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[
1
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ted
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[
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.
I
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with
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k
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14
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5
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Octo
b
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20
25
:
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1
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9
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413
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4130
q
u
alities
an
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s
to
ac
h
iev
e
r
esu
lts
an
d
ex
p
an
d
o
p
p
o
r
t
u
n
ities
in
th
e
f
u
tu
r
e.
A
ll
th
is
s
ig
n
if
ican
tly
af
f
ec
ts
th
e
s
u
cc
ess
o
f
s
p
ec
ialis
ts
in
th
e
f
ield
o
f
p
e
d
ag
o
g
ical
p
s
y
ch
o
lo
g
y
[
4
]
,
[
5
]
.
T
h
e
c
o
n
c
ep
t
o
f
ar
t
th
er
a
p
y
is
to
r
eg
u
late
em
o
tio
n
s
b
y
tr
a
n
s
f
er
r
in
g
th
em
with
p
ain
ts
to
c
an
v
as.
T
h
is
p
r
o
ce
s
s
in
v
o
lv
es
u
s
in
g
s
y
m
b
o
ls
o
r
u
n
d
er
s
tan
d
a
b
le
im
ag
es
f
o
r
a
p
er
s
o
n
wh
o
d
r
aws
[
6
]
,
[
7
]
.
T
h
is
th
er
ap
y
d
o
es
n
o
t
r
eq
u
i
r
e
cr
ea
tiv
e
s
k
ills
to
p
ar
ticip
ate.
T
h
er
e
ar
e
also
v
a
r
io
u
s
th
er
ap
y
o
p
tio
n
s
,
th
at
is
,
p
eo
p
le
ca
n
u
s
e
an
y
ac
tiv
ity
f
o
r
s
elf
-
ex
p
r
ess
io
n
:
m
u
s
ic,
d
an
cin
g
,
clay
m
o
d
elin
g
,
an
d
s
o
f
o
r
th
[
8
]
.
I
n
ad
d
itio
n
to
wo
r
k
i
n
g
o
u
t
a
n
d
r
eliev
in
g
em
o
tio
n
s
,
th
is
p
s
y
ch
o
th
er
a
p
eu
tic
p
r
ac
tice
allo
ws
p
ar
ticip
an
ts
to
d
is
tr
ac
t
f
r
o
m
th
e
m
ain
p
r
o
b
lem
an
d
r
elax
.
T
h
e
r
ef
o
r
e
,
it
ap
p
lies
to
th
e
tr
ea
tm
en
t
o
f
d
e
p
r
ess
io
n
,
an
x
iety
,
a
n
d
o
t
h
er
p
s
y
ch
o
lo
g
ical
d
is
o
r
d
er
s
[
9
]
.
Ar
t
th
er
ap
y
s
ess
io
n
s
r
eg
u
late
o
n
e
’
s
em
o
tio
n
s
th
r
o
u
g
h
r
ef
lec
tio
n
an
d
ar
t.
Fo
r
ex
am
p
le,
f
i
n
e
ar
t
h
elp
s
ex
p
r
ess
em
o
tio
n
s
b
y
d
r
awin
g
v
ar
io
u
s
im
ag
es
with
p
ain
ts
o
n
ca
n
v
as.
A
m
eth
o
d
o
f
wr
it
in
g
im
p
lies
wr
itin
g
d
o
wn
all
em
o
tio
n
al
ex
p
e
r
ien
ce
s
o
n
p
ap
er
.
T
h
e
m
eth
o
d
o
f
d
an
ce
ar
t
th
er
ap
y
aim
s
to
a
ch
iev
e
a
d
is
tr
ac
tin
g
ef
f
ec
t.
T
h
is
ac
tiv
ity
h
elp
s
p
eo
p
le
av
o
id
d
ep
r
ess
in
g
th
o
u
g
h
ts
an
d
ex
p
er
ien
ce
s
s
in
ce
th
ey
b
eg
in
to
u
n
d
er
s
tan
d
th
eir
em
o
tio
n
s
d
u
r
in
g
s
ess
io
n
s
.
Peo
p
le
f
in
d
it
ea
s
ier
to
ex
p
r
ess
th
eir
em
o
tio
n
s
th
r
o
u
g
h
o
b
jects
o
r
ab
s
tr
ac
t
im
ag
es.
