Chronic stress is associated with dysregulations in the physiological stress system, resulting in diverse negative developmental outcomes. Since adolescence is a period characterized by increased stress-sensitivity, and schools are an important environment for the developing adolescent, school-based interventions promoting psychosocial functioning are of particular interest to prevent adverse outcomes. The present study therefore aimed to investigate the effectiveness of such interventions on hypothalamic pituitary adrenal-axis (i.e., cortisol) and cardiovascular (i.e., blood pressure [BP] and heart rate [HR]/heart rate variability [HRV]) parameters of stress in adolescents, and examined moderators of effectiveness. The search resulted in the inclusion of k = 9 studies for cortisol, k = 16 studies for BP, and k = 20 studies for HR/HRV. The results indicated a significant small overall effect on reducing BP, but no significant effect for HR/HRV. For cortisol, large methodological variation in the few primary studies did not allow for quantitative analyses, but a qualitative review demonstrated inconsistent results. For BP and HR/HRV, larger effects were observed for intervention programs with a mindfulness and/or meditation component, for interventions without a cognitive-behavioural component and for interventions with a higher intensity. Providing adolescents with techniques to improve indicators of physiological stress may prevent emerging mental health problems.

中文翻译：

---

学校干预对青少年生理压力的影响：荟萃分析

慢性压力与生理压力系统的失调有关，导致各种负面的发育结果。由于青春期是一个压力敏感性增加的时期，而学校是青少年发展的重要环境，因此促进心理社会功能的以学校为基础的干预措施对于防止不良后果具有特别重要的意义。因此，本研究旨在调查此类干预对下丘脑垂体肾上腺轴（即皮质醇）和心血管（即血压 [BP] 和心率 [HR]/心率变异性 [HRV]）参数的压力的有效性在青少年中，并检查了有效性的调节因素。搜索结果包含k  = 9 项皮质醇研究，k = 16 项 BP 研究，k  = 20 项 HR/HRV 研究。结果表明对降低血压的总体影响很小，但对 HR/HRV 没有显着影响。对于皮质醇，少数主要研究中的较大方法学差异不允许进行定量分析，但定性审查表明结果不一致。对于 BP 和 HR/HRV，观察到具有正念和/或冥想成分的干预计划、没有认知行为成分的干预措施以及更高强度的干预措施的效果更大。为青少年提供改善生理压力指标的技术可以预防新出现的心理健康问题。