|
 
 |
| ORIGINAL ARTICLE |
|
| Year : 2022 | Volume
: 54
| Issue : 2 | Page : 62-69 |
|
Effect of 6 month-yoga training on mental health of Indian jail inmates
Sadhana Arya, Rameswar Pal, Khushbu Jain, Sachendra Badoni, Jitender Kaushik, Pooja Kumari Gond, Ishwar V Basavaraddi
Teaching Department, Morarji Desai National Institute of Yoga, Ministry of AYUSH, Government of India, New Delhi, India
| Date of Submission | 24-Aug-2022 |
| Date of Decision | 09-Nov-2022 |
| Date of Acceptance | 10-Nov-2022 |
| Date of Web Publication | 15-Dec-2022 |
Correspondence Address:
Dr. Ishwar V Basavaraddi
Director, Morarji Desai National Institute of Yoga, Ministry of AYUSH, Government of India, 68, Ashok Road, New Delhi - 110 001
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ym.ym_113_22
Introduction: Prisoners are vulnerable to mental health-related problems. The present study was conducted to determine the effect of 6 months Yoga practice on the mental health of jail inmates. The study's main objective was to assess the impact of 6 months of Yoga practice on the mental health of Jail inmates.
Materials and Methods: A total of 37 Tihar Jail inmates (27 males and 10 females) participated in the study. With the help of questionnaires, anxiety, depression, stress, aggression, physical health, psychological health, and general well-being of the jail inmates were assessed. The study employed a Single Group Repeated Measures design. Pre and posttest methods were adopted in the study.
Results: Significant reduction in stress and aggression and improvement in physical health, psychological health, and general well-being were found after 6 months Yoga-training; however, there was no significant reduction in anxiety and depression in the combined group. In male inmates, anxiety, depression, stress, and aggression were reduced significantly, and their physical health, psychological health, and general well-being significantly improved after 6 months of Yoga training. In female inmates, aggression got reduced after 6 months of regular Yoga practice; but no significant changes were found in other parameters.
Conclusion: Regular Yoga practice for 6 months significantly improved the mental health of Tihar Jail inmates, especially male inmates. However, there is a need to conduct more studies to confirm the results.
Keywords: Aggression, anxiety, depression, physical health, psychological health, Yoga
How to cite this article:
Arya S, Pal R, Jain K, Badoni S, Kaushik J, Gond PK, Basavaraddi IV. Effect of 6 month-yoga training on mental health of Indian jail inmates. Yoga Mimamsa 2022;54:62-9 |
How to cite this URL:
Arya S, Pal R, Jain K, Badoni S, Kaushik J, Gond PK, Basavaraddi IV. Effect of 6 month-yoga training on mental health of Indian jail inmates. Yoga Mimamsa [serial online] 2022 [cited 2023 Jun 9];54:62-9. Available from: https://www.ym-kdham.in/text.asp?2022/54/2/62/363805 |
| Introduction | |  |
Mental health is of paramount importance for everyone. A person cannot lead a normal life without good mental health. Mental health assumes greater significance for jail-inmates. The prevalence of mental health-related problems such as depression, stress, and anxiety was found to be higher in jail inmates than in the general population.[1],[2] Inmates in prison were found to have high prevalence rates of psychiatric morbidity.[3] Studies reported more heightened physical aggression in Nigerian prison inmates as compared to noninmates selected from the general population.[4] A study reported a high prevalence of depression, stress, and anxiety in inmates of a Turk prison.[5] Further, another study revealed high prevalence of mental health related problems.[6]
Imprisonment is a method of dealing with people who commit acts that may threaten the well-being of society and are forbidden by the law. A jail is a place that houses people who have committed some offense/crime and have been imprisoned by a law enforcement agency. Here, the inmates are forcibly confined and denied certain freedoms under the state's authority as a form of punishment. Imprisonment carries separation from family members, enforced solitude, loss of social status, overcrowding, uncertainties about the trial, fear of punishment, sensory deprivation, exposure to hard-core offenders, insecurity, uncertainty about the future, loss of freedom, lack of privacy, hard life of prison, etc., These conditions place a tremendous psychological burden and therefore, may seriously affect the well-being of prisoners.
