Pythagorean Self-Awareness serves effectively for Stress Management on Freshmen

A quasi-experimental study

  • Bitchava Ioanna C. Doctoral candidate in Clinical Psychology Postgraduate Course Stress Management and Health Promotion, Athens Kapodistrian National University Medical School Athens, Greece
  • Angie-M. P. Paleologou Assistant Professor of Clinical Psychology, Self-Lineation Special Laboratory, Department of Philosophy, Pedagogy, and Psychology (Section of Psychology), University of Ioannina, Greece
  • Chrousos George P., Prof. (Dr.) Professor and Chairman of the Department of Pediatrics at the Athens University Medical School, AthensCountry Greece
  • Artemios K. Artemiadis Medical Doctor (Neurologist) at 417 NIMTS Hospital, Athens, Greece
  • Darviri Christina, Prof. (Dr.) Professor of Prevention and Health Promotion, The Medical School of the Kapodistrian University of Athens, Greece
Keywords: Freshmen, Stress, Pythagorean Self-Awareness, Stress-Management Techniques


Adjustment to conditions surrounding the first year of studies in tertiary education can be highly stressful. Because of the pertinent challenges, University freshmen evidently run risks for developing mental and physical ailments probably undermining their entire wellbeing. Aims: This study evaluates effects of two preventive or/and corrective intervention methods dealing with their difficulties. Sample: Freshmen (N=60). Methods: In a parallel quasi-experimental design the above freshmen were randomly sub-grouped for attending to 8 consecutive weekly sessions of either Pythagorean Self-Awareness Intervention (PSAI) or Stress Management Techniques Intervention (SMTI). Several self-report measures were administered at pre- and post-intervention phases. Assessment included various factors: (a) psychological: stress, anxiety, depression, anger, emotionality, (b) physiological: Body-Mass-Index (BMI) via engaging in healthy habits, lifestyle, sleep, (c) basic cognitive: visuospatial memory, verbal learning and (d) complex mental: fatigue-vs-coherence, speed processing, self-efficacy. Results: Significant post-intervention improvements were noted for most dimensions, irrespective of group allocation. SMTI was superior to PSAI for reducing BMI and improving basic cognitive features, whereas PSAI was superior for improving psychological and complex mental processes. Conclusions: Results are encouraging to suggest these interventions be introduced in academic settings as effective meta-cognitive multifaceted procedures for stress management, to help students become more successful in their personal as well as academic lives.

Article DOI : 10.5958/2347-6869.2017.00012.7


Abdollahi, A., Abu Talib, M., Yaacob, S. N., & Ismail, Z. (2014). Hardiness as a mediator between perceived stress and happiness in nurses. Journal of psychiatric and mental health nursing, 21(9), 789-796. Doi:
Ahmed, I., Banu, H., Al-Fageer, R., & Al-Suwaidi, R. (2009). Cognitive emotions: depression and anxiety in medical students and staff. Journal of critical care, 24(3), e1-e7. Doi:
Allison, K. D. (2015). Stress, anxiety symptomology, and the need for student support services for university freshmen of first-generation status, low-SES backgrounds, and those registered with disabilities. [Doctoral dissertation]. Louisiana: Xavier University.
Anagnostopoulou, T., & Kioseoglou, G. (2012). State-Trait Anger Expression Inventory, in A. Stalikas, S. Triliva, and P. Roussi (Eds.), The psychometric instruments in Greece: A comprehensive collection and presentation of questionnaires, tests, instruments and assessment kits in Greece, p. 576. Athens: Topos Publications [in Greek].
Anagnostopoulou T. (2012). Sense of Coherence Scale, in A. Stalikas, S. Triliva, and P. Roussi (Eds.), The psychometric instruments in Greece: A comprehensive collection and presentation of questionnaires, tests, instruments and assessment kits in Greece, p. 576. Athens: Topos Publications [in Greek].
Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social science & medicine, 36(6), 725-733. Doi:
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90-96. Doi:
Benedict, R. H., Schretlen, D., Groninger, L., Dobraski, M., & Shpritz, B. (1996). Revision of the Brief Visuospatial Memory Test: Studies of normal performance, reliability, and validity. Psychological Assessment, 8(2), 145. Doi:
Cevik, V., & Altun, A. (2016). Roles of working memory performance and instructional strategy in complex cognitive task performance. Journal of Computer Assisted Learning, 32(6), 594-606. Doi:
Coetzee, M., & Harry, N. (2015). Gender and hardiness as predictors of career adaptability: an exploratory study among Black call centre agents. South African Journal of Psychology, 45(1), 81-92. Doi:
Conley, C. S., Durlak, J. A., & Kirsch, A. C. (2015). A meta-analysis of universal mental health prevention programs for higher education students. Prevention Science, 16(4), 487-507. Doi:
Darcy, A., Roe, S., McKnight, F., & Nolan, C. (2013). Fatigue in College Students. [Unpublished Thesis Dissertation]. Dublin: Trinity College.
Darviri, C., Alexopoulos, E. C., Artemiadis, A. K., Tigani, X., Kraniotou, C., Darvyri, P., & Chrousos, G. P. (2014). The Healthy Lifestyle and Personal Control Questionnaire (HLPCQ): a novel tool for assessing self-empowerment through a constellation of daily activities. BMC public health, 14(1), 995.Doi:
Darviri, C., Zavitsanou, C., Delikou, A., Giotaki, A., Artemiadis, A., Anagnostouli, M., & Chrousos, G. P. (2016). Pythagorean Self-Awareness Serves Successfully as a New Cognitive Behavioral-Based Technique in Multiple Sclerosis Physical and Psychosocial Well-Being and Quality of Life. Psychology, 7(04): 572. Doi:
Delis, D. C., Kramer, J. H., Kaplan, E., & Ober, B. A. (2000). CVLT-II: California Verbal Learning Test: Adult Version. Psychological Corporation.
Di Paolo, N. C., & Shayakhmetov, D. M. (2016). Interleukin 1 [alpha] and the inflammatory process. Nature Immunology, 17(8), 906-913. Doi:
Doane, L. D., Gress-Smith, J. L., & Breitenstein, R. S. (2015). Multi-method assessments of sleep over the transition to college and the associations with depression and anxiety symptoms. Journal of youth and adolescence, 44(2), 389-404. Doi:
Doerr, J. M., Ditzen, B., Strahler, J., Linnemann, A., Ziemek, J., Skoluda, and Hoppmann, C.A., and Nater, U. M. (2015). Reciprocal relationship between acute stress and acute fatigue in everyday life in a sample of university students. Biological psychology 110, 42-49. Doi:
Dozois, D. J., Seeds, P. M., & Collins, K. A. (2009). Transdiagnostic approaches to the prevention of depression and anxiety. Journal of Cognitive Psychotherapy, 23(1), 44-59.. Doi:
Drake, E. C., Sladek, M. R., & Doane, L. D. (2016). Daily cortisol activity, loneliness, and coping efficacy in late adolescence: A longitudinal study of the transition to college. International Journal of Behavioral Development, 40(4), 334-345.. Doi:
Fernandez, A., Howse, E., Rubio-Valera, M., Thorncraft, K., Noone, J., Luu, X., Veness, B., Leech, M., Llewellyn, G., & Salvador-Carulla, L. (2016). Setting-based interventions to promote mental health at the university: a systematic review. International Journal of Public Health 61(7), 797-807. Doi:
Fleshner, M., Frank, M., & Maier, S. F. (2017). Danger signals and inflammasomes: stress-evoked sterile inflammation in mood disorders. Neuropsychopharmacology, 42(1), 36-45.Doi:
Glynou, E., Schwarzer, R. & Jerusalem M. (1994). Greek Adaptation of the General Self-Efficacy Scale, URL (October, 2015):
Goldwurm, G. F., Bielli, D., Corsale, B., & Marchi, S. (2006). Optimism training: Methodology and results. Homeostasis In Health And Disease 44(1–2), 27–33.
