Τhe Effect of the Pythagorean Self-Awareness Intervention on Psychological, Lifestyle and Cognitive Measures of a Community Sample

Eleni Zigkiri, Nicolas Nicolaides, Flora Bacopoulou, Dimitrios Simos, Dimitrios Vlachakis, George Chrousos, Christina Darviri


Background: The aim of this study was to evaluate the effect of a novel cognitive-behavioral stress management intervention, termed  “Pythagorean Self-Awareness Intervention” (PSAI). Materials and Methods: The PSAI was applied to a community sample for eight weeks. Measurements included demographic characteristics, daily habits, sleep quality, fatigue, perceived stress levels and depressive symptoms. Cognitive function was measured by the Symbol Digits Modality Test (SDMT), the California Verbal Learning Test (CVLT) and the Brief Visuospatial Memory Test-Revised (BVMT-R). Results: The high-compliance group showed statistically significant differences in healthy lifestyle and personal control choices (HLPCQ; p=0.006), sleep quality (PSQI; p=0.007), self-regulation eating behavior (SREBQ; p=0.009), perceived stress (PSS; p=0.001) and depressive symptoms (p=0.003).  Conclusions: Frequent practice of the PSAI had a positive effect on the psychological, lifestyle, and cognitive measures of the community sample. Larger studies are needed to establish the PSAI as an effective stress management method.


cognitive-behavioral intervention; community sample; Pythagorean Self-Awareness Intervention; stress; stress management


Anagnostouli M, Babili I, Chrousos G, Artemiadis A, & Darviri C 2019 A novel cognitive-behavioral stress management method for multiple sclerosis. A brief report of an observational study. Neurol Res 41 223-226

Αnagnostopoulou T & Kioseoglou G 2002 Sense of Coherence Scale [in Modern Greek]. In Stalikas A, Triliva S, Roussi P (Eds.), Psychometric Tools in Greece 291-292

Andreou E, Alexopoulos EC, Lionis C, Varvogli L, Gnardellis C, Chrousos GP & Darviri, C 2011 Perceived stress scale: reliability and validity study in Greece. Int J Environ Res Public Health 8 3287-3298

Benedict RH 1997 Brief Visuospatial Memory Test–Revised. Lutz, FL: Psychological Assessment Resources.

Bernard HR & Bernard HR 2013 Social research methods: Qualitative and quantitative approaches. SAGE Publications.

Bougea AM, Spandideas N, Alexopoulos EC, Thomaides T, Chrousos GP & Darviri C 2013 Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial. Explore (NY) 9 91-99

Chatzikonstantinou F, Miskedaki A, Antoniou C, Chatzikonstantinou M, Chrousos GP & Darviri C 2019 A novel cognitive stress management technique for acne vulgaris: a short report of a pilot experimental study. Int J Dermatol 58 218-220

Chrousos GP 2009 Stress and disorders of the stress system. Nat Rev Endocrinol 5 374

Crocq MA 2015 A history of anxiety: from Hippocrates to DSM. Dialogues Clin Neurosci 17 319

Darviri C, Alexopoulos EC, Artemiadis AK, Tigani X, Kraniotou C, Darvyri P & Chrousos GP 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 14 995

Darviri C, Zavitsanou C, Delikou A, Giotaki A, Artemiadis A, Anagnostouli M, Varvogli L, Vasdekis S & Chrousos GP 2016a Pythagorean self-awareness serves successfully as a new cognitive behavioral-based technique in multiple sclerosis physical and psychosocial well-being and quality of life. PSYCH 7 572

Darviri C, Zavitsanou C, Delikou A, Giotaki A, Artemiadis A, Terentiou A & Chrousos GP 2016b A Novel Non-Pharmaceutical Treatment for Patients with Mild Cognitive Impairment. PSYCH 7 678

Daskalou & Sigkollitou. 2012 Positive and Negative Affect Scale (PANAS). In: Stalikas A, Triliva S, Roussi P (Eds.), Psychometric Instruments in Greece.

