
m
y
1.
I
NT
RO
D
UCT
I
O
N
Me
n
tal
h
ea
lth
is
a
s
ig
n
i
f
ican
t
co
n
ce
r
n
in
to
d
a
y
’
s
s
o
ciet
y
.
Me
n
tal
well
-
b
ei
n
g
in
cl
u
d
es
m
u
ltip
le
d
im
en
s
io
n
s
,
s
u
ch
as
em
o
tio
n
a
l
r
ea
ctio
n
s
,
co
g
n
itiv
e
p
r
o
ce
s
s
es,
b
eh
av
io
r
s
,
a
n
d
s
o
cial
r
elatio
n
s
h
ip
s
.
T
h
e
W
o
r
ld
Hea
lth
Or
g
an
izatio
n
(
W
HO)
[
1
]
h
as
n
o
ted
th
at
ap
p
r
o
x
i
m
at
ely
2
5
%
o
f
E
u
r
o
p
ea
n
s
ex
p
e
r
ien
ce
m
en
tal
h
ea
lth
is
s
u
es.
I
n
2
0
2
1
,
W
HO
[
1
]
als
o
n
o
ted
th
at
th
er
e
wer
e
1
9
0
,
9
0
0
d
ea
th
s
in
t
h
e
E
u
r
o
p
ea
n
U
n
io
n
r
esu
ltin
g
f
r
o
m
m
en
tal
an
d
b
eh
a
v
io
r
al
d
is
o
r
d
e
r
s
,
ac
co
u
n
tin
g
f
o
r
3
.
6
%
o
f
all
d
ea
th
s
.
Ad
d
itio
n
ally
,
a
2
0
2
2
s
u
r
v
ey
r
ev
ea
le
d
th
at
5
5
%
o
f
ad
u
lts
ac
r
o
s
s
E
u
r
o
p
e
a
r
e
at
r
is
k
o
f
d
ep
r
ess
io
n
,
with
c
o
u
n
tr
ies
lik
e
Po
lan
d
,
Gr
ee
ce
,
an
d
C
y
p
r
u
s
h
a
v
in
g
th
e
h
ig
h
est
s
h
a
r
es
at
6
5
%.
R
esear
ch
h
as
co
n
s
is
ten
tly
h
i
g
h
lig
h
ted
th
e
p
r
ev
alen
ce
o
f
co
n
d
itio
n
s
s
u
ch
as
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
lectro
en
ce
p
h
a
lo
g
r
a
p
h
y
a
n
d
h
ea
r
t ra
te
va
r
ia
b
ilit
y
p
r
o
g
n
o
s
t
ics in
men
ta
l h
ea
lth
…
(
N
u
r
n
a
d
ia
h
Za
mri
)
761
d
ep
r
ess
io
n
,
a
n
x
iety
,
an
d
s
tr
ess
am
o
n
g
in
d
iv
id
u
als
wo
r
k
in
g
i
n
s
er
v
ice
-
o
r
ien
ted
jo
b
s
.
Acc
o
r
d
in
g
to
W
an
g
et
a
l.
[
2
]
,
a
2
0
2
2
r
ep
o
r
t r
ev
ea
le
d
th
a
t 5
7
.
8
m
illi
o
n
ad
u
lts
(
2
2
.
8
%)
i
n
th
e
US e
x
p
er
ie
n
ce
d
m
e
n
tal
illn
ess
,
1
9
.
4
m
illi
o
n
(
7
.
6
%)
h
ad
b
o
th
s
u
b
s
tan
ce
s
u
s
e
d
is
o
r
d
er
a
n
d
m
en
tal
illn
ess
,
an
d
1
2
.
3
m
illi
o
n
(
4
.
8
%)
s
er
io
u
s
ly
co
n
tem
p
late
d
s
u
icid
e.
I
n
Den
m
ar
k
,
7
1
.
4
%
o
f
s
ch
o
o
l
lead
er
s
s
h
o
wed
ad
e
q
u
ate
h
ea
lth
liter
ac
y
,
b
u
t
wo
r
k
l
o
ad
escalatio
n
was
h
ig
h
er
am
o
n
g
th
o
s
e
with
in
s
u
f
f
icien
t
liter
ac
y
(
8
1
.
6
%)
co
m
p
ar
ed
to
th
o
s
e
with
s
u
f
f
ici
en
t
li
ter
ac
y
(
6
6
.
0
%)
[
3
]
.
Me
an
wh
ile,
Du
r
an
d
-
M
o
r
ea
u
et
a
l.
[
4
]
f
o
u
n
d
in
c
o
n
clu
s
iv
e
ev
id
en
ce
o
n
th
e
e
f
f
icac
y
o
f
m
in
d
f
u
ln
ess
f
o
r
im
p
r
o
v
in
g
wo
r
k
er
s
'
m
en
tal
h
ea
lth
,
h
ig
h
lig
h
t
h
in
g
th
e
n
ee
d
f
o
r
m
o
r
e
r
i
g
o
r
o
u
s
an
d
s
tan
d
ar
d
i
ze
d
r
esear
ch
in
th
is
ar
ea
.
Giv
en
t
h
e
wid
esp
r
ea
d
m
en
tal
h
ea
lth
is
s
u
es
am
o
n
g
wo
r
k
er
s
,
it'
s
cr
u
cial
to
ex
ten
d
th
ese
in
v
esti
g
atio
n
s
s
p
ec
if
ically
to
s
er
v
ice
wo
r
k
e
r
s
.
Ma
lay
s
ia,
lik
e
m
an
y
o
th
e
r
n
a
tio
n
s
,
f
ac
es
s
ig
n
if
ican
t
m
en
ta
l
h
ea
lth
ch
allen
g
es,
p
ar
ticu
la
r
ly
with
in
s
er
v
ice
in
d
u
s
tr
ies,
with
o
n
e
in
th
r
ee
Ma
lay
s
ian
s
ag
ed
1
6
an
d
a
b
o
v
e
d
ea
lin
g
with
m
e
n
tal
h
ea
lth
is
s
u
es,
ac
co
r
d
in
g
to
th
e
Min
is
tr
y
o
f
Hea
lth
Ma
l
ay
s
ia.
Mo
h
am
ed
et
a
l.
[
5
]
ass
ess
ed
o
cc
u
p
atio
n
al
s
tr
ess
am
o
n
g
p
o
lice
o
f
f
icer
s
u
s
in
g
p
o
lice
s
tr
ess
q
u
esti
o
n
n
air
es
(
PS
Q)
an
d
f
o
u
n
d
th
at
a
m
o
n
g
Ma
lay
s
ian
p
o
lice
o
f
f
ic
er
s
,
4
1
.
1
%
r
ep
o
r
ted
m
o
d
er
ate
d
e
p
r
ess
io
n
,
4
5
%
ex
p
er
ien
ce
d
m
o
d
er
ate
an
x
iety
,
an
d
3
1
.
8
%
u
n
d
er
wen
t
m
o
d
er
ate
s
tr
ess
.
T
h
e
m
ajo
r
ity
o
f
p
o
lice
o
f
f
icer
s
e
x
p
er
ien
ce
d
m
o
d
e
r
ate
to
s
ev
er
e
lev
els
o
f
d
e
p
r
ess
io
n
,
a
n
x
iety
,
a
n
d
s
tr
ess
d
u
r
in
g
th
e
C
OVI
D
-
1
9
p
an
d
em
ic.
Ad
d
itio
n
ally
,
Azm
i
et
a
l.
[
6
]
e
x
am
i
n
ed
Ma
lay
s
ia'
s
wo
r
k
p
lace
m
e
n
tal
h
ea
lth
laws
an
d
p
o
licies,
co
m
p
ar
in
g
th
em
with
th
o
s
e
in
d
ev
elo
p
ed
C
o
m
m
o
n
w
ea
lth
co
u
n
tr
ies
lik
e
th
e
UK.
Us
in
g
q
u
alitativ
e
an
d
co
m
p
ar
ativ
e
m
eth
o
d
s
,
t
h
ey
a
n
aly
ze
d
th
e
p
r
in
ci
p
les
an
d
e
f
f
ec
tiv
en
ess
o
f
th
ese
f
r
am
ew
o
r
k
s
.
T
h
eir
s
tu
d
y
co
n
clu
d
e
d
th
at
Ma
lay
s
ia
n
ee
d
s
a
co
m
p
r
eh
e
n
s
iv
e
leg
al
f
r
am
e
wo
r
k
an
d
ef
f
ec
tiv
e
p
o
licies
to
s
u
p
p
o
r
t
wo
r
k
p
lace
m
en
tal
h
ea
lth
,
lear
n
in
g
f
r
o
m
t
h
e
UK'
s
m
o
r
e
ad
v
an
ce
d
ap
p
r
o
ac
h
es.
T
h
en
,
Ab
d
u
llah
et
a
l.
[
7
]
in
v
esti
g
ated
th
e
im
p
ac
t
o
f
p
s
y
ch
o
s
o
cial
f
ac
to
r
s
(
d
ec
is
io
n
latitu
d
e,
s
o
cial
s
u
p
p
o
r
t,
a
n
d
wo
r
k
in
g
en
v
ir
o
n
m
en
t)
o
n
em
p
lo
y
ee
s
'
m
en
tal
h
ea
lth
an
d
ex
am
in
ed
th
e
m
o
d
er
atin
g
ef
f
ec
t
o
f
em
o
tio
n
al
d
is
tr
ess
.
An
aly
zin
g
r
esp
o
n
s
es
f
r
o
m
2
1
6
em
p
lo
y
ee
s
in
p
r
i
v
ate
d
ev
elo
p
m
en
t
co
m
p
a
n
ies,
th
eir
r
esu
lts
s
h
o
wed
th
at
o
n
ly
d
ec
is
io
n
la
titu
d
e
s
ig
n
if
ican
tly
af
f
ec
ts
m
e
n
tal
illn
ess
,
wh
ile
em
o
tio
n
al
d
is
tr
ess
d
o
es n
o
t m
o
d
er
ate
th
is
r
elatio
n
s
h
ip
.
T
h
eir
s
tu
d
y
s
u
g
g
ested
th
at
p
r
o
v
id
i
n
g
em
p
lo
y
ee
s
with
g
r
ea
ter
d
ec
is
io
n
-
m
ak
i
n
g
f
r
e
ed
o
m
ca
n
r
ed
u
ce
m
e
n
tal
il
ln
ess
an
d
e
n
h
an
ce
p
r
o
d
u
ctiv
ity
.
Mu
n
ian
d
y
et
a
l.
[
8
]
ass
ess
ed
awa
r
en
ess
an
d
p
e
r
ce
p
tio
n
s
o
f
m
en
tal
illn
ess
wit
h
in
th
e
Ma
lay
s
ian
co
n
s
tr
u
ctio
n
in
d
u
s
tr
y
,
aim
i
n
g
to
id
en
tif
y
f
ac
to
r
s
c
o
n
tr
ib
u
tin
g
to
m
en
tal
h
ea
lth
is
s
u
es
am
o
n
g
e
m
p
lo
y
ee
s
an
d
th
eir
im
p
ac
t
o
n
ab
s
en
teeism
an
d
p
r
esen
teeism
.
Usi
n
g
a
q
u
an
titativ
e
ap
p
r
o
ac
h
,
th
eir
s
tu
d
y
f
o
u
n
d
th
at
wh
ile
m
o
s
t
co
n
s
tr
u
ctio
n
wo
r
k
er
s
r
ep
o
r
ted
s
tab
le
m
en
tal
h
ea
lth
,
th
er
e
wer
e
n
o
tab
le
in
s
tan
ce
s
o
f
an
x
iety
,
s
tr
ess
,
d
ep
r
ess
io
n
,
an
d
PTSD,
p
a
r
ticu
lar
ly
a
m
o
n
g
y
o
u
n
g
er
,
wh
ite
-
co
llar
em
p
lo
y
ee
s
with
less
wo
r
k
ex
p
e
r
ien
ce
an
d
in
s
ec
u
r
e
e
m
p
lo
y
m
e
n
t.
T
h
ei
r
r
esear
ch
h
ig
h
lig
h
ted
th
e
n
ee
d
f
o
r
ac
tiv
e
atten
tio
n
to
m
e
n
tal
h
ea
lt
h
b
y
s
ch
o
lar
s
a
n
d
g
o
v
er
n
m
en
tal
a
g
en
cies,
with
f
in
d
i
n
g
s
s
h
o
win
g
a
b
s
en
teeism
an
d
p
r
esen
teeism
r
ates
o
f
5
.