At
th
e
s
am
e
tim
e,
an
ar
t
p
s
y
ch
o
lo
g
is
t
ca
n
v
is
u
ally
tr
ac
k
th
e
p
r
o
g
r
ess
o
f
th
eir
p
atien
ts
an
d
co
r
r
ec
t
s
o
m
e
n
u
a
n
ce
s
.
Du
r
in
g
th
e
s
ess
io
n
s
,
th
e
s
p
ec
ialis
t
m
o
n
ito
r
s
th
e
ch
an
g
e
in
a
p
er
s
o
n
’
s
r
ea
ct
io
n
to
th
e
tr
i
g
g
er
s
,
s
ettin
g
s
itu
atio
n
al
task
s
o
r
co
n
d
u
ctin
g
test
s
.
T
h
e
test
q
u
esti
o
n
s
co
n
ce
r
n
th
e
f
ee
lin
g
s
an
d
r
e
ac
tio
n
s
o
f
a
p
er
s
o
n
in
ce
r
tain
ca
s
es [
1
0
]
.
On
e
o
f
t
h
e
m
o
s
t
p
o
p
u
la
r
tech
n
iq
u
es
o
f
ar
t
th
e
r
ap
y
is
f
in
e
a
r
t.
I
n
a
d
iag
n
o
s
tic
s
en
s
e,
it
ca
n
s
h
o
w
th
e
in
n
er
s
tate
o
f
a
p
er
s
o
n
.
T
h
e
p
r
ef
er
r
ed
co
lo
r
s
ca
n
tell
ab
o
u
t
m
o
o
d
,
th
e
p
o
wer
o
f
e
m
o
tio
n
s
,
an
d
ex
p
e
r
ien
ce
d
em
o
tio
n
s
[
1
1
]
–
[
1
3
]
.
Fo
r
in
s
t
an
ce
,
th
e
u
s
e
o
f
d
ar
k
an
d
g
l
o
o
m
y
c
o
lo
r
s
in
d
icate
s
is
o
lati
o
n
an
d
d
e
p
r
ess
iv
e
th
o
u
g
h
ts
.
I
n
tu
r
n
,
m
u
ted
s
h
ad
es
em
b
o
d
y
d
etac
h
m
en
t,
wh
ile
b
r
ig
h
t
an
d
wa
r
m
c
o
n
v
e
y
a
li
v
ely
r
ea
ctio
n
a
n
d
a
v
iv
id
m
a
n
if
estatio
n
o
f
em
o
tio
n
s
[
1
3
]
.
T
h
e
co
lo
r
s
c
o
m
b
in
ati
o
n
allo
ws
s
p
ec
ialis
t
to
co
n
clu
d
e
th
e
p
s
y
ch
o
lo
g
ical
s
tate
o
f
a
p
atien
t
[
1
4
]
.
Fu
r
th
er
m
o
r
e,
t
h
e
im
ag
es
a
n
d
f
ea
tu
r
es
o
f
t
h
e
d
r
awn
o
b
jects
also
p
la
y
a
r
o
le.
Sh
ar
p
en
ed
lin
es,
h
atch
in
g
,
a
n
d
s
h
ar
p
tr
an
s
itio
n
s
ca
n
in
d
icate
n
er
v
o
u
s
o
v
er
s
tr
ain
an
d
te
n
d
en
cies
to
n
e
u
r
o
s
is
.
Sm
o
o
th
lin
es
an
d
cu
r
ls
ch
ar
ac
ter
ize
s
o
f
t
a
n
d
d
r
ea
m
y
p
eo
p
le.
T
h
e
im
a
g
es
th
at
a
p
er
s
o
n
p
o
r
tr
ay
s
a
ls
o
h
av
e
im
p
o
r
tan
t
d
iag
n
o
s
tic
s
ig
n
if
ican
ce
.
So
m
e
o
f
th
em
m
a
y
s
u
g
g
est
a
ten
d
e
n
cy
to
s
ev
er
e
p
s
y
ch
iatr
ic
d
is
e
ases
[
1
2
]
,
[
1
3
]
.
T
h
e
lo
ca
tio
n
s
o
f
th
e
o
b
jects
in
th
e
p
ictu
r
e
ar
e
an
o
th
er
im
p
o
r
tan
t
asp
ec
t.