Yoga has been found effective for improving mental health-related parameters. Among the milder form of psychiatric conditions, anxiety and depression have been extensively investigated. Several studies further demonstrate the beneficial effects of Yoga in improving the mental health of prisoners. A study found Yoga as a form of physical activity effective for reducing psychological distress levels in inmates of a Swedish prison.[7] The study reported the beneficial effects of Yoga in significantly decreasing depression and stress and improving self-awareness in female inmates in the Yoga group.[8] A review study established that Yoga and meditation improved mood, concentration, and decision-making and an ability to override impulses; and reduced stress and psychological distress in female prisoners in Delhi.[9] A study reported that Yoga significantly improved the measures of prisoners' mood and psychological well-being, as well as facilitated cognitive processes relating to sustained attention and behavioral inhibition.[10] Studies found positive changes in the states of anxiety, stress, depression, regression, fatigue, guilt, extraversion, and arousal in the trainees after a 4-month residential course in Yoga studies.
Although many studies were conducted to determine the impacts of Yogic practice on the mental health of populations of different ages, gender, occupation, healthy, and disease category, long-term studies about the effects of Yoga on jail inmates are rare.
With this background, the present study was conducted to assess the effect of the 6 months Yoga-training on the mental health of Tihar Jail, Delhi inmates. The study was part of a project “Sanjeevan” undertaken by Morarji Desai National Institute of Yoga, New Delhi, and Prison Headquarters, Central Jail, Tihar, New Delhi, to train Tihar Jail inmates as Yoga trainers. For this study, aggression, anxiety, depression, stress, physical health, psychological health, and general well-being were used to assess the effect of yoga-training on jail inmates' mental health. All the parameters are associated with mental health. Aggression, anxiety, depression, and stress are negatively correlated, while physical health, psychological health, and general well-being positively correlate with mental health. The study was carried out with the hypothesis that regular Yoga practice will reduce aggression, anxiety, depression, and stress; and enhance the jail inmates' physical health, psychological health, and general well-being. Thus, the yogic practices will improve mental health by bringing about favorable changes in the jail inmates' aggression, anxiety, depression, stress, psychological health, and general well-being.
| Materials and Methods | | |
Participants
The Tihar Jail inmates who got enrolled themselves in the yoga-training program were the participants in the study. The final sample consisted of 37 participants, 27 males, and 10 female inmates. Their age ranged from 21 to 60 years. Their minimum educational qualification was 12th standard. Physically and mentally healthy particpants were included in the study whereas participants suffering from chronic diseases, alcoholism, drug addiction, and mental disability were excluded. Regular yoga practitioners were also excluded from the study.
The first assessment (pre-yoga training) sample consisted of 68 inmates, including 44 males and 24 females. In the second assessment, 34 males and 17 females participated. In the third and final phase of the evaluation, only 27 males and 10 females participated. The reasons for gradual reduction/dropout in the participants were many – like some participants got parole, some got bail, and some were released.
Design of the study
Present study was conducted with single group repeated measures design wherein all dependent variables were collected at 3 different time intervals. The design of the study is illustrated in [Figure 1].
Data collection
The data were collected on all the dependent variables in three phases. For this, all the questionnaires were given to the jail inmates individually. Before administering the questionnaire, the participants were briefed about the purpose of data collection.
The process and stages of data collection are illustrated in [Figure 2]. In phase I, baseline data were collected on day 7 after the preparatory phase of the yoga-training before the yoga-training started. In phase II, data were collected on day 90 after the completion of 3 months of yoga-training. In phase III, data were collected on day 180 after yoga-training. Yogic practices are mentioned in [Table 1].
Signed individual consent was obtained from the participants. The study was approved by the Institutional Ethical Committee, Morarji Desai National Institute of Yoga, New Delhi-110001.