8
%
an
d
2
2
.
4
%,
r
esp
ec
tiv
ely
,
lead
in
g
to
s
ig
n
if
i
ca
n
t
co
s
ts
.
Ad
d
itio
n
ally
,
b
u
r
n
o
u
t
was
p
r
ev
alen
t
am
o
n
g
Ma
lay
s
ian
ju
n
io
r
d
o
cto
r
s
(
2
6
.
5
%)
a
n
d
u
n
iv
er
s
ity
ac
a
d
e
m
ician
s
(
1
0
.
7
%)
[
9
]
,
u
n
d
er
s
co
r
in
g
th
e
u
r
g
e
n
t
n
ee
d
f
o
r
f
u
r
th
e
r
r
esear
ch
to
ad
d
r
ess
m
en
tal
h
ea
lth
co
n
ce
r
n
s
.
B
ey
o
n
d
e
x
p
lo
r
i
n
g
s
tatis
tics
a
n
d
th
e
m
e
n
tal
h
ea
lth
lan
d
s
ca
p
e,
u
p
co
m
in
g
d
is
cu
s
s
io
n
s
will
ce
n
ter
o
n
th
er
ap
eu
tic
a
p
p
r
o
ac
h
es,
in
clu
d
in
g
ar
o
m
ath
er
a
p
y
.
Xie
et
a
l
.
[
1
0
]
h
i
g
h
lig
h
ted
th
e
b
en
ef
it
s
o
f
ar
o
m
ath
er
ap
y
,
s
h
o
win
g
its
p
o
ten
tial to
allev
ia
te
p
h
y
s
ical
s
y
m
p
to
m
s
,
r
e
d
u
ce
s
tr
ess
an
d
an
x
iety
,
an
d
en
h
a
n
c
e
m
o
o
d
.
Similar
ly
,
Kwo
n
et
a
l.
[
1
1
]
d
em
o
n
s
tr
ate
d
ar
o
m
ath
er
ap
y
'
s
p
o
s
itiv
e
ef
f
e
cts
o
n
em
o
tio
n
al
well
-
b
ein
g
a
n
d
f
atig
u
e
r
e
d
u
ctio
n
d
u
r
in
g
ex
er
cise.
I
n
ad
d
itio
n
t
o
ar
o
m
ath
e
r
ap
y
,
d
ee
p
b
r
ea
th
i
n
g
s
er
v
es
as
an
alter
n
ativ
e
f
o
r
m
an
ag
in
g
m
en
tal
h
ea
lth
,
as
s
h
o
wn
b
y
Ma
h
ala
k
s
h
m
i
et
a
l.
[
1
2
]
,
wh
o
f
o
u
n
d
s
i
g
n
if
ican
t
s
tr
ess
r
ed
u
ctio
n
an
d
an
x
iety
allev
iatio
n
th
r
o
u
g
h
d
ee
p
b
r
ea
th
in
g
ex
er
ci
s
es.
An
alter
n
ativ
e
m
eth
o
d
e
x
p
lo
r
ed
b
y
I
s
m
ail
an
d
R
o
f
i
[
1
3
]
u
tili
zin
g
r
u
q
y
ah
s
h
o
ws
p
r
o
m
is
e
in
tr
ea
tin
g
m
e
n
tal
d
is
o
r
d
er
s
th
r
o
u
g
h
s
p
ir
itu
al
ap
p
r
o
ac
h
es.
Ho
wev
er
,
n
o
n
e
o
f
th
ese
th
er
ap
ies
h
av
e
y
et
u
tili
ze
d
m
o
d
e
r
n
d
ev
ic
es
ca
p
ab
le
o
f
ca
p
tu
r
in
g
m
en
tal
h
ea
lth
in
d
icat
o
r
s
f
r
o
m
b
o
th
elec
tr
o
en
ce
p
h
al
o
g
r
am
(
EEG
)
an
d
h
ea
r
t r
ate
v
ar
iab
ilit
y
(
HR
V
)
.
R
ec
en
t
s
tu
d
ies
h
av
e
u
tili
ze
d
E
E
G
an
d
H
R
V
d
ev
ices
to
d
e
tect
an
d
a
n
aly
ze
v
ar
io
u
s
m
en
tal
h
ea
lth
co
n
d
itio
n
s
.
H
o
wev
er
,
s
im
p
ly
r
ely
in
g
o
n
ea
r
ly
d
etec
tio
n
is
n
o
t
s
u
f
f
icien
t
to
p
r
ev
en
t
m
en
tal
d
is
o
r
d
er
s
[
1
4
]
.
I
t
is
cr
u
cial
to
im
p
lem
en
t
ef
f
ec
tiv
e
th
er
ap
eu
tic
i
n
ter
v
en
tio
n
s
to
m
an
ag
e
th
ese
co
n
d
itio
n
s
.
E
v
alu
a
tin
g
th
e
p
r
o
g
r
ess
o
f
p
atien
ts
ca
n
b
e
ch
allen
g
in
g
d
u
e
to
in
h
er
en
t
b
iases
an
d
d
iv
er
s
e
th
eo
r
etica
l
o
r
ien
tatio
n
s
am
o
n
g
clin
ician
s
[
15]
–
[
1
9
]
.
T
h
is
r
esear
ch
aim
s
to
e
x
p
lo
r
e
p
atien
t
r
esp
o
n
s
es
to
d
if
f
e
r
en
t
th
e
r
ap
ies,
em
p
lo
y
in
g
E
E
G
an
d
HR
V
s
ig
n
al
d
ata.
T
h
e
t
h
er
ap
e
u
tic
ap
p
r
o
ac
h
will
in
clu
d
e
a
r
o
m
a
th
er
ap
y
,
d
ee
p
b
r
ea
th
in
g
ex
er
cises
,
r
u
q
y
ah
,
an
d
co
m
p
ar
is
o
n
s
with
a
co
n
tr
o
l
g
r
o
u
p
.
T
h
er
a
p
y
s
ess
io
n
s
an
d
c
o
n
s
u
ltatio
n
s
will
b
e
h
eld
f
o
r
w
o
r
k
er
s
in
th
e
Ku
ala
T
er
en
g
g
a
n
u
r
eg
io
n
.
B
y
u
tili
zin
g
E
E
G
an
d
HR
V
s
ig
n
als,
th
e
r
esear
ch
aim
s
to
ca
p
tu
r
e
b
r
ai
n
wav
e
p
atter
n
s
an
d
h
ea
r
t
r
h
y
th
m
s
,
en
a
b
lin
g
th
e
id
en
tific
atio
n
o
f
p
h
y
s
ical
in
d
i
ca
to
r
s
r
elate
d
to
d
ep
r
ess
io
n
,
s
tr
e
s
s
,
an
d
an
x
iety
th
r
o
u
g
h
b
o
th
v
is
u
al
a
n
d
au
d
ito
r
y
m
eth
o
d
s
.
T
h
e
s
tu
d
y
will
a
n
aly
ze
f
in
d
in
g
s
f
r
o
m
s
tan
d
ar
d
ized
q
u
esti
o
n
n
air
es
d
ep
r
ess
io
n
an
x
iety
s
tr
ess
s
ca
le
(
DASS
)
,
b
ec
k
an
x
iety
in
d
ex
(
B
AI
)
,
b
ec
k
d
ep
r
ess
io
n
in
d
ex
(
B
DI
)
co
llected
v
ia
an
o
n
lin
e
p
latf
o
r
m
(
e
-
MA
S
T
)
,
alo
n
g
s
id
e
E
E
G
an
d
HR
V
d
at
a,
u
s
in
g
ap
p
r
o
p
r
iate
s
tatis
tical
an
aly
s
is
m
eth
o
d
s
.
T
h
u
s
,
th
is
r
esear
ch
aim
s
to
p
r
o
v
id
e
a
m
o
r
e
in
teg
r
ated
,
o
b
je
ctiv
e,
an
d
c
o
n
tex
tu
ally
r
elev
a
n
t
u
n
d
er
s
tan
d
in
g
o
f
th
e
ef
f
icac
y
o
f
v
ar
io
u
s
m
e
n
tal
h
ea
lth
th
er
ap
ies
am
o
n
g
Ma
la
y
s
ian
wo
r
k
er
s
,
co
n
s
o
lid
atin
g
d
a
ta
f
r
o
m
DASS,
B
AI
,
an
d
B
DI
alo
n
g
with
E
E
G
an
d
HR
V
m
ea
s
u
r
em
en
ts
[
1
5
]
–
[
1
9
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
7
6
0
-
7
7
2
762
T
h
is
p
ap
er
is
s
tr
u
ctu
r
ed
in
th
e
f
o
llo
win
g
way
:
I
n
Sectio
n
2
,
th
e
tech
n
iq
u
es
u
tili
ze
d
f
o
r
ca
p
t
u
r
in
g
HR
V
an
d
E
E
G
d
ata
d
u
r
in
g
th
er
a
p
y
s
ess
io
n
s
ar
e
d
escr
ib
ed
.
Secti
o
n
3
p
r
esen
ts
th
e
o
v
e
r
ar
ch
in
g
f
in
d
in
g
s
r
elate
d
to
d
em
o
g
r
a
p
h
ics,
DASS,
B
DI
,
a
n
d
B
AI
c
o
llected
f
r
o
m
th
e
e
-
MA
ST
p
latf
o
r
m
.
Sectio
n
4
o
f
f
er
s
an
an
aly
s
is
o
f
HR
V
an
d
E
E
G
o
u
tc
o
m
es
f
r
o
m
v
ar
io
u
s
th
er
ap
e
u
tic
ap
p
r
o
ac
h
es.
L
astl
y
,
Sectio
n
5
r
ev
iews
th
e
f
in
d
in
g
s
o
f
th
e
s
tu
d
y
an
d
s
u
g
g
ests
p
o
s
s
ib
le
d
ir
ec
tio
n
s
f
o
r
f
u
tu
r
e
r
esear
ch
.
2.
P
RO
CE
DUR
E
F
O
R
M
E
NT
AL
H
E
A
L
T
H
T
H
E
RAP
Y
T
h
is
s
ec
tio
n
o
u
tlin
es
th
e
p
r
o
p
o
s
ed
s
tep
-
by
-
s
tep
p
r
o
ce
d
u
r
e
f
o
r
co
n
d
u
ctin
g
t
h
e
r
esear
ch
a
n
d
ac
h
iev
in
g
all
th
e
estab
li
s
h
ed
g
o
als.
T
o
ac
co
m
p
lis
h
th
e
o
b
jectiv
es
o
u
tlin
ed
,
th
e
th
er
ap
y
will
b
e
co
n
d
u
cted
in
f
o
u
r
s
eq
u
e
n
tial
p
h
ases
:
−
Step
1
:
I
d
en
tify
t
h
e
tar
g
et
r
e
s
p
o
n
d
en
t
g
r
o
u
p
an
d
u
tili
ze
th
e
e
-
MA
ST
web
p
latf
o
r
m
f
o
r
d
is
tr
ib
u
tin
g
th
e
q
u
esti
o
n
n
air
es.
E
ac
h
r
esp
o
n
d
en
t
will
r
esp
o
n
d
to
a
s
er
ies
o
f
q
u
esti
o
n
n
air
es
d
esig
n
ed
to
ev
alu
ate
th
eir
m
e
n
tal
h
ea
lth
co
n
d
itio
n
u
s
in
g
th
e
e
-
MA
ST
to
o
l
as sh
o
wn
in
Fig
u
r
e
1
.
T
h
is
p
r
o
ce
s
s
in
clu
d
es two
p
r
im
ar
y
s
ec
tio
n
s
: PA
R
T
A,
wh
ich
co
llects
d
em
o
g
r
ap
h
ic
d
ata,
an
d
PAR
T
B
,
co
n
s
i
s
tin
g
o
f
a
m
en
tal
h
ea
lth
s
cr
ee
n
in
g
a
s
s
es
s
m
en
t
b
ased
o
n
th
e
DASS
2
1
f
r
am
ew
o
r
k
.
I
n
v
itatio
n
s
h
av
e
b
ee
n
ex
te
n
d
ed
to
1
5
2
c
o
m
p
a
n
ies
lo
ca
ted
in
th
e
Ku
ala
T
er
en
g
g
an
u
r
eg
io
n
,
wh
ic
h
en
co
m
p
ass
es
s
er
v
ice
in
d
u
s
tr
ies
in
b
o
th
Ku
al
a
T
er
en
g
g
a
n
u
an
d
Ku
ala
Ner
u
s
,
Ma
lay
s
ia.