T
h
ese
d
iag
n
o
s
tic
cr
it
er
ia
ca
n
r
ev
ea
l
th
e
m
ain
p
r
o
b
lem
s
o
f
th
e
ex
am
in
ed
p
er
s
o
n
f
o
r
f
u
r
th
e
r
p
s
y
ch
o
l
o
g
ical
ass
is
tan
ce
[
1
5
]
,
[
1
6
]
.
T
h
e
ass
is
tan
ce
co
v
er
s
th
e
wo
r
k
with
em
o
tio
n
s
an
d
e
x
p
r
ess
io
n
o
n
p
ap
er
with
th
e
h
e
lp
o
f
p
ai
n
ts
,
p
en
cils
,
o
r
c
r
ay
o
n
s
.
Ar
t
th
er
ap
y
is
a
r
elev
a
n
t
tech
n
iq
u
e
f
o
r
th
e
f
o
r
m
atio
n
o
f
p
r
o
f
ess
io
n
al
q
u
alities
o
f
f
u
tu
r
e
ed
u
ca
tio
n
al
p
s
y
ch
o
lo
g
is
ts
.
I
t
allo
ws
th
em
to
r
ec
o
g
n
ize
p
s
y
c
h
o
lo
g
ical
b
lo
ck
s
an
d
wea
k
n
ess
es,
as
wel
l
as
wo
r
k
th
r
o
u
g
h
th
em
to
ac
h
iev
e
em
o
tio
n
al
s
tab
ilit
y
an
d
in
cr
ea
s
e
p
r
o
d
u
ct
iv
ity
.
T
h
e
u
ltima
te
g
o
al
o
f
t
h
is
th
er
ap
y
o
f
to
u
n
d
er
s
tan
d
o
n
eself
an
d
d
ec
id
e
o
n
th
e
d
ir
ec
tio
n
o
f
p
r
o
f
ess
io
n
al
a
c
t
i
v
i
t
y
[
1
7
]
.
T
h
e
v
alu
e
ca
te
g
o
r
ies
u
n
d
o
u
b
ted
ly
u
n
d
er
lie
c
h
an
g
es
i
n
ed
u
ca
tio
n
al
s
y
s
tem
s
.
I
t
is
n
ec
ess
ar
y
t
o
s
tu
d
y
d
if
f
e
r
en
ce
s
an
d
s
im
ilar
ities
in
th
e
v
al
u
e
o
r
ien
tatio
n
s
o
f
y
o
u
th
f
r
o
m
d
if
f
er
en
t
co
u
n
tr
ies,
as
well
as
“
m
o
v
em
en
ts
”
in
t
h
e
h
ier
a
r
ch
y
o
f
v
alu
es.
T
h
is
s
tu
d
y
ca
n
f
in
d
n
ew
d
ir
ec
tio
n
s
in
th
e
co
n
ten
t a
n
d
o
r
g
an
izatio
n
o
f
ed
u
ca
tio
n
an
d
tr
ain
in
g
f
o
r
s
tu
d
en
t y
o
u
th
.
T
h
e
m
o
tiv
atio
n
o
f
th
is
s
tu
d
y
was
to
o
b
tain
a
d
d
itio
n
al
d
ata
o
n
th
e
p
s
y
c
h
o
lo
g
ical
s
tate
an
d
its
ch
an
g
es
d
u
r
in
g
th
e
ex
p
er
im
en
t
with
a
r
t
th
er
ap
y
.
T
h
e
aim
o
f
th
e
r
ese
ar
ch
is
to
s
tu
d
y
t
h
e
im
p
ac
t
o
f
ar
t
th
er
ap
y
o
n
th
e
p
s
y
ch
o
-
em
o
tio
n
al
s
tate
o
f
ed
u
ca
tio
n
al
p
s
y
c
h
o
lo
g
is
ts
.
T
h
e
s
tu
d
y
also
id
e
n
tifie
s
h
o
w
a
r
t
th
er
ap
y
r
e
v
ea
ls
a
p
er
s
o
n
’
s
s
tr
en
g
th
s
f
o
r
u
n
d
er
s
tan
d
in
g
in
d
i
v
id
u
ality
an
d
ch
o
o
s
in
g
a
f
u
r
th
er
p
ath
o
f
d
e
v
elo
p
m
en
t.