Materials/tools used
The following questionnaires were used for the data collection.
Aggression inventory
The Hindi version of the Aggression Inventory (AI) developed by Sultania was used to assess aggression in Tihar Jail inmates.[11] AI is a Hindi adaptation of the Buss-Durkee Aggression Scale. The AI has 67 items divided into eight subscales that measure assault, indirect aggression, irritability, negativism, resentment suspicion, verbal aggression, and guilt. The responses are recorded in “Sahi” (True) and “Galat” (False). The test-retest reliability coefficient is 0.82 for males and 0.79 for females. The manual for AI developed by Sultania (2006; P 5-6) was used for scoring.[11]
Anxiety, depression and stress scale
The Hindi version of the Anxiety, Depression, and Stress Scale developed by Bhatnagar et al. was used to assess the anxiety, depression, and aggression of the Tihar Jail inmates.[12] The scale has 48 items divided into three subscales: anxiety, depression, and stress. Internal consistency of the anxiety, depression, and stress, when measured by Cronbach's Alpha, is 0.76, 0.75, and 0.61, respectively. The manual for anxiety, depression, and stress scale developed by Bhatnagar et al. (2011; p 6) was used for scoring.[12]
PGI Health Questionnaire
The Hindi version of the PGI Health Questionnaire was used to assess jail inmates' physical and psychological health. The PGI Health Questionnaire is developed by Verma et al. 2016.[13] The questionnaire has 38 items divided into two parts – “Part A” and “Part B.” Its reliability by the test-retest method is 0.88 and by the split-half method is 0.86. The manual for PGI Health Questionnaire developed by Verma et al. (1974; p 10) was used for scoring.[13]
PGI general well-being measure
The Hindi version of the PGI general well-being measure developed by Verma and Verma (2016) was used to assess the general well-being of Tihar Jail inmates. The scale consists of 20 items that measure the general well-being in terms of subjective feelings of contentment, happiness, satisfaction with life's experiences, and of one's role in the work, sense of achievement, utility, belongingness, and no distress, dissatisfaction or worry, etc. Its test-retest reliability was 0.86 for the Hindi version. The Manual for PGI General Well-being Measure developed by Verma and Verma (1989; p 8) was used for scoring.[14]
Statistical analysis
All the statistics was performed using Statistical Package for the Social Sciences (SPSS) version 22 for windows (SPSS Software, IBM Corporation, USA). The study aimed to assess the effect of Yogic practices in one direction only. Therefore, one-tailed t-test was applied to test the significance of the difference between the means of pre-yoga training and post yoga training data on each D.V. separately. Statistical significance was set at 0.05 α (p ≤ 0.05). Statistical analysis was done separately for male inmates, female inmates, and a combined group of males and females. For each group, the t-test was applied in the three pairs for all dependent variables. Pair 1 comparison was made between the baseline data (pre-yoga-training data) and the data obtained after 3 months' yoga-training. In Pair 2 comparison was made between the baseline data (pre-yoga-training data) and the data obtained after 6 months' yoga-training. In Pair 3, the t-test was applied for the data obtained after 3 and 6 months of yoga training.
| Results | | |
The results of the study are depicted in [Table 2], [Table 3], [Table 4]. | Table 3: Psychological response following Yogic practices in female group
Click here to view |
 | Table 4: Psychological response following Yogic practices in combined group
Click here to view |
Aggression in male inmates was significantly (p < 0.01) reduced after 6 months yoga-training. [Table 2] shows that the reduction in aggression in the initial 3 months of yoga–training was nonsignificant. Results also show that a rapid reduction in aggression occurred in the later phase (3–6 months) of yoga-training as there was a significant (p < 0.01) reduction in aggression after 6 months of Yoga training when compared with aggression after 3 months of yoga practice. In female inmates, aggression increased negligibly in the initial 3 months; but later, it reduced. Results also show that aggression got significantly (p < 0.05) reduced in the later phase [3–6 months, [Table 3]]. In the combined group, aggression was continuously reduced. This reduction was highly significant (p < 0.01) after 6 months of Yoga training. Aggression after 3 months of Yoga-training got reduced, but it is statistically nonsignificant. Results also show that aggression got highly reduced in the latter half (3–6 months) of yoga training [Table 4].