On
ce
r
esp
o
n
s
es
ar
e
s
u
b
m
itted
,
th
e
e
-
MA
ST
s
y
s
tem
will
au
t
o
m
atica
lly
an
aly
ze
th
e
r
esu
lts
an
d
p
r
o
v
id
e
a
co
m
p
r
eh
e
n
s
iv
e
ev
alu
atio
n
o
f
m
en
tal
h
ea
lth
s
tatu
s
,
alo
n
g
wit
h
tailo
r
ed
r
ec
o
m
m
en
d
atio
n
s
o
n
th
e
f
o
llo
win
g
p
a
g
e.
Fig
u
r
e
1
.
e
-
MA
ST
web
-
b
ased
p
latf
o
r
m
−
Step
2
: Sele
ctin
g
p
ar
ticip
an
ts
b
ased
o
n
e
-
MA
ST
s
co
r
es
On
ce
r
esp
o
n
d
en
ts
s
u
b
m
it
th
ei
r
ass
es
s
m
en
ts
,
th
e
e
-
MA
ST
to
o
l
will
au
to
m
atica
lly
p
r
o
d
u
ce
r
esu
lts
f
o
r
ea
ch
in
d
iv
i
d
u
al,
d
eliv
er
in
g
a
th
o
r
o
u
g
h
a
n
aly
s
is
o
f
th
eir
m
e
n
tal
h
ea
lth
an
d
tailo
r
e
d
r
ec
o
m
m
en
d
atio
n
s
o
n
th
e
f
o
llo
win
g
p
ag
e.
T
h
ese
r
esu
lts
will
b
e
d
o
c
u
m
en
ted
,
allo
win
g
r
esp
o
n
d
en
ts
to
m
o
n
ito
r
th
eir
m
en
tal
h
ea
lth
o
v
e
r
tim
e.
I
n
d
iv
i
d
u
als
with
s
co
r
es
r
an
g
in
g
f
r
o
m
m
ild
to
ex
tr
em
e
m
en
tal
h
ea
lth
co
n
ce
r
n
s
will
b
e
id
en
tifie
d
to
a
d
v
an
ce
to
th
er
ap
y
s
ess
io
n
s
,
d
u
r
in
g
wh
ich
th
ey
will
r
ec
eiv
e
co
m
p
r
eh
e
n
s
iv
e
d
etails
alo
n
g
with
th
e
'R
e
s
ea
r
ch
I
n
f
o
r
m
atio
n
Sh
ee
t &
C
o
n
s
en
t.
−
Step
3
: Co
n
d
u
ctin
g
th
er
ap
y
s
ess
io
n
s
with
th
e
Ho
s
p
ital Su
lta
n
ah
Nu
r
Z
a
h
ir
ah
(
HSNZ
)
team
T
h
er
ap
y
Ph
ase
1
:
All selec
ted
p
ar
ticip
an
ts
will b
e
en
co
u
r
ag
e
d
to
ac
cu
r
ately
an
d
th
o
r
o
u
g
h
ly
co
m
p
lete
b
o
th
th
e
b
ec
k
d
ep
r
ess
io
n
in
v
e
n
to
r
y
(
B
DI
)
[
2
0
]
an
d
th
e
b
ec
k
an
x
iety
in
v
en
to
r
y
(
B
AI
)
[
2
1
]
as
ess
en
tial
p
ar
ts
o
f
th
e
ev
alu
atio
n
p
r
o
ce
s
s
.
T
h
is
s
t
ep
is
v
ital
f
o
r
g
ain
in
g
in
s
ig
h
ts
i
n
to
th
eir
lev
els
o
f
an
x
iety
an
d
d
ep
r
ess
io
n
,
th
er
eb
y
en
h
an
cin
g
th
e
o
v
er
all
ass
ess
m
en
t
o
f
th
eir
m
e
n
tal
h
ea
lth
.
T
h
e
B
DI
an
d
B
AI
,
cr
ea
ted
b
y
Aar
o
n
T
.
B
ec
k
,
ar
e
r
esp
ec
ted
s
elf
-
r
ep
o
r
t
in
s
tr
u
m
e
n
ts
u
s
ed
to
ass
ess
th
e
in
te
n
s
ity
o
f
d
e
p
r
ess
io
n
an
d
an
x
iety
s
y
m
p
to
m
s
,
r
esp
ec
tiv
ely
[
2
2
]
.
E
ac
h
to
o
l
f
ea
tu
r
es
2
1
item
s
r
ated
o
n
a
s
ca
le
f
r
o
m
0
to
3
,
m
a
k
in
g
th
em
wid
el
y
ap
p
licab
le
in
b
o
th
clin
ical
an
d
r
esear
ch
e
n
v
ir
o
n
m
en
ts
f
o
r
s
cr
ee
n
in
g
,
e
v
alu
atio
n
,
a
n
d
th
e
r
ap
eu
tic
p
lan
n
in
g
.
T
h
er
ap
y
Ph
a
s
e
2
:
I
t
is
im
p
o
r
t
an
t
to
ca
r
ef
u
lly
attac
h
t
h
e
E
E
G
an
d
HR
V
m
o
n
ito
r
in
g
d
ev
i
ce
s
to
th
e
p
ar
ticip
an
ts
,
en
s
u
r
i
n
g
t
h
at
th
e
y
ar
e
ac
cu
r
ately
an
d
s
ec
u
r
ely
p
o
s
itio
n
ed
.
T
h
is
will
allo
w
f
o
r
h
i
g
h
-
q
u
ality
a
n
d
co
m
p
r
eh
e
n
s
iv
e
d
ata
co
llectio
n
d
u
r
in
g
th
e
m
o
n
ito
r
in
g
p
h
ase.
T
h
e
d
ev
ices
in
u
s
e
in
clu
d
e
th
e
5
-
ch
an
n
el
E
E
G
s
ig
n
al
d
etec
to
r
,
I
n
s
ig
h
t
2
,
f
r
o
m
E
MO
T
I
V,
an
d
th
e
HR
V
s
ig
n
al
d
etec
to
r
,
e
m
W
av
e
Pro
[
2
3
]
,
as
illu
s
tr
ated
in
Fig
u
r
e
2
.
Fig
u
r
e
2
(
a
)
p
r
esen
ts
th
e
E
E
G
d
ev
ice,
w
h
ile
Fig
u
r
e
2
(
b
)
s
h
o
ws th
e
HR
V
d
ev
ice.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
lectro
en
ce
p
h
a
lo
g
r
a
p
h
y
a
n
d
h
ea
r
t ra
te
va
r
ia
b
ilit
y
p
r
o
g
n
o
s
t
ics in
men
ta
l h
ea
lth
…
(
N
u
r
n
a
d
ia
h
Za
mri
)
763
T
h
er
ap
y
Ph
ase
3
:
Star
t
th
e
p
r
o
ce
s
s
o
f
r
ec
o
r
d
in
g
E
GG
an
d
H
R
V
b
y
ca
r
ef
u
lly
s
ettin
g
u
p
th
e
n
ec
ess
ar
y
eq
u
ip
m
en
t
to
en
s
u
r
e
ac
cu
r
ate
p
h
y
s
io
lo
g
ical
d
ata
c
o
llectio
n
.
Par
ticip
an
ts
wer
e
th
en
in
s
tr
u
ct
ed
to
tak
e
p
ar
t
in
a
5
-
m
in
u
te
r
esti
n
g
p
er
i
o
d
,
d
u
r
in
g
wh
ich
th
e
y
wer
e
e
n
co
u
r
ag
ed
to
r
elax
f
u
lly
.
T
h
is
allo
wed
f
o
r
th
e
estab
lis
h
m
en
t
o
f
b
aselin
e
p
h
y
s
io
lo
g
ical
m
ea
s
u
r
em
en
ts
.
(
a)
(
b
)
Fig
u
r
e
2
.
Setu
p
m
o
n
ito
r
in
g
d
e
v
ices u
n
tu
k
th
e
r
ap
y
p
h
ase
2
f
o
r
(
a)
E
E
G
s
ig
n
al
d
etec
to
r
d
e
v
i
ce
s
an
d
(
b
)
HR
V
s
ig
n
al
d
etec
to
r
d
e
v
ices
T
h
er
ap
y
Ph
ase
4
: E
ac
h
th
er
ap
y
s
ess
io
n
last
s
1
5
m
in
u
tes an
d
co
n
s
is
ts
o
f
v
ar
io
u
s
m
o
d
alities
,
in
clu
d
in
g
ar
o
m
ath
er
a
p
y
,
d
ee
p
b
r
ea
th
in
g
ex
er
cises
,
r
u
q
y
a
h
,
a
n
d
a
co
n
t
r
o
l
g
r
o
u
p
.
T
h
ese
s
ess
io
n
s
ar
e
d
es
ig
n
ed
with
s
p
ec
i
f
ic
in
ter
v
en
t
io
n
s
tailo
r
ed
t
o
ac
h
ie
v
e
p
ar
ticu
lar
th
e
r
ap
eu
tic
o
b
jec
tiv
es a
s
s
o
ciate
d
with
ea
ch
m
eth
o
d
.
Ar
o
m
ath
er
a
p
y
in
co
r
p
o
r
ates
ess
en
tial
o
ils
f
r
o
m
n
atu
r
al
p
lan
t
s
o
u
r
ce
s
t
o
s
u
p
p
o
r
t
p
h
y
s
ical,
em
o
tio
n
al,
an
d
m
en
tal
welln
ess
,
with
Gela
m
Oil
f
r
o
m
t
h
e
Me
laleu
ca
ca
ju
p
u
ti
tr
ee
b
ein
g
n
o
tab
l
y
s
ig
n
if
ican
t
[
2
4
]
.
T
h
e
d
ee
p
b
r
ea
th
in
g
tech
n
iq
u
e
in
v
o
lv
es
a
co
n
s
cio
u
s
ef
f
o
r
t
to
b
r
ea
th
e
in
d
ee
p
ly
t
h
r
o
u
g
h
th
e
n
o
s
e,
allo
win
g
th
e
ab
d
o
m
en
to
ex
p
an
d
,
f
o
llo
we
d
b
y
a
s
lo
w
ex
h
alatio
n
th
r
o
u
g
h
t
h
e
m
o
u
t
h
[
2
5
]
.
T
h
is
ap
p
r
o
ac
h
aim
s
to
en
co
u
r
ag
e
r
ela
x
atio
n
,
m
itig
ate
s
tr
ess
,
an
d
im
p
r
o
v
e
o
v
er
all
well
-
b
ein
g
b
y
s
tim
u
latin
g
th
e
b
o
d
y
'
s
r
elax
atio
n
r
esp
o
n
s
e.
R
u
q
y
a
h
,
wh
ich
is
g
r
o
u
n
d
ed
in
I
s
lam
ic
p
r
ac
tices,
in
clu
d
es
th
e
r
ec
itatio
n
o
f
s
elec
ted
Qu
r
an
ic
v
er
s
es
f
o
r
s
p
ir
itu
al
h
ea
lin
g
a
n
d
p
r
o
tectiv
e
b
e
n
ef
its
,
co
m
m
o
n
l
y
u
s
i
n
g
Su
r
ah
Al
-
Fat
ih
ah
an
d
Su
r
ah
Ar
-
R
ah
m
an
.
R
esear
ch
f
r
o
m
R
af
iq
u
e
et
a
l.
[
2
6
]
h
as
s
h
o
wn
th
at
Su
r
ah
Ar
-
R
ah
m
an
ca
n
b
e
b
en
ef
icial
in
r
ed
u
cin
g
s
y
m
p
to
m
s
o
f
d
ep
r
ess
io
n
,
wh
ile
Su
r
ah
Al
-
Fatih
ah
h
as
b
ee
n
f
o
u
n
d
to
s
u
p
p
o
r
t
em
o
tio
n
al
s
t
ab
ilit
y
b
y
e
n
h
an
ci
n
g
n
eu
r
al
ac
tiv
ity
an
d
c
o
o
r
d
in
atio
n
a
m
o
n
g
n
eu
r
o
n
s
[
2
7
]
.
T
h
e
co
n
tr
o
l
g
r
o
u
p
p
lay
s
a
v
ital
r
o
l
e
in
p
r
o
v
id
in
g
a
co
m
p
ar
is
o
n
b
en
ch
m
ar
k
,
c
o
n
s
is
tin
g
o
f
p
a
r
ticip
an
ts
wh
o
d
o
n
o
t
u
n
d
er
g
o
an
y
in
ter
v
en
tio
n
s
,
th
u
s
r
em
ain
in
g
in
r
eg
u
lar
co
n
d
itio
n
s
.