T
h
e
s
u
cc
ess
o
f
an
ed
u
ca
tio
n
al
p
s
y
c
h
o
lo
g
is
t
d
ir
ec
tly
d
ep
en
d
s
o
n
th
eir
p
er
s
o
n
al
q
u
alities
.
T
h
er
ef
o
r
e,
it
w
as
cr
u
cial
to
ass
ess
th
e
lev
el
o
f
p
s
y
ch
o
lo
g
ical
p
r
e
p
ar
atio
n
an
d
em
o
tio
n
al
s
tate
o
f
th
e
p
ar
ticip
an
ts
in
th
e
ex
p
e
r
i
m
en
t.
T
h
e
m
eth
o
d
s
o
f
ar
t
th
er
ap
y
i
n
th
e
co
n
tex
t
o
f
p
er
s
o
n
ality
f
o
r
m
atio
n
r
ec
e
iv
ed
in
s
u
f
f
icien
t
s
cien
tific
att
en
tio
n
an
d
r
eq
u
ir
e
ad
d
itio
n
al
r
esear
c
h
an
d
r
e
v
is
io
n
.
T
h
e
r
esear
ch
task
is
to
u
n
d
er
s
tan
d
h
o
w
th
e
co
m
p
en
s
ato
r
y
f
ac
t
o
r
o
f
ar
t
th
er
ap
y
af
f
ec
ts
s
tu
d
en
ts
.
T
o
d
o
th
is
,
it
is
n
ec
ess
ar
y
to
ass
es
s
th
e
s
ev
er
ity
o
f
ce
r
tain
em
o
tio
n
al
cr
iter
ia
b
ef
o
r
e
s
tar
tin
g
th
er
ap
y
,
an
d
th
en
m
o
n
ito
r
th
e
d
y
n
am
ics
th
r
o
u
g
h
p
o
s
t
-
test
in
g
.
An
o
th
er
im
p
o
r
tan
t
task
is
th
e
in
tr
o
d
u
ctio
n
an
d
im
p
lem
en
tati
o
n
o
f
ar
t th
er
a
p
y
.
2.
L
I
T
E
R
AT
U
RE
R
E
VI
E
W
I
n
th
e
s
tu
d
y
o
n
th
e
in
f
lu
en
c
e
o
f
ar
t
th
er
ap
y
o
n
th
e
p
r
o
f
ess
io
n
al
p
o
s
itio
n
an
d
ac
h
iev
em
en
ts
o
f
ed
u
ca
tio
n
al
p
s
y
c
h
o
lo
g
is
ts
,
th
e
m
ain
tr
en
d
s
o
f
s
u
cc
ess
ar
e
ess
en
tial.
T
o
ac
h
iev
e
s
u
cc
ess
,
o
n
e
n
ee
d
s
to
f
in
d
a
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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t
J
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al
&
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es E
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SS
N:
2252
-
8
8
2
2
P
ilo
t stu
d
y
o
n
th
e
u
s
e
o
f a
r
t th
era
p
y
tech
n
iq
u
es to
imp
r
o
ve
th
e
p
s
yc
h
o
-
emo
ti
o
n
a
l
… (
Ta
tig
u
l S
a
mu
r
a
to
v
a
)
4131
in
d
iv
id
u
al
ap
p
r
o
ac
h
,
as
well
as
h
av
e
a
f
air
ly
lar
g
e
em
o
tio
n
al
r
eso
u
r
ce
.
I
n
th
is
ca
s
e,
it
ca
n
b
e
r
ea
s
o
n
a
b
le
to
r
ely
o
n
th
e
o
p
in
i
o
n
s
o
f
h
ig
h
ly
s
o
u
g
h
t
-
af
ter
s
p
ec
ialis
ts
in
th
e
f
ield
o
f
p
s
y
ch
o
lo
g
y
f
r
o
m
Ger
m
an
y
an
d
th
e
USA.
T
h
ese
ex
p
er
ts
s
aid
th
at
to
ac
h
iev
e
h
ig
h
r
esu
lts
,
it
is
n
ec
ess
ar
y
to
in
c
r
ea
s
e
p
r
o
d
u
ctiv
ity
i
n
d
icato
r
s
,
as
well
as
alwa
y
s
s
tr
iv
e
to
s
tu
d
y
n
ew
tech
n
iq
u
es
[
3
]
.