Guendelman, S., Medeiros, S., & Rampes, H. (2017). Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies. Frontiers in Psychology, 8..Doi:
Horgan, A., Sweeney, J., Behan, L., & McCarthy, G. (2016). Depressive symptoms, college adjustment and peer support among undergraduate nursing and midwifery students. Journal of Advanced Nursing, 72(12), 3081-3092. Doi:
Hunt, J., & Eisenberg, D. (2010). Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health, 46(1), 3-10. Doi:
Hurdiel, R., Watier, T., Honn, K., Pezé, T., Zunquin, G., & Theunynck, D. (2017). Effects of a 12-week physical activities programme on sleep in female university students. Research in Sports Medicine, 25(2), 191-196. Doi:
Hystad, S. W., Eid, J., Laberg, J. C., Johnsen, B. H., & Bartone, P. T. (2009). Academic stress and health: Exploring the moderating role of personality hardiness. Scandinavian journal of educational research, 53(5), 421-429. Doi:
Jackson, L. M., Pancer, S., Pratt, M. W., & Hunsberger, B. E. (2000). Great Expectations: The Relation Between Expectancies and Adjustment During the Transition to University1. Journal of Applied Social Psychology, 30(10), 2100-2125. Doi:
James, D., Sebren, A., DerAnanian, C., Bruening, M., Rooney, L., Araas, T., & Swan, P. D. (2016). Associations Among Self-Compassion, Eating Behaviors, and Stress in College Freshmen. Journal of Basic and Applied Sciences, 12, 92-97. Doi:
Kafetsios, Κ. (2012). Emotional Intelligence Scale - Wong and Law, in A. Stalikas, S. Triliva, and P. Roussi (Eds.), The psychometric instruments in Greece: A comprehensive collection and presentation of questionnaires, tests, instruments and assessment kits in Greece, p. 424. Athens: Topos Publications [in Greek].
Kalantzi-Azizi, A., Karademas, E., Sotiropoulou, G. A (2001). Cognitive behavioral programme of group intervention in student population for supporting their expectations of self-efficacy. Psychologia 8(2), 267-80. [In Greek].
Khambatta, C. & Jevon N. (2011). Fatigue: The Essential Guide. Peterborough: Need2Know.
Kötter, T., Tautphäus, Y., Obst, K. U., Voltmer, E., & Scherer, M. (2016). Health‐promoting factors in the freshman year of medical school: a longitudinal study. Medical education, 50(6), 646-656.. Doi:
Kross, E., Bruehlman-Senecal, E., Park, J., Burson, A., Dougherty, A., Shablack, H., Bremner, R., Mojer, J., & Ayduk O. (2014). Self-talk as a regulatory mechanism: how you do it matters. Journal of Personality and Social Psychology 106(2), 304. Doi:
Kurré, J., Scholl, J., Bullinger, M., & Petersen-Ewert, C. (2011). Integration and health-related quality of life of undergraduate medical students with migration backgrounds. Results of a survey. GMS Psycho-Social-Medicine, 8. Doc07 doi:
Leder, J., Häusser, J. A., & Mojzisch, A. (2013). Stress and strategic decision-making in the beauty contest game. Psychoneuroendocrinology, 38(9), 1503-1511. Doi:
Lee, C., Dickson, D. A., Conley, C. S., & Holmbeck, G. N. (2014). A closer look at self-esteem, perceived social support, and coping strategy: a prospective study of depressive symptomatology across the transition to college. Journal of Social and Clinical Psychology, 33(6), 560-585.. Doi:
Lovibond, S.H. & Lovibond, P. (1995). Manual for the Depression Anxiety Stress Scales (2nd Ed.). Sydney: Psychology Foundation.