T
h
er
a
p
y
Ph
ase
5
:
Af
ter
c
o
m
p
l
etin
g
th
e
ass
ig
n
ed
task
s
o
r
ev
al
u
atio
n
s
,
p
a
r
ticip
an
ts
r
est
f
o
r
a
n
ad
d
itio
n
al
5
m
in
u
tes
to
allo
w
f
o
r
b
r
ief
r
e
co
v
er
y
an
d
r
elax
atio
n
.
T
h
is
r
e
s
t
p
er
io
d
h
elp
s
s
tab
ilizes
th
eir
p
h
y
s
io
lo
g
ical
s
tate
.
Fo
llo
win
g
th
e
r
est,
th
e
r
ec
o
r
d
in
g
o
f
E
E
G
an
d
HR
V
co
n
clu
d
es.
T
h
is
en
s
u
r
es
a
co
m
p
lete
an
d
ac
cu
r
ate
r
ep
r
esen
tatio
n
o
f
th
e
p
h
y
s
io
lo
g
ical
d
ata
co
llected
d
u
r
in
g
th
e
r
est p
h
ase.
T
h
er
ap
y
Ph
ase
6
:
C
lear
an
d
co
m
p
r
e
h
en
s
iv
e
in
s
tr
u
ctio
n
s
wer
e
g
iv
en
to
all
p
ar
ticip
a
n
ts
.
T
h
ese
in
s
tr
u
ctio
n
s
em
p
h
asized
t
h
e
i
m
p
o
r
t
an
ce
o
f
r
ev
is
itin
g
an
d
co
m
p
letin
g
t
h
e
B
DI
an
d
B
AI
as
o
u
tlin
ed
i
n
th
e
ass
es
s
m
en
t
p
r
o
ce
d
u
r
es.
T
h
is
s
tep
is
cr
u
cial
f
o
r
g
at
h
er
in
g
u
p
d
ated
in
s
ig
h
ts
in
to
th
eir
a
n
x
ie
ty
an
d
d
ep
r
ess
io
n
lev
els.
I
t u
ltima
tely
en
h
an
ce
s
o
u
r
u
n
d
er
s
tan
d
i
n
g
o
f
th
eir
m
e
n
tal
h
ea
lth
s
tatu
s
.
−
Step
4
: A
n
aly
zin
g
HR
V
an
d
E
E
G
Data
I
n
th
is
p
h
ase,
we
co
n
d
u
ct
a
th
o
r
o
u
g
h
an
aly
s
is
o
f
th
e
E
E
G
an
d
HR
V
d
ata
to
g
ain
v
alu
ab
le
in
s
ig
h
ts
in
to
th
e
b
r
ain
'
s
elec
tr
ical
s
ig
n
als
an
d
th
e
f
lu
ctu
atio
n
s
in
tim
e
in
t
er
v
als
b
etwe
en
h
ea
r
tb
ea
ts
.
T
h
i
s
in
clu
d
es
ass
ess
in
g
v
ar
io
u
s
f
r
eq
u
e
n
cy
b
an
d
s
in
th
e
E
E
G,
as
well
as
ex
am
i
n
in
g
b
o
th
tim
e
an
d
f
r
eq
u
e
n
cy
f
ea
tu
r
es
o
f
th
e
HR
V
d
ata.
T
o
f
ac
ilit
ate
u
n
d
er
s
tan
d
in
g
o
f
th
e
co
n
d
u
cted
r
esear
ch
,
Fig
u
r
e
3
p
r
esen
ts
a
s
u
m
m
ar
y
o
f
th
e
p
r
o
ce
s
s
es
f
r
o
m
Step
1
to
Step
4
.
T
h
is
in
clu
d
es
id
en
tify
in
g
th
e
r
esp
o
n
d
en
t
g
r
o
u
p
t
h
r
o
u
g
h
to
th
e
a
n
aly
s
is
o
f
HR
V
an
d
E
E
G
d
ata.
T
h
e
f
o
llo
win
g
s
ec
tio
n
will d
elv
e
i
n
to
th
e
ex
am
in
atio
n
o
f
th
e
e
-
M
AST,
HR
V,
an
d
E
E
G
d
ata
co
l
lecte
d
.
3.
G
E
NE
R
AL
R
E
SU
L
T
S O
N
DE
M
O
G
RAP
H
I
C,
DAS
S,
B
DI AND
B
AI
W
e
s
h
ar
ed
in
f
o
r
m
atio
n
with
1
5
7
o
r
g
a
n
izatio
n
s
lo
ca
ted
in
Ku
ala
T
er
en
g
g
an
u
an
d
Ku
ala
Ner
u
s
,
an
d
3
0
o
f
th
em
ch
o
s
e
to
tak
e
p
ar
t
in
t
h
e
s
tu
d
y
.
T
h
is
led
to
a
r
o
u
n
d
2
9
4
p
ar
ticip
an
ts
co
m
p
letin
g
th
e
D
ASS
q
u
esti
o
n
n
air
e
av
ailab
le
o
n
t
h
e
e
-
MA
ST
p
l
atf
o
r
m
.
Fro
m
th
is
g
r
o
u
p
,
ap
p
r
o
x
im
ately
7
1
i
n
d
iv
id
u
al
s
s
h
o
wed
m
o
d
er
ate
to
s
ig
n
if
ican
t
lev
els
o
f
d
ep
r
ess
io
n
,
an
x
iety
,
o
r
s
tr
ess
an
d
wer
e
s
u
b
s
eq
u
en
tly
in
v
ited
t
o
atten
d
th
er
ap
y
s
ess
io
n
s
.
I
n
d
iv
id
u
als
with
s
p
ec
if
ic
m
ed
i
ca
l
co
n
d
itio
n
s
wer
e
n
o
t
in
clu
d
ed
in
th
is
s
elec
tio
n
.
Prio
r
to
t
h
e
s
tar
t
o
f
th
er
ap
y
,
p
ar
ticip
an
t
s
ar
e
r
eq
u
ir
ed
to
f
ill
o
u
t
th
e
B
DI
a
n
d
B
AI
ass
ess
m
en
ts
,
wh
ich
ar
e
in
co
r
p
o
r
ate
d
in
to
th
e
e
-
MA
ST
s
o
f
twar
e,
h
elp
in
g
to
p
r
o
v
id
e
a
th
o
r
o
u
g
h
ass
ess
m
en
t o
f
th
eir
m
en
tal
h
ea
lth
.
EEG
HR
V
EEG
HR
V
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
7
6
0
-
7
7
2
764
Fig
u
r
e
3
.
Flo
wch
ar
t
o
f
th
e
s
tep
s
3
.
1
.
Dem
o
g
ra
ph
ic
I
n
th
is
r
esear
ch
,
d
ata
was
g
at
h
er
ed
f
r
o
m
7
1
p
ar
ticip
a
n
ts
,
in
clu
d
in
g
2
8
m
ales
an
d
4
3
f
em
ales,
wh
o
co
m
p
leted
th
e
DASS
ass
es
s
m
en
t
an
d
s
h
o
wed
r
elev
an
t
s
y
m
p
to
m
s
.
T
h
e
g
en
d
e
r
d
is
tr
ib
u
tio
n
o
f
th
e
r
esp
o
n
d
en
ts
in
d
icate
d
th
at
3
9
%
wer
e
m
ale
an
d
6
1
%
f
em
ale.
Dem
o
g
r
a
p
h
ic
in
f
o
r
m
atio
n
was
s
o
u
r
ce
d
f
r
o
m
th
e
e
-
MA
ST
p
latf
o
r
m
,
h
i
g
h
lig
h
tin
g
th
e
in
d
i
v
id
u
als
with
th
e
h
ig
h
est
s
co
r
es
o
n
th
e
q
u
esti
o
n
n
air
e.
Ad
d
itio
n
al
d
etails
f
r
o
m
th
e
e
-
MA
ST
d
atab
ase
will b
e
p
r
esen
ted
in
th
e
f
o
llo
win
g
s
ec
tio
n
.
3
.
2
.
Depre
s
s
io
n DA
SS
T
h
e
DASS,
is
a
s
elf
-
r
ep
o
r
t
to
o
l
u
tili
ze
d
to
ev
alu
ate
th
e
s
ev
er
ity
o
f
s
y
m
p
to
m
s
r
elate
d
to
d
ep
r
ess
io
n
,
an
x
iety
,
a
n
d
s
tr
ess
,
as
d
escr
ib
e
d
b
y
I
an
n
atto
n
e
et
a
l.
[
2
8
]
.
I
t
co
n
tain
s
th
r
ee
d
is
tin
ct
s
u
b
s
ca
les:
o
n
e
f
o
r
d
e
p
r
ess
io
n
,
o
n
e
f
o
r
a
n
x
iety
,
an
d
o
n
e
f
o
r
s
tr
ess
,
ea
ch
aim
ed
at
m
ea
s
u
r
in
g
th
e
in
ten
s
ity
o
f
s
y
m
p
to
m
s
lin
k
ed
to
th
ese
m
en
tal
h
ea
lth
co
n
d
itio
n
s
.
T
h
e
DASS
is
co
m
m
o
n
ly
em
p
lo
y
e
d
in
b
o
th
r
esear
ch
an
d
clin
ical
co
n
t
ex
ts
to
id
en
tif
y
an
d
tr
ac
k
s
y
m
p
to
m
s
o
f
d
ep
r
ess
io
n
,
an
x
iety
,
an
d
s
tr
ess
,
o
f
f
er
in
g
im
p
o
r
tan
t
in
s
ig
h
ts
in
to
a
p
er
s
o
n
’
s
o
v
er
all
m
en
tal
h
ea
lth
.
Fig
u
r
e
4
r
ev
ea
ls
n
o
ta
b
le
g
en
d
er
d
if
f
er
e
n
ce
s
in
th
e
lev
els
o
f
d
ep
r
ess
io
n
Fig
u
r
e
4
(
a)
,
an
x
iety
Fig
u
r
e
4
(
b
)
,
an
d
s
tr
ess
Fig
u
r
e
4
(
c)
am
o
n
g
r
esp
o
n
d
en
ts
.
I
n
ter
m
s
o
f
d
ep
r
es
s
io
n
,
a
h
ig
h
er
p
e
r
ce
n
tag
e
o
f
f
e
m
ales
f
all
in
to
th
e
ex
tr
em
e
ca
teg
o
r
y
(
1
4
.
0
8
%)
c
o
m
p
ar
ed
to
m
ales
(
2
.
8
2
%).
A
d
d
itio
n
ally
,
m
o
r
e
m
ales
ar
e
c
lass
if
ied
as
n
o
r
m
al
(
1
8
.
3
1
%)
co
m
p
ar
e
d
to
f
em
ale
s
(
1
9
.
7
2
%).
Fo
r
an
x
iety
,
b
o
th
g
en
d
er
s
h
av
e
an
eq
u
al
p
er
ce
n
tag
e
class
if
ied
as
n
o
r
m
al
(
1
4
.
0
8
%).
Ho
wev
er
,
f
em
ales
s
h
o
w
h
ig
h
er
p
e
r
ce
n
ta
g
es
in
th
e
s
ev
er
e
(
9
.
8
6
%)
an
d
ex
tr
em
e
(
9
.
8
6
%)
ca
teg
o
r
ies
co
m
p
ar
ed
to
m
ale
s
(
s
ev
er
e:
1
.
4
1
%,
e
x
tr
em
e:
2
.
8
2
%).
R
eg
ar
d
in
g
s
tr
ess
,
a
h
i
g
h
er
p
er
ce
n
ta
g
e
o
f
f
em
ales
ar
e
n
o
r
m
al
(
2
9
.
5
8
%)
co
m
p
ar
ed
to
m
ales
(
2
3
.
9
4
%).
No
tab
ly
,
n
o
m
ales
wer
e
cla
s
s
if
ied
as
s
ev
er
e
o
r
ex
tr
em
e
in
ter
m
s
o
f
s
tr
ess
,
wh
ile
f
em
ales h
ad
7
.
0
4
% in
th
e
s
e
v
er
e
an
d
1
.
4
1
% in
th
e
e
x
tr
em
e
ca
teg
o
r
ies.