I
n
ter
v
iews
co
n
d
u
cte
d
with
f
em
ale
ed
u
ca
t
io
n
al
p
s
y
ch
o
lo
g
is
ts
s
h
o
wed
th
at
th
e
m
o
s
t
im
p
o
r
t
an
t
f
ac
to
r
s
f
o
r
s
u
cc
ess
ar
e
le
ad
er
s
h
ip
q
u
alities
,
p
er
s
ev
er
an
ce
,
ef
f
ec
tiv
e
tim
e
m
an
ag
em
en
t,
a
n
d
co
n
s
tan
t
s
elf
-
im
p
r
o
v
em
en
t
[
2
]
.
All
th
ese
q
u
alities
ca
n
b
e
p
r
esen
t
o
n
ly
in
an
em
o
tio
n
ally
s
tab
le
p
er
s
o
n
.
Stu
d
en
ts
o
f
ten
f
ac
e
lear
n
in
g
d
if
f
icu
lties
,
an
x
iety
d
u
r
in
g
e
x
am
s
,
an
d
v
a
r
io
u
s
cr
is
es
th
at
lead
to
b
u
r
n
o
u
t.
Ar
t
th
e
r
ap
y
p
er
f
o
r
m
s
s
ev
er
al
f
u
n
ctio
n
s
:
h
ed
o
n
is
tic,
co
m
f
o
r
tin
g
,
a
n
d
c
o
m
p
en
s
at
o
r
y
.
Hed
o
n
is
tic
an
d
co
m
p
en
s
ato
r
y
f
u
n
ctio
n
s
r
est
o
n
a
d
is
tr
ac
tin
g
an
d
r
elax
in
g
ef
f
ec
t,
wh
ile
co
m
p
en
s
ato
r
y
f
u
n
ctio
n
co
m
b
ats
em
o
tio
n
al
p
r
o
b
lem
s
an
d
lead
s
to
s
elf
-
d
ev
elo
p
m
en
t [
4
]
.
C
u
r
r
en
tly
,
th
er
e
ar
e
o
n
ly
a
f
ew
m
eth
o
d
s
o
f
ar
t
th
er
ap
y
.
T
h
ese
m
eth
o
d
s
in
clu
d
e
p
ain
ti
n
g
,
m
u
s
ic,
d
an
cin
g
,
a
n
d
an
y
o
th
er
k
in
d
o
f
ar
t.
Du
r
in
g
th
e
s
ess
io
n
s
,
p
ar
ticip
an
ts
ca
n
d
r
aw
p
ictu
r
es
b
y
tr
an
s
f
er
r
in
g
em
o
tio
n
s
to
ca
n
v
as
(
ar
t
th
er
ap
y
)
,
r
ec
o
r
d
th
eir
em
o
tio
n
s
o
n
p
ap
er
b
y
ex
p
r
ess
in
g
th
em
th
r
o
u
g
h
wo
r
d
s
o
r
s
y
m
b
o
ls
(
wr
itin
g
th
er
ap
y
)
,
o
r
d
is
tr
ac
t
f
r
o
m
p
r
o
b
lem
s
(
d
an
ce
th
er
ap
y
)
.
T
h
is
s
tr
ateg
y
ty
p
ically
s
er
v
es
as
a
m
eth
o
d
o
f
r
eliev
in
g
m
en
tal
p
r
ess
u
r
e
an
d
im
p
r
o
v
in
g
m
o
r
ale.
Fo
r
e
x
am
p
le,
I
len
e
Ser
lin
(
Ox
f
o
r
d
)
p
r
ac
ticed
d
an
ce
th
er
ap
y
to
s
u
p
p
o
r
t
wo
m
en
s
u
f
f
er
in
g
f
r
o
m
b
r
ea
s
t
ca
n
ce
r
.
T
h
e
tech
n
iq
u
e
p
r
o
v
ed
to
b
e
s
u
cc
ess
f
u
l
in
th
e
co
n
tex
t
o
f
im
p
r
o
v
in
g
th
e
m
en
tal
an
d
em
o
tio
n
al
s
tate
o
f
th
e
p
ar
ticip
an
ts
[
18
]
.