Study shows that anxiety in male inmates got consistently reduced with yoga-practice for 6 months; however, this reduction was highly significant after 6 months' continuous practice of Yoga. It also shows that the reduction in anxiety in male inmates in the first half (initial three months) of Yoga practice was statistically nonsignificant [Table 2]. Anxiety in female inmates increased for 6 months even with Yoga-practice, although this increase was very mild and statistically nonsignificant. Thus, Yoga-training remained ineffective in reducing the anxiety of female inmates [Table 3]. Anxiety in the combined group continuously decreased for 6 months with Yoga-training, but this reduction was statistically nonsignificant [Table 4].
Depression in male inmates was consistently decreased for 6 months with Yoga-practice. This reduction was found significant after 6 months; the initial 3 months of Yoga-training were statistically nonsignificant. The statistical analysis shows that depression got significantly (p < 0.05) reduced during the period later half (3–6 months) of the Yoga-training [Table 2] in males. In female inmates, there was no change in the state of depression in the initial 3 months. However, it increased afterward, although it was statistically nonsignificant [Table 3]. Depression in the combined group was statistically nonsignificant [Table 4].
In the male group, stress was consistently reduced. [Table 2] shows that a significant (p < 0.01) reduction in stress of male inmates was found after 6 months of yoga training. The stress reduction was statistically nonsignificant after the initial 3 months of Yoga-training. Results also show that there was a significant (p < 0.01) reduction in stress in the latter half (after 6 months) of Yoga-training when a comparison was made between the data on stress after 3 months and 6 months of Yoga-training. In the female group, stress consistently increased during 6 months, although this increase was very mild and statistically nonsignificant [Table 3]. In the combined group, stress was consistently reduced during 6 months' Yoga training. The analysis shows that the reduction in stress was significant (p < 0.05) after 6 months of Yoga training [Table 4].
Table 2 shows that the physical health of male inmates improved consistently during 6 months of Yoga-training. Significant improvement in the physical health of male inmates was found after 3 months (p < 0.05) as well as 6 months (p < 0.01). Thus, Yoga-training effectively brought significant improvement in the physical health of male inmates over 6 months. In female inmates, improvement in physical health was found in the initial three months, although this improvement was statistically nonsignificant [Table 3]. There was a slight deterioration in the later 3 months; their health was still better than before the Yoga-training started. Overall no significant change was found in the physical health of female inmates. In the combined group, consistent improvement in physical health was seen for 6 months. This improvement was found statistically significant (p < 0.05) only after 6 months' Yoga training; before this the improvement remained statistically nonsignificant [Table 4]. It implies that the improvement in physical health in the later phase of 3 months was comparatively mild.
Table 2 indicates that the psychological health of male inmates was found continuously better for 6 months with Yoga-training. However, statistically significant (p < 0.05) improvement was noticed only after 6 months. Improvement in the psychological health of male jail inmates after 3 months was statistically nonsignificant. Mild deterioration was found in the psychological health of female inmates for 6 months during the Yoga-training program [Table 3]. This deterioration was noninsignificant and negligible. It can be stated that overall, no significant change was found in the psychological health of female inmates. In the combined group, the psychological health of the inmates was found continuously improve for 6 months with Yoga training but statistically significant (p < 0.05) improvement was noticed only after 6 months [Table 4].