T
h
ese
f
in
d
in
g
s
s
u
g
g
est
th
at
f
em
ales
in
th
e
s
tu
d
y
p
o
p
u
lati
o
n
ex
p
er
ien
ce
h
ig
h
er
lev
els
o
f
ex
tr
em
e
d
ep
r
ess
io
n
an
d
a
n
x
iety
c
o
m
p
ar
ed
to
m
ales.
Fo
r
s
tr
ess
,
alth
o
u
g
h
f
e
m
ales
s
h
o
w
h
ig
h
er
lev
els
o
f
s
ev
er
e
an
d
ex
tr
em
e
s
tr
ess
,
a
g
r
ea
ter
p
r
o
p
o
r
tio
n
o
f
f
em
ales
ar
e
also
in
th
e
n
o
r
m
al
ca
teg
o
r
y
co
m
p
ar
ed
to
m
ales.
T
h
is
g
en
d
er
d
is
p
ar
ity
h
ig
h
lig
h
ts
th
e
n
ee
d
f
o
r
g
en
d
e
r
-
s
p
ec
if
ic
ap
p
r
o
ac
h
es
i
n
m
en
tal
h
ea
lth
in
te
r
v
en
tio
n
s
an
d
s
u
p
p
o
r
t
s
y
s
tem
s
.
Fo
llo
win
g
th
e
DASS
s
ca
le,
r
e
s
p
o
n
d
en
ts
will
u
n
d
er
g
o
s
u
b
s
eq
u
en
t
test
s
,
in
clu
d
in
g
th
e
B
DI
an
d
B
AI
,
with
th
eir
d
ata
to
b
e
p
r
esen
ted
in
t
h
e
n
ex
t sectio
n
.
3
.
3
.
P
o
s
t
B
DI a
nd
B
AI f
o
r
re
s
ult
co
m
pa
riso
n
T
h
e
p
o
s
t
-
th
er
a
p
y
ass
ess
m
en
ts
k
n
o
wn
as
th
e
B
DI
an
d
B
AI
ar
e
co
n
d
u
cted
af
ter
p
ar
ticip
an
ts
h
av
e
co
m
p
leted
a
th
er
a
p
eu
tic
in
ter
v
en
tio
n
.
Fo
llo
win
g
th
ei
r
th
er
ap
y
s
ess
io
n
s
,
in
d
iv
id
u
als
ar
e
ask
ed
to
f
ill
o
u
t
th
e
B
DI
an
d
B
AI
ag
ain
v
ia
th
e
e
-
MA
ST
p
latf
o
r
m
.
T
h
e
m
ain
p
u
r
p
o
s
e
o
f
th
ese
ass
ess
m
en
ts
i
s
to
th
o
r
o
u
g
h
ly
ass
ess
h
o
w
ef
f
ec
tiv
e
th
e
th
e
r
ap
y
h
as b
ee
n
in
r
ed
u
cin
g
s
y
m
p
t
o
m
s
r
elate
d
to
d
ep
r
ess
io
n
an
d
an
x
iety
d
is
o
r
d
er
s
.
T
h
u
s
,
Fig
u
r
e
5
r
ev
ea
ls
B
DI
an
d
B
AI
r
esu
lts
wh
er
e,
th
e
p
o
s
t
B
DI
r
esu
lts
ca
n
b
e
s
h
o
wn
in
Fig
u
r
e
5
(
a)
an
d
B
AI
r
esu
lts
ca
n
b
e
s
h
o
wn
in
Fig
u
r
e
5
(
b
)
.
T
h
e
p
o
s
t
-
th
er
a
p
y
r
esu
lts
d
em
o
n
s
tr
ate
s
ig
n
if
i
ca
n
t
im
p
r
o
v
em
e
n
ts
in
d
ep
r
ess
io
n
an
d
an
x
iety
lev
els
am
o
n
g
b
o
th
m
ale
a
n
d
f
e
m
ale
r
esp
o
n
d
en
ts
.
A
n
o
tab
le
p
r
o
p
o
r
tio
n
o
f
b
o
t
h
g
en
d
er
s
f
all
in
t
o
th
e
n
o
r
m
al
ca
teg
o
r
y
p
o
s
t
-
th
er
ap
y
,
with
f
em
ales
s
h
o
win
g
s
lig
h
tly
h
ig
h
er
p
er
ce
n
tag
es
(
4
1
%
f
o
r
B
DI
an
d
2
7
%
f
o
r
B
AI
)
co
m
p
ar
ed
to
m
ales
(
3
4
%
f
o
r
B
DI
an
d
1
7
%
f
o
r
B
AI
)
.
W
h
ile
m
ales
p
r
im
ar
ily
f
all
in
to
th
e
n
o
r
m
al
o
r
lig
h
t
ca
teg
o
r
ies
f
o
r
d
ep
r
ess
io
n
,
f
em
ales
s
h
o
w
a
m
o
r
e
v
ar
ied
d
is
tr
ib
u
tio
n
,
in
clu
d
in
g
m
ild
a
n
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
lectro
en
ce
p
h
a
lo
g
r
a
p
h
y
a
n
d
h
ea
r
t ra
te
va
r
ia
b
ilit
y
p
r
o
g
n
o
s
t
ics in
men
ta
l h
ea
lth
…
(
N
u
r
n
a
d
ia
h
Za
mri
)
765
m
o
d
er
ate
ca
te
g
o
r
ies.
Fo
r
an
x
iety
,
b
o
t
h
g
e
n
d
er
s
a
r
e
m
o
s
tly
in
t
h
e
n
o
r
m
al,
lig
h
t,
an
d
m
ild
ca
te
g
o
r
ies,
b
u
t
f
em
ales
h
av
e
a
h
ig
h
er
p
er
ce
n
tag
e
in
th
e
m
o
d
er
ate
ca
te
g
o
r
y
.
T
h
ese
r
esu
lts
in
d
icate
th
at
th
e
th
er
a
p
ies
wer
e
ef
f
ec
tiv
e
,
p
ar
ticu
lar
ly
f
o
r
f
e
m
ales,
th
o
u
g
h
s
o
m
e
m
ay
s
till
n
ee
d
f
u
r
th
er
th
er
a
p
eu
tic
in
ter
v
e
n
tio
n
,
h
ig
h
lig
h
tin
g
th
e
im
p
o
r
tan
ce
o
f
o
n
g
o
i
n
g
,
tailo
r
e
d
m
en
tal
h
ea
lth
s
u
p
p
o
r
t.
(
a)
(
b
)
(
c)
Fig
u
r
e
4
.
DASS test r
esu
lt f
o
r
(
a)
d
ep
r
esio
n
,
(
b
)
an
x
iety
,
an
d
(
c)
s
tr
ess
(a
)
(
b
)
Fig
u
r
e
5
.
B
DI
an
d
B
AI
r
esu
lts
f
o
r
(
a
)
B
DI
r
ep
o
r
t a
f
ter
th
e
r
ap
ies
an
d
(
b
)
B
AI
r
e
p
o
r
t a
f
te
r
th
er
ap
ies
T
ab
le
1
s
u
m
m
ar
izes
th
e
e
f
f
ec
tiv
en
ess
o
f
d
if
f
er
en
t
t
h
er
a
p
ies
in
lo
wer
in
g
B
DI
an
d
B
AI
s
co
r
es.
Ar
o
m
ath
er
ap
y
an
d
d
ee
p
b
r
ea
th
in
g
th
e
r
ap
y
r
esu
lted
in
s
im
ilar
av
er
ag
e
r
ed
u
ctio
n
s
,
with
B
D
I
s
co
r
es
d
ec
r
ea
s
in
g
b
y
0
.
5
9
an
d
0
.
6
5
p
o
in
ts
,
r
esp
ec
tiv
ely
,
an
d
B
AI
s
co
r
es
b
y
1
.
1
2
a
n
d
1
.
0
6
p
o
in
ts
.
T
h
is
led
to
an
o
v
e
r
all
m
ea
n
r
ed
u
ctio
n
o
f
1
.
7
1
p
o
in
ts
,
r
ef
le
ctin
g
a
2
6
%
im
p
r
o
v
em
en
t.
R
u
q
y
ah
th
er
ap
y
ac
h
iev
ed
a
m
ea
n
r
e
d
u
ctio
n
o
f
0
.
4
5
p
o
in
ts
in
B
DI
an
d
1
.
1
5
p
o
in
ts
in
B
AI
,
cu
lm
in
atin
g
in
a
to
tal
d
ec
r
ea
s
e
o
f
1
.
6
0
p
o
in
ts
,
o
r
a
2
4
%
im
p
r
o
v
em
en
t.
0
5
10
15
13
8
1
4
2
14
7
5
7
10
Num
b
e
r
o
f
r
e
s
po
n
de
n
t
s
D
EPRESS
I
O
N
S
C
A
L
E
0
5
10
15
10
1
14
1
2
10
6
13
7
7
Num
b
e
r
o
f
r
e
s
po
n
de
n
t
s
A
N
X
I
ET
Y
S
C
A
L
E
0
10
20
30
17
4
7
0
0
21
4
12
5
1
Num
b
e
r
o
f
r
e
s
po
n
de
n
t
s
S
T
R
ESS
S
C
A
L
E
0
5
10
15
20
25
30
24
4
0
0
0
0
29
4
6
4
0
0
Num
b
e
r
o
f
r
e
s
po
n
de
n
t
s
P
O
S
T
B
D
I
R
EPO
R
T
0
10
20
12
6
7
3
0
0
19
9
8
7
0
0
Num
b
e
r
o
f
r
e
s
po
n
de
n
t
s
P
O
S
T
B
A
I
R
EPO
R
T
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
7
6
0
-
7
7
2
766
T
h
e
co
n
t
r
o
l
g
r
o
u
p
s
h
o
wed
r
ed
u
ctio
n
s
o
f
0
.
5
9
p
o
in
ts
in
B
DI
a
n
d
1
.
0
6
p
o
in
ts
in
B
AI
,
lead
in
g
to
an
o
v
e
r
all
m
ea
n
r
ed
u
ctio
n
o
f
1
.
6
5
p
o
i
n
ts
,
in
d
icatin
g
a
2
5
%
im
p
r
o
v
em
en
t.
T
h
ese
r
esu
lts
im
p
ly
th
at
ar
o
m
ath
er
a
p
y
,
d
ee
p
b
r
ea
th
in
g
,
an
d
r
u
q
y
a
h
th
e
r
ap
y
ar
e
b
en
ef
icial
in
allev
iatin
g
s
y
m
p
to
m
s
r
elate
d
t
o
d
e
p
r
e
s
s
io
n
an
d
a
n
x
iety
,
ev
id
en
ce
d
b
y
s
ig
n
if
ican
t
r
e
d
u
ctio
n
s
in
m
ea
n
s
co
r
es.
T
h
e
c
o
m
p
ar
ab
le
o
u
tco
m
es
o
f
a
r
o
m
ath
er
ap
y
a
n
d
d
ee
p
b
r
ea
th
in
g
in
d
icate
th
eir
s
im
ilar
ef
f
ec
tiv
en
ess
in
en
h
an
cin
g
m
e
n
tal
h
ea
lth
.
Fo
llo
win
g
th
is
an
aly
s
is
o
f
th
e
DAS
S,
B
DI
,
an
d
B
AI
d
ata,
th
e
s
u
b
s
eq
u
en
t sectio
n
will f
o
cu
s
o
n
th
e
f
in
d
in
g
s
r
elate
d
t
o
HR
V
an
d
E
E
G.
T
ab
le
1
.
Me
an
s
co
r
e
o
f
r
ed
u
cin
g
lev
els in
B
DI
an
d
B
AI
test
s
Th
e
r
a
p
y
B
D
I
B
A
I
O
v
e
r
a
l
l
A
r
o
mat
h
e
r
a
p
y
0
.
5
9
1
.
1
2
1
.
7
1
D
e
e
p
b
r
e
a
t
h
i
n
g
0
.
6
5
1
.
0
6
1
.
7
1
R
u
q
y
a
h
0
.
4
5
1
.
1
5
1
.
6
0
C
o
n
t
r
o
l
g
r
o
u
p
0
.
5
9
1
.
0
6
1
.
6
5
4.
H
RV
AND
E
E
G
RE
S
UL
T
S
F
RO
M
DIFF
E
RE
N
T
T
H
E
R
AP
I
E
S
T
h
e
o
u
tco
m
es
o
f
th
e
r
ap
ies
th
at
in
co
r
p
o
r
ated
ar
o
m
ath
er
a
p
y
,
d
ee
p
b
r
ea
th
in
g
ex
er
cises
,
r
u
q
y
ah
,
an
d
a
co
n
tr
o
l
g
r
o
u
p
wer
e
e
v
alu
ated
th
r
o
u
g
h
HR
V
an
aly
s
is
with
t
h
e
em
W
av
e
Pro
s
o
f
twar
e
an
d
E
E
G
an
aly
s
is
u
s
in
g
eM
o
tiv
s
o
f
twar
e.