T
h
e
p
h
en
o
m
en
o
n
o
f
u
s
in
g
a
r
t
th
er
ap
y
as
a
p
alliativ
e
ca
r
e
o
p
p
o
r
tu
n
ity
is
wid
esp
r
ea
d
.
T
h
e
r
e
f
o
r
e,
th
e
Am
er
ican
Ass
o
ciatio
n
o
f
Ar
t
T
h
er
ap
is
ts
r
esear
ch
ed
th
e
im
p
ac
t o
f
th
is
s
tr
ateg
y
o
n
p
eo
p
le
with
in
cu
r
ab
le
d
is
ea
s
es.
T
h
e
r
esear
ch
was
u
n
d
er
th
e
g
u
id
a
n
ce
o
f
a
p
s
y
ch
o
l
o
g
is
t
wh
o
co
n
d
u
cted
s
p
ec
ialized
s
ess
io
n
s
.
Fam
ily
m
em
b
er
s
o
f
te
r
m
in
a
lly
ill
p
eo
p
le
also
p
ar
ticip
ated
in
s
im
ilar
s
ess
io
n
s
.
As
a
r
esu
lt,
th
e
r
esp
o
n
d
en
t
s
d
em
o
n
s
tr
ated
in
cr
ea
s
ed
s
elf
-
esteem
,
im
p
r
o
v
e
d
s
en
s
o
r
y
an
d
co
g
n
itiv
e
ab
ilit
ies,
as
well
as
em
o
tio
n
al
r
esil
ien
ce
an
d
s
o
cial
s
k
ills
.
T
h
e
r
esea
r
ch
p
r
o
v
e
d
th
at
a
r
t
th
er
ap
y
h
elp
s
to
co
p
e
with
s
tr
ess
an
d
teac
h
es
p
s
y
ch
o
lo
g
ical
ad
ap
tatio
n
to
v
ar
io
u
s
life
s
itu
atio
n
s
[
19
]
.
Scien
tis
ts
f
r
o
m
th
e
Neth
er
lan
d
s
co
n
s
id
er
ed
th
e
tech
n
iq
u
e
o
f
ar
t
th
er
ap
y
f
o
r
t
h
e
tr
ea
tm
en
t
o
f
an
x
iety
d
is
o
r
d
er
.
Ho
wev
er
,
th
eir
co
n
clu
s
io
n
s
r
e
g
ar
d
in
g
ef
f
ec
tiv
e
n
ess
wer
e
am
b
ig
u
o
u
s
.
T
h
u
s
,
th
er
e
is
an
u
r
g
en
t
n
ee
d
f
o
r
m
o
r
e
r
esear
ch
o
n
t
h
is
is
s
u
e
[
20
].
I
n
th
e
USA,
r
esear
ch
er
s
in
tr
o
d
u
ce
d
a
r
t
th
er
a
p
y
f
o
r
p
eo
p
le
with
ch
r
o
n
ic
d
is
ea
s
es.
T
h
e
ef
f
ec
tiv
en
ess
o
f
th
e
th
er
ap
y
was
in
s
u
f
f
icien
t.
T
h
e
au
th
o
r
s
ass
o
ciate
d
th
e
o
b
tain
ed
r
esu
lt
was
a
s
m
all
s
a
m
p
le
an
d
a
lack
o
f
s
tu
d
ies,
lik
e
th
e
r
esear
ch
er
s
f
r
o
m
th
e
Neth
er
lan
d
s
[
20
]
,
[
21
]
.
Scien
tis
ts
f
r
o
m
th
e
Un
iv
er
s
ity
o
f
Ma
s
s
ac
h
u
s
etts
co
n
d
u
cte
d
r
ev
iew
s
tu
d
ies
o
n
th
e
im
p
ac
t
o
f
v
ar
io
u
s
ar
t
th
er
ap
y
ty
p
es
(
d
a
n
ce
,
ar
t,
m
u
s
ic,
an
d
wr
itin
g
)
o
n
m
en
tal
d
is
o
r
d
e
r
s
.
T
h
e
th
er
a
p
y
was
lo
w
-
r
is
k
an
d
h
ad
h
ig
h
in
d
icato
r
s
o
f
ef
f
ec
tiv
e
n
ess
.