General well-being in male inmates was continuously improved for 6 months with Yoga training. The improvement was highly significant (p < 0.01) after 6 months Yoga-training. The improvement in the initial 3 months of Yoga-training programme (0–3 months) was mild and statistically nonsignificant. [Table 2] shows that improvement in the latter 3 months of the Yoga-training programme was quite fast. [Table 3] shows that general well-being in female inmates was better in the initial 3 months though this improvement was statistically nonsignificant. In the later half (3–6 months) of the Yoga training, general well-being in females reportedly came down though this decrease in the general well-being was found statistically nonsignificant. Even after deterioration, general well-being was better than in the pre-Yoga-training stage. General well-being in the combined group was continuously improved after 6 months' Yoga-training. The improvement was found significant after 3 months (p < 0.05) and highly significant after 6 months (p < 0.01) when compared with the pre-Yoga-training state [Table 4]. No difference was found in the general well-being when comparisons were made between the initial 3 months (first half) and the later 3 months (second half) of the Yoga-training programme.
| Discussion | | |
The present study revealed that 6 months of yoga practice reduced anxiety, depression, stress, and aggression in male inmates; and improved their physical health, psychological health, and general well-being. In the combined group (consisting of male and female inmates), Yoga-practice significantly reduced stress and aggression and improved the physical health, psychological health, and general well-being of Tihar jail inmates. However, in the case of female inmates, yoga-training remained ineffective. It can be stated that the Yoga-protocol of the present study brought desirable changes in the mental health of both the male inmates and the combined group (consisting of males and females both). These findings can be explained in light of the mind-body connection, which states that there are two-way communications between mind and body.
Yogic practices, especially asanas, pranayama, and shat-karmas, work upon the mind through the biological mechanism. In asanas, the equilibrium developed by the synchronization between breath and body movement soothes the mind. This might help alleviate anxiety, depression, stress, and aggression and improve physical health, psychological health, and general well-being. Asanas and shat-karmas strengthen various body-systems, regulate the secretion of the endocrine system, and boost energy and immunity of the body. Pranayamas regularize breathing; and activate the parasympathetic nervous system, which in turn has a soothing effect on the mind. The state of mind can be altered by controlling the breath.[15] Yoga-Nidra can relieve accumulated tensions, increase stress-resistance and overall efficiency, and prevent the development of psychosomatic diseases.[16] Yoga-Nidra reflects an integrated response by the hypothalamus, resulting in decreased sympathetic (excitation) nervous activity and increased parasympathetic (relaxation) function. The shift toward parasympathetic dominance is related to reduced anxiety.[17] Meditation regulates emotions. The practice of meditation brings about structural changes in the brain. Meditation increases the thickness of the brain structures, which are associated with emotional regulation.[15]
Another finding of the present study was that the effects of Yoga-training were gender-specific. There was inconsistency in the results of male and female inmates. In the case of female inmates, Yoga-training remained ineffective. Sometimes, very mild negative trends were also reported in female inmates, although these changes were negligible and statistically nonsignificant. This feature in the female inmates is intriguing. This finding may be attributed to psychological and physiological differences between males and females. Differences in the inherent tendency of males and females to respond to the stimuli may affect the results. Women inmates were more likely to report clinically significant anxiety symptoms, borderline personality features, somatic concerns, and trauma-related symptoms.[18] Although men and women can generate cognitive reappraisals in adverse situations, men have higher mental reappraisal capacity correlated to depressive daily-life experiences.[19] Physiological differences in males and females may also cause this behavioral pattern. Men and women may differ in the neural circuits associated with emotion representation and integration.[20] Several structural or functional gender differences in anxiety-relevant brain regions, such as the prefrontal cortex, hippocampus, and extended amygdala complex, have been revealed in imaging studies.[21] A quantitative meta-analysis of neuroimaging studies reveals that women respond more strongly to negative emotional stimuli with increased neurobiological reactivity to negative emotion. It also reported that men react strongly to positive stimuli. This was corroborated by the brain activation differences, especially amygdala.[22] In the study, most of the significant desirable changes were found after 6 months of Yoga-training. In the first half of the training period (initial 3 months), improvements barring a few instances, were generally statistically nonsignificant. Therefore, it can be stated that minimum 6 months of Yoga-practice was required to bring about desirable changes in the mental health of the jail inmates, though this cannot be generalized to female inmates.