T
h
e
co
llecte
d
d
ata
f
r
o
m
th
ese
d
e
v
ices
u
n
d
e
r
wen
t
ad
d
itio
n
al
ex
am
in
atio
n
t
h
r
o
u
g
h
Py
th
o
n
an
d
th
e
MN
E
lib
r
a
r
y
.
T
h
is
f
ac
ilit
at
ed
an
in
-
d
ep
th
ex
p
lo
r
atio
n
o
f
E
E
G
r
h
y
t
h
m
s
an
d
p
r
o
v
i
d
ed
i
n
s
ig
h
ts
in
to
h
o
w
th
e
th
er
ap
ies im
p
ac
ted
b
o
th
au
t
o
n
o
m
ic
n
er
v
o
u
s
s
y
s
tem
f
u
n
ctio
n
an
d
b
r
ai
n
ac
tiv
ity
.
4
.
1
.
H
RV
T
h
is
s
eg
m
en
t
will
ev
alu
ate
HR
V
s
ig
n
als
g
ath
er
ed
th
r
o
u
g
h
o
u
t
th
e
ex
p
er
i
m
en
t
u
s
in
g
th
e
e
m
W
av
e
Pro
s
o
f
twar
e.
T
h
is
to
o
l
is
s
p
ec
if
i
ca
lly
cr
af
ted
f
o
r
c
o
m
p
r
eh
en
s
iv
e
an
aly
s
is
o
f
HR
V
m
etr
ics,
o
f
f
er
in
g
v
alu
ab
le
in
s
ig
h
ts
in
to
h
ea
r
t
r
ate
tr
en
d
s
an
d
co
h
er
en
ce
lev
els.
T
h
is
a
n
aly
s
is
aid
s
in
en
h
an
cin
g
o
u
r
u
n
d
er
s
tan
d
i
n
g
o
f
au
to
n
o
m
ic
n
er
v
o
u
s
s
y
s
tem
f
u
n
ctio
n
an
d
t
h
e
p
h
y
s
io
lo
g
ical
r
ea
ctio
n
s
n
o
ted
d
u
r
in
g
th
e
s
tu
d
y
.
Fig
u
r
e
6
p
r
esen
ts
an
HR
V
r
esu
lt
f
r
o
m
ar
o
m
ath
e
r
ap
y
.
T
h
e
r
e
m
ain
in
g
HR
V
r
esu
lts
f
o
r
o
t
h
e
r
th
er
ap
ies
ar
e
ex
p
lain
ed
i
n
T
ab
le
2
.
T
ab
le
2
p
r
esen
ts
th
e
d
ata
o
n
HR
V
o
b
s
er
v
atio
n
s
b
ef
o
r
e,
d
u
r
in
g
,
an
d
af
ter
f
o
u
r
d
if
f
er
en
t
th
er
ap
eu
tic
i
n
ter
v
en
tio
n
s
.
T
h
e
in
ter
p
r
etatio
n
o
f
th
e
HR
V
g
r
a
p
h
r
elies
o
n
co
h
er
e
n
ce
le
v
el
r
a
tio
s
,
wh
ich
f
all
in
to
th
r
ee
ca
teg
o
r
ies:
lo
w,
m
ed
i
u
m
,
an
d
h
ig
h
.
Acc
o
r
d
in
g
[
2
9
]
,
lo
w
co
h
er
en
ce
(
r
ed
)
i
n
d
icate
s
a
lack
o
f
s
y
n
ch
r
o
n
izatio
n
b
etwe
en
h
ea
r
t
r
ate
v
ar
iab
ilit
y
a
n
d
b
r
ea
th
in
g
p
atter
n
s
,
o
f
ten
ass
o
ciate
d
w
ith
h
ig
h
er
lev
els
o
f
s
tr
ess
an
d
an
x
iety
.
Me
d
iu
m
co
h
er
en
ce
(
b
lu
e
)
r
ef
lects
a
m
o
d
e
r
ate
d
eg
r
ee
o
f
s
y
n
ch
r
o
n
izatio
n
,
allo
win
g
f
o
r
s
o
m
e
lev
el
o
f
r
elax
atio
n
an
d
m
e
n
tal
clar
ity
.
I
n
co
n
tr
ast,
h
ig
h
co
h
er
en
ce
(
g
r
ee
n
)
s
ig
n
if
ies o
p
tim
al
s
y
n
ch
r
o
n
izatio
n
o
f
p
h
y
s
io
lo
g
ical
p
r
o
ce
s
s
es,
lin
k
e
d
to
lo
wer
s
tr
ess
,
en
h
an
ce
d
c
o
g
n
itiv
e
f
u
n
ctio
n
,
em
o
tio
n
al
b
alan
ce
,
an
d
o
v
er
all
welln
ess
.
An
aly
zin
g
th
e
f
in
d
i
n
g
s
f
r
o
m
T
ab
le
2
r
e
v
ea
ls
n
o
ta
b
le
tr
en
d
s
r
e
g
ar
d
in
g
HR
V
co
h
er
en
ce
lev
els
ac
r
o
s
s
th
e
f
o
u
r
th
er
ap
ies
ass
ess
ed
.
Ar
o
m
ath
er
ap
y
r
esu
lted
in
h
ig
h
c
o
h
er
en
ce
i
n
8
0
%
o
f
th
e
ca
s
es
d
u
r
in
g
th
e
tr
ea
tm
en
t,
with
lo
w
an
d
m
e
d
iu
m
co
h
er
e
n
ce
o
b
s
er
v
e
d
in
1
0
%
ea
ch
.
D
ee
p
b
r
ea
th
in
g
e
x
h
ib
ited
r
em
a
r
k
ab
le
r
esu
lts
,
with
9
5
%
o
f
ca
s
es
ac
h
iev
i
n
g
h
i
g
h
co
h
er
en
ce
d
u
r
i
n
g
th
e
in
ter
v
e
n
tio
n
,
h
ig
h
lig
h
tin
g
its
s
ig
n
if
ican
t
ef
f
ec
tiv
en
ess
in
f
o
s
ter
in
g
p
h
y
s
io
lo
g
ical
b
alan
ce
.
I
n
th
e
ca
s
e
o
f
R
u
q
y
ah
,
6
0
%
o
f
in
s
tan
ce
s
s
h
o
wed
h
ig
h
co
h
er
en
ce
d
u
r
in
g
th
er
ap
y
.
T
h
e
co
n
tr
o
l
g
r
o
u
p
,
h
o
wev
er
,
m
ai
n
tain
ed
a
m
o
d
er
ate
lev
el
o
f
co
h
er
e
n
ce
th
r
o
u
g
h
o
u
t
th
e
s
tu
d
y
,
in
d
icatin
g
th
at
d
ee
p
b
r
ea
t
h
in
g
s
tan
d
s
o
u
t a
s
th
e
m
o
s
t b
en
ef
ici
al
th
er
ap
y
f
o
r
ac
h
ie
v
in
g
o
p
tim
al
s
y
n
ch
r
o
n
izatio
n
an
d
en
h
an
cin
g
o
v
er
all
well
-
b
e
in
g
.
Fig
u
r
e
6
.
HR
V
r
esu
lts
f
o
r
ar
o
m
ath
er
ap
y
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
lectro
en
ce
p
h
a
lo
g
r
a
p
h
y
a
n
d
h
ea
r
t ra
te
va
r
ia
b
ilit
y
p
r
o
g
n
o
s
t
ics in
men
ta
l h
ea
lth
…
(
N
u
r
n
a
d
ia
h
Za
mri
)
767
T
ab
le
2
.
R
esu
lt o
f
HR
V
r
ea
d
in
g
Th
e
r
a
p
y
B
e
f
o
r
e
D
u
r
i
n
g
A
f
t
e
r
A
r
o
mat
h
e
r
a
p
y
Lo
w
–
4
0
%
M
e
d
i
u
m
–
2
0
%
H
i
g
h
–
4
0
%
Lo
w
–
1
0
%
M
e
d
i
u
m
–
1
0
%
H
i
g
h
–
8
0
%
Lo
w
–
1
0
%
M
e
d
i
u
m
–
3
0
%
H
i
g
h
–
7
0
%
D
e
e
p
B
r
e
a
t
h
i
n
g
Lo
w
–
1
0
%
M
e
d
i
u
m
–
2
0
%
H
i
g
h
–
7
0
%
Lo
w
–
0%
M
e
d
i
u
m
–
5%
H
i
g
h
–
9
5
%
Lo
w
–
1%
M
e
d
i
u
m
–
3
0
%
H
i
g
h
–
6
9
%
R
u
q
y
a
h
Lo
w
–
6
0
%
M
e
d
i
u
m
–
2
5
%
H
i
g
h
–
1
5
%
Lo
w
–
2
0
%
M
e
d
i
u
m
–
2
0
%
H
i
g
h
–
6
0
%
Lo
w
–
4
0
%
M
e
d
i
u
m
–
3
5
%
H
i
g
h
–
2
5
%
C
o
n
t
r
o
l
G
r
o
u
p
Lo
w
–
2
1
%
M
e
d
i
u
m
–
1
0
%
H
i
g
h
–
6
9
%
Lo
w
–
1
8
%
M
e
d
i
u
m
–
2
2
%
H
i
g
h
–
7
0
%
Lo
w
–
1
7
%
M
e
d
i
u
m
–
2
3
%
H
i
g
h
–
7
0
%
4
.
2
.
EEG
T
h
is
s
ec
tio
n
f
o
cu
s
es
o
n
e
x
a
m
in
in
g
th
e
r
esu
lts
o
b
tain
ed
f
r
o
m
E
E
G
s
ig
n
als,
u
tili
zin
g
b
o
th
th
e
E
m
o
tiv
PR
O
An
aly
ze
r
an
d
Py
t
h
o
n
f
o
r
an
aly
s
is
.
T
h
e
E
E
G
d
at
a
u
n
d
er
wen
t
p
r
o
ce
s
s
in
g
th
r
o
u
g
h
th
e
E
m
o
tiv
PR
O
An
aly
ze
r
s
o
f
twar
e,
wh
ich
o
f
f
e
r
s
in
-
d
ep
t
h
in
s
ig
h
ts
in
t
o
b
r
ain
wav
e
ac
tiv
ity
.
Fu
r
th
er
m
o
r
e,
P
y
th
o
n
was
em
p
lo
y
ed
f
o
r
ad
d
itio
n
al
d
ata
p
r
o
ce
s
s
in
g
,
en
ab
lin
g
a
th
o
r
o
u
g
h
in
v
e
s
tig
atio
n
o
f
th
e
E
E
G
s
ig
n
als.
T
h
e
s
u
b
s
eq
u
en
t
s
u
b
s
ec
tio
n
s
will
ex
p
lo
r
e
th
e
s
p
ec
if
ic
r
esu
lts
an
d
in
ter
p
r
etatio
n
s
f
r
o
m
t
h
is
E
E
G
an
al
y
s
is
,
p
r
o
v
id
in
g
an
u
n
d
er
s
tan
d
i
n
g
o
f
th
e
n
e
u
r
al
r
e
s
p
o
n
s
es o
b
s
er
v
ed
th
r
o
u
g
h
o
u
t th
e
ex
p
er
im
e
n
t.
Fig
u
r
e
7
d
is
p
lay
s
th
e
E
E
G
b
an
d
p
o
wer
d
ata
f
o
r
d
elta
wav
es
o
b
s
er
v
ed
d
u
r
in
g
ar
o
m
ath
e
r
ap
y
,
wh
ile
Fig
u
r
e
8
s
h
o
ws
th
e
E
E
G
b
an
d
p
o
wer
d
ata
f
o
r
d
elta
wav
es
o
b
s
er
v
ed
af
ter
ar
o
m
ath
er
a
p
y
.
T
h
e
o
th
er
th
er
a
p
ies
—
d
ee
p
b
r
ea
t
h
in
g
,
r
u
q
y
ah
,
a
n
d
t
h
e
co
n
tr
o
l
g
r
o
u
p
—
ar
e
e
x
p
lain
ed
as
f
o
llo
ws;
T
h
is
d
ata
h
ig
h
l
ig
h
ts
th
e
in
f
lu
en
ce
s
o
f
th
ese
p
r
ac
tices
o
n
p
r
o
m
o
ti
n
g
r
elax
atio
n
a
n
d
f
ac
ilit
atin
g
d
e
ep
s
leep
.