Nev
er
th
eless
,
th
e
s
cien
tis
t
s
f
ailed
to
r
ec
o
g
n
ize
th
ese
m
eth
o
d
s
as
v
alid
d
u
e
to
th
e
lack
o
f
s
tan
d
ar
d
izatio
n
an
d
co
n
s
is
ten
cy
b
etwe
en
th
e
c
o
n
d
u
cted
s
tu
d
ie
s
.
T
o
co
n
f
ir
m
t
h
e
f
ea
s
ib
ilit
y
o
f
th
e
s
tu
d
ied
th
e
r
ap
y
,
it
is
n
ec
ess
ar
y
to
cr
ea
te
a
co
m
m
o
n
m
eth
o
d
o
l
o
g
y
an
d
co
n
d
u
ct
ad
d
itio
n
al
test
s
[
22
]
.
I
n
Swed
en
,
th
is
ty
p
e
o
f
th
er
ap
y
a
llo
wed
p
eo
p
le
with
s
ev
er
e
d
ep
r
ess
io
n
to
g
o
th
r
o
u
g
h
an
in
ter
n
al
d
ialo
g
u
e
an
d
co
m
e
to
th
e
co
r
e
o
f
t
h
eir
p
r
o
b
lem
.
T
h
e
ar
two
r
k
s
cr
ea
ted
b
y
th
e
p
ar
ticip
an
ts
d
u
r
in
g
t
h
e
s
ess
io
n
wer
e
ev
alu
ated
b
y
a
p
s
y
ch
o
th
er
ap
is
t
w
h
o
d
elv
e
d
in
to
th
e
ess
en
ce
o
f
th
ese
im
ag
es.
A
f
ter
th
at,
th
e
p
ar
ticip
an
ts
d
is
cu
s
s
ed
th
e
r
esu
lt
s
in
p
er
s
o
n
al
s
ess
io
n
s
with
a
p
s
y
ch
o
th
er
ap
is
t
to
s
ea
r
ch
f
o
r
s
u
b
co
n
s
cio
u
s
p
s
y
ch
o
lo
g
ical
b
lo
ck
s
an
d
f
ix
atio
n
s
o
n
p
r
o
b
l
em
s
[
23
]
.
Swed
is
h
r
esear
ch
er
s
d
is
cu
s
s
ed
ch
an
g
e
s
in
p
atien
ts
wh
o
u
n
d
e
r
wen
t
ar
t
th
er
ap
y
.
T
h
e
au
th
o
r
s
ex
p
e
r
im
en
ted
with
t
h
is
ty
p
e
o
f
th
er
a
p
y
an
d
n
o
ted
it
s
p
o
s
itiv
e
ef
f
ec
t
o
n
th
e
em
o
tio
n
al
b
ac
k
g
r
o
u
n
d
,
th
e
ex
p
r
e
s
s
io
n
o
f
f
ee
lin
g
s
,
s
elf
-
esteem
,
an
d
th
o
u
g
h
ts
o
f
th
e
f
u
tu
r
e
[
24
].
C
h
in
ese
r
esear
ch
in
th
e
f
ield
o
f
ar
t
t
h
er
ap
y
f
o
c
u
s
ed
o
n
th
e
tech
n
iq
u
e
o
f
ar
t
an
d
its
ef
f
ec
ts
o
n
d
ep
r
ess
io
n
,
an
x
iety
,
an
d
v
ar
io
u
s
co
g
n
itiv
e
d
is
o
r
d
e
r
s
,
in
clu
d
i
n
g
au
tis
m
an
d
s
ch
izo
p
h
r
e
n
ia.
T
h
is
tech
n
iq
u
e
ca
n
b
e
an
in
d
ep
en
d
en
t
ty
p
e
o
f
t
h
er
ap
y
,
as
well
as
an
ad
d
itio
n
to
t
h
e
m
ain
tr
ea
tm
e
n
t.
T
h
e
s
tu
d
y
p
r
o
v
e
d
th
at
th
is
ar
t
th
er
ap
y
r
ev
ea
led
th
e
em
o
tio
n
s
o
f
p
atien
ts
an
d
also
s
er
v
ed
a
s
a
d
iag
n
o
s
tic
cr
iter
io
n
f
o
r
th
e
ir
p
s
y
ch
o
th
er
ap
is
ts
[
25
]
.