The Yogic practices module consist of Prayer, Shat kriya, Sukshma Vyama, Sthula vyama, Yogasana, Pranayama, practices leading to Dhyana. Regular practice of pranayama, Yoga Nidra and practices leading towards Dhyana may decrease stress improve mental health through the alteration of the central and peripheral nervous system. It may decrease the sympathetic activity. Regular yogic practice may decrease autonomic arousal. As previous study showed that regular practice of Yoga alter heart rate variability frequency domain and time domain parameters and decrease sympathetic activity in the practitioner.[23] Decrement of sympathetic activity may lead to decrease stress and depression and elevate the moods. Previous studies showed that Yogic practice also increases the levels of serotonin and dopamine which may improve mental health. Regular Yogic practices decrease cortisol level, adrenocortico tropic hormone level which may lead decrease stress via hypothalamo– pituitary – adrenal axis and improve mental health of the practitioner.[23] Apart from that Yogic practice may improve spirituality and positive psychological change may occur among the inmates, which may improve mental health of the practitioner.
Strength and limitations of the study
This study provides information regarding the impact of Yoga on the mental health of jail inmates. The study brings forth the need for further research to verify or confirm the study results. It also highlights the need to conduct a study specifically on female inmates to know more about their specific requirements. This type of study is rare.
The study provides valuable insights regarding the positive effect of Yoga-training on the mental health of jail inmates. However, it had some limitations which need to be addressed in further studies, such as the sample size of the study, especially that of female inmates, was small, it was a single group study without any control group, the study had little control over varying jail-conditions like outcomes of court hearings (denial of bail, parole), frequent fights in barracks, etc., These conditions are strong enough to adversely affect the inmates and nullify the positive effects of Yoga-training.
| Conclusion | | |
Yoga-training programme was found quite effective in improving the mental health of male inmates. It significantly reduced anxiety, depression, stress, and aggression; and improved their physical health, psychological health, and general well-being. Further research is required to confirm the findings of the present study.
Acknowledgments
We express our gratitude to Sh. Vaidya Rajesh Kotecha, Secretary, Ministry of AYUSH, Government of India, for continuous support in conducting the study. The authors are grateful to Sh. Vijay Dev, Chief Secretary, GNCT, Delhi, for his authorization and permission to conduct the study. We are also thankful to Shri Ajay Kashyap, DG (Prison), Central Jail Tihar, for his support and necessary permission to complete this study. We want to thank Shri P N Ranjit Kumar, Joint Secretary, Ministry of AYUSH, for his help and necessary permissions to complete this study. We are thankful to Shri Sailendra Singh Parihar, DIG, Central Jail Tihar, for his support and necessary permission to complete this study. This study was conducted as part of Project SANJEEVAN at Central Jail, Tihar, New Delhi. We express our sincere thanks to the Administration and all staff members of Central Jail Tihar for their cooperation extended to conduct the study. We extend our thanks to Dr. I. N. Acharya, Programme Officer (Yoga Therapy), and Dr. Guru Dev, Assistant Professor (Yoga Therapy), for their coordination in completing this Project. We are thankful to Sh. Satyam Tiwari and Nitika, students of MDNIY, for their help in scoring the responses. Last but not least, we are also thankful to all the participants of the study who willingly participated in the study.
Ethics approval and consent to participate
This article does not contain any individually identifying data of any participant. The protocol used with the subjects was reviewed and approved by the Morarji Desai National Institute of Yoga Institutional Review Board. Additionally, written consent for the publication of the data was signed by each participant.