Dee
p
b
r
ea
th
i
n
g
th
er
a
p
y
s
h
o
ws
th
e
h
ig
h
est
d
elta
wav
e
b
a
n
d
p
o
wer
at
1
8
.
0
d
B
,
in
d
icatin
g
its
s
tr
o
n
g
ef
f
ic
ac
y
in
p
r
o
m
o
tin
g
r
elax
atio
n
.
Ar
o
m
ath
er
ap
y
also
s
ig
n
if
ican
tly
in
cr
ea
s
es
d
elta
w
av
e
b
an
d
p
o
wer
,
s
u
g
g
esti
n
g
ef
f
ec
tiv
e
r
elax
atio
n
b
en
ef
its
,
th
o
u
g
h
s
lig
h
tly
less
th
an
d
ee
p
b
r
ea
th
in
g
.
R
u
q
y
ah
in
itially
in
cr
ea
s
es
d
elta
wav
es
b
u
t
s
h
o
ws
less
s
u
s
tain
ed
ef
f
ec
ts
co
m
p
ar
ed
to
t
h
e
o
th
e
r
th
er
ap
ies,
p
o
ten
tially
im
p
ac
ti
n
g
lo
n
g
-
ter
m
r
ela
x
atio
n
s
tate
s
in
co
n
s
is
ten
tly
.
T
h
ese
f
in
d
in
g
s
u
n
d
e
r
s
co
r
e
d
ee
p
b
r
ea
th
in
g
th
er
a
p
y
'
s
ef
f
ec
tiv
en
ess
in
in
d
u
cin
g
an
d
m
ai
n
tain
in
g
d
ee
p
r
ela
x
atio
n
,
o
f
f
e
r
in
g
i
n
s
ig
h
ts
in
to
d
i
v
er
s
e
th
er
ap
eu
tic
ap
p
r
o
ac
h
es
f
o
r
m
a
n
ag
in
g
s
tr
ess
an
d
p
r
o
m
o
tin
g
well
-
b
ein
g
.
As
a
r
esu
lt,
th
e
E
E
G
d
at
a
g
ath
er
ed
f
r
o
m
th
e
E
m
o
tiv
d
e
v
ice
will
b
e
an
al
y
ze
d
u
s
in
g
Py
th
o
n
co
d
e
with
t
h
e
MN
E
lib
r
ar
y
(
MN
E
-
Py
th
o
n
)
.
T
h
e
MN
E
li
b
r
ar
y
,
wh
ich
s
tan
d
s
f
o
r
Ma
g
n
eto
en
ce
p
h
alo
g
r
a
p
h
y
an
d
E
lectr
o
en
ce
p
h
alo
g
r
ap
h
y
,
is
an
o
p
en
-
s
o
u
r
ce
Py
th
o
n
to
o
l
tailo
r
e
d
f
o
r
th
e
a
n
aly
s
is
o
f
n
eu
r
o
im
a
g
i
n
g
d
ata,
e
n
co
m
p
ass
in
g
b
o
th
E
E
G
an
d
m
ag
n
eto
en
ce
p
h
alo
g
r
a
p
h
y
(
ME
G)
.
An
an
aly
s
is
o
f
E
E
G
b
r
ain
wav
e
p
atter
n
s
o
b
s
er
v
e
d
b
ef
o
r
e,
d
u
r
in
g
,
an
d
af
ter
v
ar
io
u
s
th
er
a
p
ies,
in
clu
d
in
g
ar
o
m
ath
er
a
p
y
,
d
ee
p
b
r
ea
th
in
g
,
r
u
q
y
a
h
,
a
n
d
a
c
o
n
tr
o
l
g
r
o
u
p
.
T
h
e
E
E
G
an
aly
s
is
r
ef
lects
elec
tr
ical
b
r
ain
ac
tiv
ity
,
h
ig
h
lig
h
tin
g
b
eta
wav
es
(
1
3
-
3
0
Hz)
th
at
ar
e
lin
k
e
d
to
a
ler
tn
ess
an
d
co
n
ce
n
tr
atio
n
.
E
f
f
ec
tiv
e
co
g
n
itiv
e
p
r
o
ce
s
s
in
g
is
in
d
icate
d
wh
e
n
th
e
ac
tiv
ity
r
e
m
ain
s
b
elo
w
2
0
m
icr
o
v
o
lts
.
T
h
e
r
esu
lts
im
p
ly
th
at
b
o
th
ar
o
m
ath
er
a
p
y
an
d
d
ee
p
b
r
ea
t
h
in
g
s
h
o
w
p
o
te
n
tial
f
o
r
en
h
a
n
cin
g
r
elax
atio
n
an
d
o
v
er
all
m
en
tal
h
ea
lth
,
wh
ich
s
u
g
g
ests
a
n
ee
d
f
o
r
ad
d
itio
n
al
r
esear
ch
to
e
x
p
lo
r
e
th
eir
ef
f
e
cts
o
n
m
en
tal
well
-
b
ein
g
.
T
h
e
u
p
co
m
i
n
g
s
ec
tio
n
will f
o
cu
s
o
n
ex
a
m
in
in
g
t
h
e
E
E
G
s
ig
n
als to
id
en
tify
th
e
p
ea
k
d
u
r
atio
n
n
ee
d
ed
to
ac
h
iev
e
a
s
tate
o
f
ca
lm
n
ess
.
Fig
u
r
e
7
.
E
E
G
r
esu
lts
f
o
r
ar
o
m
ath
er
ap
y
(
b
ef
o
r
e)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
7
6
0
-
7
7
2
768
Fig
u
r
e
8
.
E
E
G
r
esu
lts
f
o
r
ar
o
m
ath
er
ap
y
(
d
u
r
in
g
)
4
.
3
.
M
a
x
im
um
t
im
e
o
f
a
chiev
ing
ca
lm
nes
s
E
x
p
lo
r
in
g
th
e
ef
f
ec
tiv
en
ess
o
f
d
if
f
er
en
t
th
e
r
ap
ies
in
f
o
s
ter
in
g
r
elax
atio
n
an
d
tr
an
q
u
ilit
y
is
ess
en
tial
f
o
r
tack
lin
g
m
e
n
tal
h
ea
lth
is
s
u
es.
No
tab
le
th
er
ap
ies
in
th
is
ar
ea
in
clu
d
e
ar
o
m
ath
er
a
p
y
,
d
ee
p
b
r
ea
th
in
g
e
x
er
cises
,
an
d
r
u
q
y
ah
.
T
h
is
s
tu
d
y
is
d
esig
n
ed
to
in
v
esti
g
ate
th
e
tim
e
n
e
ed
ed
to
attain
a
s
en
s
e
o
f
ca
lm
t
h
r
o
u
g
h
E
E
G
s
ig
n
als
f
o
r
t
h
ese
th
er
a
p
eu
tic
a
p
p
r
o
ac
h
es,
as
well
as
a
co
n
tr
o
l
g
r
o
u
p
.
T
h
e
g
o
al
is
t
o
g
ain
i
n
s
ig
h
ts
th
at
ca
n
o
p
tim
ize
th
er
ap
eu
tic
m
eth
o
d
s
an
d
im
p
r
o
v
e
m
e
n
tal
well
-
b
ein
g
.
Acc
o
r
d
in
g
t
o
W
an
g
et
a
l.
[
3
0
]
,
ar
tif
ac
ts
ar
e
d
ef
i
n
ed
as
an
y
u
n
wan
ted
i
n
ter
f
er
e
n
ce
in
r
ec
o
r
d
ed
b
r
ain
wa
v
e
ac
tiv
ity
.
T
h
ese
ar
tifa
cts
ca
n
ar
is
e
f
r
o
m
v
ar
io
u
s
s
o
u
r
ce
s
,
s
u
c
h
as
m
u
s
cle
co
n
tr
ac
tio
n
s
,
b
lin
k
in
g
,
elec
tr
ical
eq
u
i
p
m
en
t,
a
n
d
en
v
ir
o
n
m
en
tal
d
is
tu
r
b
a
n
ce
s
.
T
o
d
eter
m
in
e
wh
en
ca
lm
n
ess
is
ac
h
iev
ed
u
s
in
g
E
E
G,
we
m
ea
s
u
r
e
th
e
tim
e
b
et
wee
n
th
e
f
ir
s
t
an
d
s
ec
o
n
d
ar
t
if
ac
ts
,
p
ar
ticu
lar
ly
f
o
cu
s
in
g
o
n
th
e
lo
n
g
est
in
ter
v
al,
as
illu
s
tr
ated
in
Fig
u
r
e
9
.
Ou
r
an
aly
s
is
co
n
ce
n
tr
ates
o
n
ea
ch
g
r
o
u
p
at
th
e
Pz
elec
tr
o
d
e
p
o
s
itio
n
,
f
o
llo
win
g
th
e
r
ec
o
m
m
en
d
a
tio
n
o
f
Gao
e
t
a
l.
[
3
0
]
,
wh
ich
in
d
icate
s
f
ewe
r
ar
tifa
cts
in
th
is
lo
ca
tio
n
,
th
er
e
b
y
f
ac
ilit
atin
g
t
h
e
d
etec
tio
n
o
f
ca
lm
n
ess
,
ch
ar
ac
ter
ized
b
y
s
lo
w
b
r
ain
wav
es
.
Fig
u
r
e
9
.
T
h
e
tim
e
f
o
r
ac
h
iev
i
n
g
ca
lm
n
ess
f
o
r
ea
ch
g
r
o
u
p
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
lectro
en
ce
p
h
a
lo
g
r
a
p
h
y
a
n
d
h
ea
r
t ra
te
va
r
ia
b
ilit
y
p
r
o
g
n
o
s
t
ics in
men
ta
l h
ea
lth
…
(
N
u
r
n
a
d
ia
h
Za
mri
)
769
T
h
e
f
in
d
in
g
s
illu
s
tr
ated
in
T
ab
le
3
in
d
icate
th
at,
am
o
n
g
th
e
t
h
er
ap
ies
ass
ess
ed
,
d
ee
p
b
r
ea
th
in
g
s
tan
d
s
o
u
t a
s
th
e
m
o
s
t e
f
f
ec
tiv
e
m
eth
o
d
f
o
r
p
r
o
m
o
tin
g
s
lo
w
-
wav
e
a
ctiv
ity
,
ac
h
iev
in
g
a
d
u
r
atio
n
o
f
2
5
0
s
ec
o
n
d
s
.
T
h
is
is
n
o
tab
ly
lo
n
g
er
th
an
t
h
e
ef
f
e
cts
o
b
s
er
v
ed
with
a
r
o
m
ath
e
r
a
p
y
(
2
0
0
s
ec
o
n
d
s
)
,
r
u
q
y
ah
(
1
5
0
s
ec
o
n
d
s
)
,
an
d
th
e
co
n
tr
o
l
g
r
o
u
p
(
1
0
0
s
ec
o
n
d
s
)
.
T
h
e
ex
ten
d
ed
s
lo
w
-
wav
e
ac
ti
v
ity
d
u
r
in
g
d
ee
p
b
r
ea
th
in
g
em
p
h
asizes
its
p
o
ten
cy
in
f
o
s
ter
in
g
an
d
s
u
s
tain
in
g
a
d
ee
p
s
tate
o
f
r
elax
atio
n
.
T
h
is
p
r
o
lo
n
g
ed
s
tate
o
f
tr
an
q
u
ilit
y
p
o
s
itio
n
s
d
ee
p
b
r
ea
th
in
g
th
er
ap
y
as a
p
ar
ticu
l
ar
ly
ef
f
ec
tiv
e
tech
n
i
q
u
e
f
o
r
en
co
u
r
ag
in
g
o
n
g
o
i
n
g
r
elax
atio
n
an
d
a
d
u
r
a
b
le
s
en
s
e
o
f
ca
lm
.
T
ab
le
3
.
Ma
x
im
u
m
tim
e
ac
h
ie
v
in
g
s
lo
w
wav
es
Th
e
r
a
p
y
Ti
me
(
s)
A
r
o
ma
2
0
0
D
e
e
p
b
r
e
a
t
h
i
n
g
2
5
0
R
u
q
y
a
h
1
5
0
C
o
n
t
r
o
l
g
r
o
u
p
1
0
0
5.