Lu, W., Bian, Q., Song, Y. Y., Ren, J. Y., Xu, X. Y., & Zhao, M. (2015). Prevalence and related risk factors of anxiety and depression among Chinese college freshmen. Journal of Huazhong University of Science and Technology [Medical Sciences] 35(6), 815-822. Doi:
Lund, H. G., Reider, B. D., Whiting, A. B., & Prichard, J. R. (2010). Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of adolescent health 46(2), 124-132.Doi:
Lyrakos, G. N., Arvaniti, C., Smyrnioti, M., and Kostopanagiotou, G. (2011). P03-561-Translation and validation study of the depression anxiety stress scale in the greek general population and in a psychiatric patient's sample. European Psychiatry 26, 1731. Doi:
Marouda–Chatjoulis, A. (2003). A proposal for a problem solving process model for counseling in personal dilemmas and conflicts. Psychologia 10(2-3), 310-29. [In Greek].
Millett-Thompson, A. (2017). Dealing With College Students' Stress, Anxiety, and Depression. The Journal for Quality and Participation 39(4), 24.
Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C. M., & Colantonio, A. (2016). The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep medicine reviews 25,52-73. Doi:
NANDA International. (2011). Nursing Diagnosis - Definitions and Classifications, 2012-2014. Hoboken, NJ: Wiley-Blackwell.
Obasi, E. M., Shirtcliff, E. A., Cavanagh, L., Ratliff, K. L., Pittman, D. M., & Brooks, J. J. (2017).Hypothalamic-Pituitary-Adrenal Reactivity to Acute Stress: an Investigation into the Roles of Perceived Stress and Family Resources. Prevention Science, 1-9. Doi:
Paleologou, Α.M. (In press). Clinical Psychology and Psychotherapy Re-Orientations. Athens: Gutenberg Publications.
Paleologou, Α.M. (2015). Protocols of Seminars on the Meta-cognitional HardySurge Proactive Health Methodology. Ioannina: University of Ioannina Press.
Patton, L.D., Renn, K.A., Guido, F.M., Quaye, S.J., Evans, N.J. & Forney, D.S. (2016). Student development in college: Theory, research, and practice [2nd Ed.] San Fransisco: John Wiley and Sons.
Pedrelli, P., Shapero, B., Archibald, A., & Dale, C. (2016). Alcohol use and depression during adolescence and young adulthood: a summary and interpretation of mixed findings. Current addiction reports 3(1), 91-97. Doi:
Petzold, A., Plessow, F., Goschke, T., & Kirschbaum, C. (2010). Stress reduces use of negative feedback in a feedback-based learning task. Behavioral neuroscience 124(2), 248. Doi:
Sajadi, S. A., Farsi, Z., Rajaei, N., Mazhari, M. S., & Habibi, H. (2016). Sleep quality and the factors affecting the fatigue severity and academic performance of students at AJA University of Medical Sciences. Journal of Advances in Medical Education (JAMED) 1(2),9-15.
Saleh, D., Romo, L., & Camart, N. (2017). Is Perceived Stress of French University Students Related to Personality Traits? Psychology 7(1), 42-49. Doi:
Schwabe, L., Dalm, S., Schächinger, H., & Oitzl, M. S. (2008). Chronic stress modulates the use of spatial and stimulus-response learning strategies in mice and man. Neurobiology of learning and memory 90(3), 495-503. Doi:
Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy scale in J. Weinman, S. Wright, and M. Johnston (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs ,pp. 35-37. Windsor, UK: NFER-NELSON.
Sheridan, V., & Dunne, S. (2012). The bigger picture: undergraduate voices reflecting on academic transition in an Irish university. Innovations in Education and Teaching International 49(3), 237-247. Doi:
Sica, L. S., Sestito, L. A., & Ragozini, G. (2014). Identity coping in the first years of university: Identity diffusion, adjustment and identity distress. Journal of Adult Development 21(3), 159-172. Doi:
Smith, A. (1982). Symbol Digit Modalities Test (SDMT) Manual (Revised). Los Angeles: Western Psychological Services.