Authors contribution
All the authors have contributed equally to the design of the study, data collection, data interpretation, editing, and writing of this manuscript.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Malik JS, Singh P, Beniwal M, Kumar T. Prevalence of depression, anxiety and stress among jail inmates. Int J Community Med Public Health 2019;6:1306-9.  |
| 2. | Fazel S, Hayes AJ, Bartellas K, Clerici M, Trestman R. Mental health of prisoners: Prevalence, adverse outcomes, and interventions. Lancet Psychiatry 2016;3:871-81. |
| 3. | Osasona SO, Koleoso ON. Prevalence and correlates of depression and anxiety disorder in a sample of inmates in a Nigerian prison. Int J Psychiatry Med 2015;50:203-18. |
| 4. | Awopetu RG, Igbo HI. An assessment of aggressive behaviour between prison inmates and non-prison inmates in Makurdi Metropolis, Nigeria. Procedia Soc Behav Sci 2015;190:502-9. |
| 5. | Unver Y, Yuce M, Bayram N, Bilgel N. Prevalence of depression, anxiety, stress, and anger in Turkish prisoners. J Forensic Sci 2013;58:1210-8. |
| 6. | Lamb HR, Weinberger LE. Persons with severe mental illness in jails and prisons: A review. Psychiatr Serv 1998;49:483-92. |
| 7. | Sfendla A, Malmström P, Torstensson S, Kerekes N. Yoga practice reduces the psychological distress levels of prison inmates. Front Psychiatry 2018;9:407. |
| 8. | Danielly Y, Silverthorne C. Psychological benefits of yoga for female inmates. Int J Yoga Therap 2017;27:9-14. |
| 9. | Kaur M, Kumar R. Effect of yoga and meditation on stress management of female prisoners in Delhi – A review paper. Int J Sci Technol Manage 2016;5:494-99. |
| 10. | Bilderbeck AC, Farias M, Brazil IA, Jakobowitz S, Wikholm C. Participation in a 10-week course of yoga improves behavioural control and decreases psychological distress in a prison population. J Psychiatr Res 2013;47:1438-45. |
| 11. | Sultania MK. Manual for Aggression Inventory. Agra: National Psychological Corporation; 2005. |
| 12. | Bhatnagar P, Singh M, Pande M, Sandhya A. Manual for Anxiety, Depression and Stress Scale. Agra: National Psychological Corporation; 2011. |
| 13. | Verma SK, Pershad D, Wig NN. Manual for PGI Health Questionnaire. Agra: National Psychological Corporation; 1974. |
| 14. | Verma SK, Verma A. Manual for PGI General Well-being Measure. Agra: National Psychological Corporation; 1989. |
| 15. | Gothe NP, Khan I, Hayes J, Erlenbach E, Damoiseaux JS. Yoga effects on brain health: A systematic review of the current literature. Brain Plast 2019;5:105-22. |
| 16. | Saraswati SS, Yoga N. Bihar School of Yoga. 6 th ed. Munger: Yoga Publications Trust; 2002. |
| 17. | Rani K, Tiwari SC, Kumar S, Singh U, Prakash J, Srivastava N. Psycho-biological changes with add on Yoga Nidra in patients with menstrual disorders: A randomized clinical trial. J Caring Sci 2016;5:1-9. |
| 18. | Drapalski AL, Youman K, Stuewig J, Tangney J. Gender differences in jail inmates' symptoms of mental illness, treatment history and treatment seeking. Crim Behav Ment Health 2009;19:193-206. |
| 19. | Perchtold CM, Papousek I, Fink A, Weber H, Rominger C, Weiss EM. Gender differences in generating cognitive reappraisals for threatening situations: Reappraisal capacity shields against depressive symptoms in men, but not women. Front Psychol 2019;10:553. |
| 20. | Wu Y, Li H, Zhou Y, Yu J, Zhang Y, Song M, et al. Sex-specific neural circuits of emotion regulation in the centromedial amygdala. Sci Rep 2016;6:23112. |
| 21. | Donner NC, Lowry CA. Sex differences in anxiety and emotional behavior. Pflugers Arch 2013;465:601-26. |
| 22. | Stevens JS, Hamann S. Sex differences in brain activation to emotional stimuli: A meta-analysis of neuroimaging studies. Neuropsychologia 2012;50:1578-93. |
| 23. | Pal R, Singh SN, Chatterjee A, Saha M. Age-related changes in cardiovascular system, autonomic functions, and levels of BDNF of healthy active males: Role of yogic practice. Age (Dordr) 2014;36:9683. |
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]
|
Search Pubmed for