Anxiety, Depression - Major Depressive Disorder, Disaster, Inflammation, Psychological Stress
Conditions
Keywords
psychological stress, anxiety, mindfulness, tidal flooding, depression
Brief summary
Recurrent tidal flooding (rob) in the coastal areas of Sayung District, Demak Regency, poses a continuous environmental threat that inflicts housing damage, economic instability, and prolonged socioeconomic uncertainty on local residents. These chronic stressors frequently trigger significant psychological distress, including elevated levels of stress, anxiety, and depression, while simultaneously activating systemic inflammatory pathways and dysregulating the hypothalamic-pituitary-adrenal (HPA) axis. Mindfulness body scan is a structured, non-pharmacological mind-body technique that involves directing non-judgmental attention to physical sensations across the body. Within a psycho-neuro-immunological framework, mindfulness practice is hypothesized to reduce physiological stress responses, promote autonomic nervous system balance, and downregulate pro-inflammatory pathways. This randomized controlled trial evaluates the effectiveness of a structured 8-day mindfulness body scan intervention on both biological inflammatory markers and psychological outcomes among tidal flood survivors. Participants recruited from Sayung 1 Primary Health Center will be randomly allocated into two groups: 1. Intervention Group: Receives structured 8-day Mindfulness Body Scan training. 2. Control Group: Receives standard health monitoring. All participants will undergo baseline and post-intervention assessments, which include venous blood sampling to analyze key inflammatory and stress biomarkers-Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-Reactive Protein (CRP), and Cortisol. In addition, psychometric instruments will evaluate changes in depression, anxiety, stress, sleep quality, and overall quality of life. The primary objective is to determine whether a short-term mindfulness body scan practice can effectively reduce systemic inflammation and improve post-disaster psychological well-being in coastal communities.
Detailed description
Background: Recurrent tidal flooding in coastal Sayung, Demak, exposes residents to chronic environmental and socioeconomic stress, contributing to psychological distress and elevated systemic inflammation. Within a psychoneuroimmunological framework, mindfulness practices-specifically the body scan technique-may suppress pro-inflammatory pathways and regulate the hypothalamic-pituitary-adrenal (HPA) axis. Study Design: This is a randomized controlled trial conducted at Sayung 1 Primary Health Center, Demak. Eligible adult survivors of tidal flooding will be randomly allocated to either the intervention group or the control group. Intervention & Control: * Intervention Group: Receives structured 8-day Mindfulness Body Scan training. * Control Group: Receives standard health monitoring. Assessments: Baseline and 1-week post-intervention evaluations will be conducted for all participants: 1. Biomarkers: Venous blood samples to analyze Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-Reactive Protein (CRP), and Cortisol. 2. Psychometric Assessments: Standardized questionnaires evaluating depression, anxiety, stress, sleep quality, and quality of life.
Interventions
BEHAVIORALMindfulness Body Scan Training
A structured 8-day mind-body exercise where participants systematically direct non-judgmental attention to physical sensations throughout the body from head to toe
Sponsors
Natalia Dewi Wardani, MD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants meeting inclusion criteria are randomly assigned to either an 8-day Mindfulness Body Scan intervention or standard monitoring control.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older. * Resident of Sayung District, Demak Regency, affected by tidal flooding (rob). * Registered patient at Sayung 1 Primary Health Center. * Capable of providing written informed consent and participating in the intervention sessions.
Exclusion criteria
* Severe cognitive impairment, active psychosis, or severe psychiatric conditions preventing participation. * Uncontrolled systemic autoimmune or inflammatory diseases. * Current use of long-term systemic corticosteroid or immunosuppressive therapy. * Inability to complete questionnaires or follow basic mindfulness instructions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Serum Interleukin-6 (IL-6) Levels | Baseline (Day 0) and post-intervention (Day 8) | Measured from venous blood samples using ELISA to evaluate changes in pro-inflammatory cytokine levels (concentrations reported in pg/mL). |
| Change in Serum Tumor Necrosis Factor-alpha (TNF-α) Levels | Baseline (Day 0) and post-intervention (Day 8) | Measured from venous blood samples using ELISA to assess systemic inflammatory responses (concentrations reported in pg/mL) |
| Change in Serum C-Reactive Protein (CRP) Levels | Baseline (Day 0) and post-intervention (Day 8) | Evaluated via laboratory blood analysis as an indicator of acute phase systemic inflammation (concentrations reported in mg/L). |
| Change in Serum Cortisol Levels | Baseline (Day 0) and post-intervention (Day 8) | Measured via venous blood samples to assess HPA axis regulation and physiological stress response (concentrations reported in micro-g/dL). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Depression Score | Baseline (Day 0) and post-intervention (Day 8) | Measured using the Patient Health Questionnaire-9 (PHQ-9). Scores range from 0 to 27, where higher scores indicate greater severity of depression. |
| Change in Anxiety Score | Baseline (Day 0) and post-intervention (Day 8) | Measured using the Generalized Anxiety Disorder 7-item scale (GAD-7). Scores range from 0 to 21, where higher scores indicate greater severity of anxiety. |
| Change in Stress Score | Baseline (Day 0) and post-intervention (Day 8) | Measured using the Perceived Stress Scale (PSS-10). Scores range from 0 to 40, where higher scores indicate higher levels of perceived stress. |
| Change in Sleep Quality Score | Baseline (Day 0) and post-intervention (Day 8) | Measured using the Pittsburgh Sleep Quality Index (PSQI). Global scores range from 0 to 21, where higher scores indicate worse sleep quality. |
| Change in Quality of Life Score | Baseline (Day 0) and post-intervention (Day 8) | Measured using the 36-Item Short Form Health Survey (SF-36) Physical Component Summary. Scores range from 0 to 100, where higher scores represent better health-related quality of life. |
Countries
Indonesia
Contacts
CONTACTNatalia Dewi Wardani Dr. dr. Sp.KJ(K)
Outcome results
None listed