Spielberger, C.D., Johnson, E.H., Russell, S.F., Crane, R.J., Jacobs, G.A. & Worden, T.J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale, in M.A. Chesney and R.H. Rosenman (Eds.), Anger and hostility in cardiovascular and behavioral disorders, p.50. New York: Hemisphere.
Srivastava, S., Tamir, M., McGonigal, K. M., John, O. P., & Gross, J. J. (2009). The social costs of emotional suppression: a prospective study of the transition to college. Journal of personality and social psychology 96(4), 883. Doi:
Stock, C., Mikolajczyk, R.T., Bilir, N., Petkeviciene, J., Naydenova, V., Dudziak, U., Marin-Fernandez, B., & El Ansari, W. (2008). Gender differences in health complaints among students across European countries: Results from a survey in seven European countries. Journal of Public Health 16, 353-360. Doi:
Tognoli, J. (2003). Leaving home: Homesickness, place attachment, and transition among residential college students. Journal of College Student Psychotherapy 18(1), 35-48. Doi:
Tozzi, A., Zare, M., & Benasich, A. A. (2016). New Perspectives on Spontaneous Brain Activity: Dynamic Networks and Energy Matter. Frontiers in Human Neuroscience 10, 247. Doi:
Vaez, M., Kristenson, M., & Laflamme, L. (2004). Perceived quality of life and self-rated health among first-year university students. Social Indicators Research 68(2), 221-234. Doi:
Van Eck, K., Warren, P., & Flory, K. (2017). A variable-centered and person-centered evaluation of emotion regulation and distress tolerance: links to emotional and behavioral concerns. Journal of youth and adolescence 46(1), 136-150. Doi:
Voss, M.W., Prakash, R.S., Erickson, K.I., Basak, C., Chaddock, L., Kim, J.S., Alves, H., Heo, S., Szabo, A.N., White, S.M., Wójcicki, T.R., Mailey, E.L., Gothe, N., Olson, E.A., McAuley, E. & Kramer, A. (2010). Plasticity of brain networks in a randomized intervention trial of exercise training in older adults. Frontiers in aging neuroscience 2, 32. Doi:
Wibrowski, C. R., Matthews, W. K., & Kitsantas, A. (2016). The Role of a Skills Learning Support Program on First-Generation College Students’ Self-Regulation, Motivation, and Academic Achievement: A Longitudinal Study. Journal of College Student Retention: Research, Theory and Practice, 1521025116629152. Doi:
Wilson, G., & Gillies, R. M. (2005). Stress Associated With the Transition From High School to University: The Effect of Social Support and Self-Efficacy. Australian Journal of Guidance and Counselling 15(01), 77-92. Doi:
Wintre, M. G., Ames, M. E., Pancer, S. M., Pratt, M. W., Polivy, J., Birnie-Lefcovitch, S., & Adams, G. R. (2011). Parental divorce and first-year students' transition to university: The need to include baseline data and gender. Journal of Divorce and Remarriage 52(5), 326-343. Doi:
Wong, C. S., & Law, K. S. (2002). The effects of leader and follower emotional intelligence on performance and attitude: An exploratory study. The leadership quarterly 13(3), 243-274. Doi:
Yang, C. C., & Brown, B. B. (2016). Online self-presentation on Facebook and self development during the college transition. Journal of youth and adolescence 45(2), 402-416. Doi:
Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and cognition 19(2), 597-605. Doi:
Pythagorean Self-Awareness serves effectively for Stress Management on Freshmen:  A quasi-experimental study
How to Cite
Ioanna C., B., Paleologou, A.-M. P., George P., C., Artemiadis, A. K., & Christina, D. (2017). Pythagorean Self-Awareness serves effectively for Stress Management on Freshmen. SOCRATES, 5(2), 15-37. Retrieved from