Esch T & Stefano GB 2010a Endogenous reward mechanisms and their importance in stress reduction, exercise and the brain. Arch Med Sci 6 447

Esch T & Stefano GB 2010b The neurobiology of stress management. Neuro Endocrinol Lett 31 19-39

European Lifestyle Medicine Organization 2018 The European Lifestyle Medicine Organization. Retrieved from https://eulm.org/

Giannakou M, Roussi P, Kosmides ME, Kiosseoglou G, Adamopoulou A & Garyfallos G 2013 Adaptation of the beck depression inventory-II to greek population. Hellenic Journal of Psychology 10 120-146

Habib KE, Gold PW & Chrousos GP 2001 Neuroendocrinology of stress. Endocrinol Metab Clin North Am 30 695-728

King TK, Marcus BH, Pinto BM, Emmons KM & Abrams DB 1996 Cognitive–behavioral mediators of changing multiple behaviors: smoking and a sedentary lifestyle. Prev Med 25 684-691

Kotronoulas GC, Papadopoulou CN, Papapetrou A & Patiraki E 2011 Psychometric evaluation and feasibility of the Greek Pittsburgh Sleep Quality Index (GR-PSQI) in patients with cancer receiving chemotherapy. Support Care Cancer 19 1831-1840

Lorenzo-Luaces L, Keefe JR & DeRubeis RJ 2016 Cognitive-Behavioral Therapy: Nature and relation to non-cognitive behavioral therapy. Behav Ther 47 785-803

McEwen BS & Seeman T 1999 Protective and damaging effects of mediators of stress: elaborating and testing the concepts of allostasis and allostatic load. Ann N Y Acad Sci 896 30-47

McEwen BS & Wingfield JC 2003 The concept of allostasis in biology and biomedicine. Horm Behav 43 2-15

Nicolaides NC, Kyratzi E, Lamprokostopoulou A, Chrousos GP & Charmandari E 2015 Stress, the stress system and the role of glucocorticoids. Neuroimmunomodulation 22 6-19

Nutbeam D 2000 Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health promotion international 15 259-267

Reijnders JS, Geusgens CA, Ponds RW & van Boxtel MP 2017 “Keep your brain fit!” Effectiveness of a psychoeducational intervention on cognitive functioning in healthy adults: A randomised controlled trial. Neuropsychol Rehabil 27 455-471

Sheridan LK, Fitzgerald HE, Adams KM, Nigg JT, Martel MM, Puttler LI, Wong MM & Zucker RA 2006 Normative Symbol Digit Modalities Test performance in a community-based sample. Arch Clin Neuropsychol 21 23-28

Simos DS, Kosmidi A, Patikas D & Artemiadis A 2018 Validation of the self-regulation eating behaviour questionnaire scale in the Greek population. J Hum Nutr Diet 4 52

Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, Kondilis B, Stoffels V, Osborne RH & Brand H 2013 Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health 13 948

Stegen S, Stepanov I, Cookfair D, Schwartz E, Hojnacki D, Weinstock-Guttman B & Benedict RH 2010 Validity of the California Verbal Learning Test–II in multiple sclerosis. Clin Neuropsychol 24 189-202

Tsigos C, Kyrou I, Kassi E & Chrousos GP 2000 Stress, Endocrine Physiology and Pathophysiology. In LJ De Groot, GP Chrousos, K Dungan, KR Feingold, A Grossman, JM Hershman, C Koch, et al. (Eds.) Endotext. MDText.com, Inc

Tsigos C & Chrousos GP 2002 Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress. J Psychosom Res 53 865-871

Tsoli S, Vasdekis S, Tigani X, Artemiadis A, Chrousos GP & Darviri C 2018 A novel cognitive behavioral treatment for patients with chronic insomnia: A pilot experimental study. Complement Ther Med 37 61–3

World Health Organization 2018 Track 2: Health Literacy and Health Behaviour. Retrieved from https://www.who.int/healthpromotion/conferences/7gchp/track2/en/

World Health Organization 2018 Track 3: Strengthening Health Systems. Retrieved from https://www.who.int/healthpromotion/conferences/7gchp/track3/en/

World Health Organization 2017 Number of People over 60 Years Set to Double by 2050; Major Societal Changes Required. Retrieved from http://www.who.int/entity/mediacentre/news/releases/2015/older-persons-day/en/

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