CO
NCLU
SI
O
N
B
y
d
em
o
n
s
tr
atin
g
th
e
ef
f
ec
ti
v
en
ess
o
f
d
ee
p
b
r
ea
t
h
in
g
,
r
u
q
y
ah
an
d
ar
o
m
ath
er
a
p
y
in
p
r
o
m
o
tin
g
ca
lm
n
ess
an
d
r
e
d
u
cin
g
s
y
m
p
to
m
s
o
f
s
tr
ess
,
an
x
iety
,
an
d
d
ep
r
ess
io
n
,
o
u
r
r
esear
ch
c
o
n
tr
i
b
u
tes
to
a
d
v
an
cin
g
th
er
ap
eu
tic
in
ter
v
en
tio
n
s
in
m
en
tal
h
ea
lth
m
a
n
ag
em
en
t.
T
h
e
p
r
o
p
o
s
ed
d
i
f
f
er
en
t
th
er
ap
ies
h
av
e
b
ee
n
s
h
o
wn
to
s
ig
n
if
ican
tly
r
ed
u
ce
s
y
m
p
to
m
s
o
f
s
tr
ess
,
an
x
iety
,
an
d
d
e
p
r
e
s
s
io
n
b
ased
o
n
E
E
G
an
d
HR
V
d
ata.
Ou
r
th
o
r
o
u
g
h
in
v
esti
g
atio
n
in
d
icate
s
th
at
d
ee
p
b
r
ea
th
in
g
ex
er
cises
an
d
ar
o
m
ath
er
a
p
y
ar
e
h
i
g
h
ly
ef
f
e
ctiv
e
m
eth
o
d
s
f
o
r
f
o
s
ter
in
g
r
elax
atio
n
am
o
n
g
i
n
d
iv
id
u
als
with
m
e
n
tal
h
ea
lth
ch
allen
g
es.
T
h
e
p
r
ac
tice
o
f
d
ee
p
b
r
ea
th
i
n
g
co
n
s
is
ten
tly
r
esu
lts
in
elev
ated
co
h
er
en
ce
lev
els
d
u
r
i
n
g
th
e
r
a
p
eu
tic
s
ess
io
n
s
,
h
ig
h
lig
h
tin
g
it
s
s
ig
n
if
ican
t
r
o
le
in
im
p
r
o
v
in
g
well
-
b
ei
n
g
an
d
m
a
n
ag
in
g
s
tr
es
s
.
Ad
d
itio
n
ally
,
ar
o
m
ath
er
ap
y
is
p
ar
ticu
lar
ly
ef
f
ec
tiv
e
in
f
ac
ilit
atin
g
d
ee
p
r
elax
atio
n
,
as
ev
id
en
ce
d
b
y
th
e
h
ig
h
est
p
o
wer
s
p
ec
t
r
al
d
en
s
ity
(
PS
D)
v
alu
es
f
o
r
d
elta
b
r
ain
wav
es.
Fu
r
th
er
m
o
r
e
,
d
ee
p
b
r
ea
th
in
g
e
x
er
cises
h
av
e
b
ee
n
s
h
o
w
n
to
m
ain
tain
s
lo
w
-
wav
e
ac
ti
v
ity
f
o
r
p
r
o
lo
n
g
e
d
p
er
i
o
d
s
,
s
u
g
g
esti
n
g
th
eir
ef
f
ec
tiv
e
n
ess
in
b
o
th
in
itiatin
g
a
n
d
s
u
s
tain
in
g
a
r
elax
ed
s
tate.
T
h
ese
r
es
u
lts
em
p
h
asize
th
e
v
alu
e
o
f
in
teg
r
atin
g
r
esear
ch
-
s
u
p
p
o
r
ted
r
elax
atio
n
s
tr
ateg
ies
in
to
tr
ea
tm
en
t
p
lan
s
,
p
o
ten
tial
ly
lead
in
g
to
m
o
r
e
h
o
lis
t
ic
an
d
ef
f
ec
tiv
e
m
en
tal
h
ea
lth
ca
r
e
s
o
lu
tio
n
s
.
I
m
p
lem
en
tin
g
th
ese
f
in
d
in
g
s
ac
r
o
s
s
d
iv
er
s
e
o
cc
u
p
atio
n
al
g
r
o
u
p
s
an
d
c
o
m
m
u
n
ity
s
ettin
g
s
h
o
ld
s
p
r
o
m
is
e
f
o
r
im
p
r
o
v
in
g
m
en
tal
h
ea
lth
o
u
tco
m
es
b
e
y
o
n
d
tr
ad
itio
n
al
clin
ical
en
v
ir
o
n
m
en
ts
.
Un
d
er
s
tan
d
in
g
h
o
w
th
ese
in
te
r
v
en
tio
n
s
ca
n
b
e
ad
ap
ted
an
d
in
te
g
r
ated
i
n
to
v
ar
io
u
s
p
r
o
f
ess
io
n
al
co
n
tex
ts
co
u
ld
p
r
o
v
id
e
v
alu
a
b
le
in
s
ig
h
ts
in
to
th
eir
ap
p
licab
ilit
y
an
d
ef
f
ec
tiv
en
ess
in
r
ea
l
-
wo
r
ld
s
ce
n
ar
io
s
.
T
h
e
id
en
tific
atio
n
o
f
d
ee
p
b
r
ea
th
in
g
ex
er
cises
an
d
ar
o
m
ath
er
ap
y
as
h
ig
h
ly
ef
f
ec
tiv
e
th
er
ap
ies
s
u
g
g
ests
th
e
n
ee
d
to
tailo
r
tr
ea
tm
en
t
ap
p
r
o
ac
h
es
b
ased
o
n
in
d
iv
i
d
u
al
n
ee
d
s
a
n
d
p
r
ef
e
r
en
ce
s
.
C
o
m
p
ar
ed
to
p
r
ev
io
u
s
s
tu
d
ies,
o
u
r
f
in
d
in
g
s
alig
n
with
th
e
estab
lis
h
ed
b
en
e
f
its
o
f
d
ee
p
b
r
ea
th
i
n
g
an
d
ar
o
m
ath
er
a
p
y
,
b
u
t
p
r
o
v
id
e
m
o
r
e
d
etailed
in
s
ig
h
ts
in
t
o
th
eir
ef
f
ec
tiv
en
ess
m
ea
s
u
r
ed
th
r
o
u
g
h
ad
v
a
n
ce
d
p
h
y
s
io
lo
g
ical
m
ar
k
er
s
.
T
h
e
s
tr
en
g
th
s
o
f
o
u
r
s
tu
d
y
in
clu
d
e
a
co
m
p
r
eh
en
s
iv
e
an
aly
s
is
o
f
E
E
G
an
d
HR
V
d
ata,
s
u
p
p
o
r
tin
g
th
e
h
ig
h
ef
f
icac
y
o
f
th
e
s
e
th
er
ap
ies.
Fu
tu
r
e
s
tu
d
ies
co
u
ld
e
x
p
lo
r
e
th
e
s
y
n
er
g
is
tic
b
e
n
ef
its
o
f
co
m
b
i
n
in
g
th
ese
tech
n
iq
u
es
with
in
th
er
a
p
y
s
ess
io
n
s
,
p
o
ten
tially
en
h
an
cin
g
th
eir
th
er
ap
eu
tic
im
p
ac
t
a
n
d
p
r
o
m
o
tin
g
s
u
s
tain
ed
m
e
n
tal
well
-
b
ein
g
.
Mo
v
in
g
f
o
r
war
d
,
f
u
r
th
er
r
esear
ch
co
u
ld
ex
p
lo
r
e
ad
d
itio
n
al
th
er
a
p
eu
tic
m
o
d
alities
an
d
ex
ten
d
t
h
e
d
u
r
atio
n
o
f
t
h
er
ap
y
s
ess
io
n
s
to
ass
es
s
lo
n
g
-
ter
m
b
e
n
ef
its
an
d
s
u
s
tain
ab
ilit
y
.
T
h
is
a
p
p
r
o
ac
h
co
u
ld
h
el
p
o
p
tim
ize
m
e
n
tal
h
ea
lth
in
ter
v
en
tio
n
s
an
d
b
r
o
a
d
en
th
eir
r
ea
ch
ac
r
o
s
s
d
if
f
er
en
t
p
o
p
u
latio
n
s
an
d
s
ettin
g
s
.
I
n
co
n
clu
s
io
n
,
o
u
r
s
tu
d
y
n
o
t
o
n
ly
d
ee
p
en
s
o
u
r
u
n
d
er
s
tan
d
in
g
o
f
ef
f
ec
tiv
e
th
er
ap
eu
tic
in
ter
v
en
tio
n
s
f
o
r
m
en
tal
h
ea
lth
b
u
t
also
h
ig
h
lig
h
ts
th
e
p
o
ten
tial
to
in
n
o
v
ate
an
d
im
p
r
o
v
e
m
en
tal
h
ea
lth
ca
r
e
p
r
ac
tices.
B
y
co
n
tin
u
in
g
to
ex
p
lo
r
e
n
ew
a
v
en
u
es
f
o
r
r
esear
ch
an
d
em
b
r
ac
in
g
in
n
o
v
ativ
e
ap
p
r
o
a
ch
es,
we
ca
n
ad
v
an
ce
t
h
e
f
ie
ld
o
f
m
e
n
tal
h
ea
lth
m
an
ag
e
m
en
t
an
d
u
ltima
tely
en
h
an
ce
th
e
well
-
b
ein
g
o
f
in
d
iv
id
u
als f
ac
in
g
m
en
tal
h
ea
lth
c
h
allen
g
es in
o
u
r
co
m
m
u
n
ities
.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
e
au
th
o
r
s
wo
u
ld
lik
e
to
e
x
t
en
d
th
ey
’
r
e
th
an
k
s
to
th
e
Un
i
SZA
Hu
m
an
R
esear
ch
E
th
ics
C
o
m
m
ittee
(
UHREC
)
f
o
r
au
th
o
r
izin
g
th
e
s
tu
d
y
.
T
h
ey
also
ap
p
r
ec
iate
th
e
v
alu
ab
le
in
s
ig
h
ts
p
r
o
v
id
ed
b
y
p
ar
ticip
an
ts
f
r
o
m
v
ar
io
u
s
o
r
g
an
izatio
n
s
in
Ku
ala
T
er
en
g
g
a
n
u
.
Fu
r
th
er
m
o
r
e,
th
e
au
th
o
r
s
r
ec
o
g
n
ize
th
e
f
in
an
cia
l su
p
p
o
r
t r
ec
eiv
e
d
f
r
o
m
th
e
Natio
n
al
I
n
s
titu
te
o
f
Occ
u
p
atio
n
al
Saf
ety
a
n
d
Hea
lth
(
NI
OSH)
f
o
r
th
is
r
esear
ch
(
Gr
an
t
No
:
Un
iSZA/2
0
2
3
/PP
L
/NI
OSH(
3
5
)
)
.
RE
F
E
R
E
NC
E
S
[
1
]
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
(
W
H
O
)
,
“
C
o
mp
r
e
h
e
n
s
i
v
e
M
e
n
t
a
l
H
e
a
l
t
h
A
c
t
i
o
n
P
l
a
n
2
0
1
3
-
2
0
3
0
,
”
2
0
1
3
.
A
c
c
e
sse
d
3
1
M
a
r
c
h
2
0
2
4
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
w
w
w
.
w
h
o
.
i
n
t
/
p
u
b
l
i
c
a
t
i
o
n
s/
i
/
i
t
e
m
/
9
7
8
9
2
4
0
0
3
1
0
2
9
.
[
2
]
M
.
L.
W
a
n
g
,
M
.
R
.
N
a
r
c
i
sse
,
K
.
To
g
h
e
r
,
a
n
d
P
.
A
.
M
c
El
f
i
sh
,
“
J
o
b
f
l
e
x
i
b
i
l
i
t
y
,
j
o
b
s
e
c
u
r
i
t
y
,
a
n
d
me
n
t
a
l
h
e
a
l
t
h
a
mo
n
g
U
S
w
o
r
k
i
n
g
a
d
u
l
t
s,
”
J
A
MA
N
e
t
w
o
r
k
O
p
en
,
v
o
l
.
7
,
n
o
.
3
,
p
.
e
2
4
3
4
3
9
,
M
a
r
.
2
0
2
4
,
d
o
i
:
1
0
.
1
0
0
1
/
j
a
m
a
n
e
t
w
o
r
k
o
p
e
n
.
2
0
2
4
.
3
4
3
9
.
Evaluation Warning : The document was created with Spire.PDF for Python.