R
esear
ch
er
s
f
r
o
m
Ger
m
an
y
in
v
esti
g
ated
th
e
e
f
f
ec
t
o
f
ar
t
th
er
ap
y
o
n
s
tr
ess
f
u
l
s
tates
in
p
eo
p
le.
As
a
r
esu
lt,
th
e
ar
t th
er
ap
y
s
ess
io
n
s
s
ig
n
if
ican
tly
r
ed
u
ce
d
s
tr
ess
lev
els an
d
wer
e
ef
f
ec
tiv
e
in
d
ea
lin
g
with
em
o
tio
n
al
b
u
r
n
o
u
t
[
26
]
.
I
n
Me
lb
o
u
r
n
e
(
Au
s
tr
alia)
,
s
cien
tis
t
s
s
tu
d
ied
th
e
u
s
e
o
f
ar
t
f
o
r
s
u
p
p
o
r
tiv
e
th
er
ap
y
o
f
p
e
o
p
le
with
p
o
s
t
-
tr
au
m
atic
s
tr
ess
d
is
o
r
d
er
.
T
h
e
r
esu
lts
wer
e
in
s
ig
n
if
ican
t.
T
h
is
o
u
tc
o
m
e
c
o
u
ld
b
e
m
ai
n
ly
d
u
e
to
th
e
lo
w
q
u
ality
o
f
t
h
e
ex
p
e
r
im
en
t a
n
d
,
th
er
ef
o
r
e,
r
eq
u
ir
es a
d
d
itio
n
al
s
y
s
tem
atiza
tio
n
an
d
r
esear
ch
[
27
]
.
I
n
ad
d
itio
n
,
a
n
ex
p
er
im
en
t
c
o
n
d
u
cted
in
De
n
m
ar
k
s
tu
d
ie
d
t
h
e
ef
f
ec
t
o
f
a
r
t
th
er
ap
y
o
n
m
e
n
tal
h
ea
lth
an
d
g
en
er
al
well
-
b
ein
g
.
T
h
e
e
x
p
er
im
en
t
p
r
o
v
e
d
th
at
p
ar
ticip
atio
n
in
cr
ea
tiv
e
p
r
o
g
r
am
s
r
eli
ev
ed
s
tr
ess
f
ac
to
r
s
an
d
im
p
r
o
v
ed
th
e
m
en
tal
s
tate
o
f
th
e
s
tu
d
y
p
ar
ticip
an
ts
[
28
]
.
Giv
en
th
e
d
ata
f
r
o
m
d
if
f
e
r
en
t
co
u
n
tr
ies,
in
m
o
s
t
ca
s
es,
th
e
ar
t th
er
ap
y
tech
n
iq
u
e
was e
f
f
ec
tiv
e.
I
t r
ed
u
ce
d
s
tr
e
s
s
th
at
n
eg
ativ
ely
af
f
ec
ted
p
e
o
p
le,
r
eg
u
lated
t
h
eir
em
o
tio
n
al
b
ac
k
g
r
o
u
n
d
,
a
n
d
h
elp
ed
th
em
d
ea
l
with
in
ter
n
al
b
lo
ck
s
an
d
co
n
f
licts
.
T
h
is
s
t
r
ateg
y
is
b
ec
o
m
in
g
wid
ely
u
s
ed
f
o
r
t
h
e
tr
ea
tm
en
t
o
f
v
ar
io
u
s
d
is
o
r
d
er
s
(
d
e
p
r
es
s
io
n
,
an
x
iety
,
a
n
d
co
g
n
itiv
e
i
m
p
air
m
en
t)
.
I
t
ca
n
s
er
v
e
as
an
ad
d
itio
n
al
m
eth
o
d
f
o
r
s
tu
d
y
in
g
th
e
em
o
tio
n
al
s
tate
an
d
p
r
o
b
lem
s
o
f
th
e
s
u
b
co
n
s
cio
u
s
.
Ho
wev
er
,
th
er
e
is
n
o
co
m
p
lete
ag
r
ee
m
e
n
t
r
eg
ar
d
in
g
th
e
ef
f
ec
tiv
en
ess
o
f
th
ese
tech
n
iq
u
es
[
20
]
,
[
22
]
,
[
27
]
.
T
h
e
r
ea
s
o
n
s
ar
e
th
e
lack
o
f
a
co
m
m
o
n
m
et
h
o
d
o
lo
g
y
an
d
s
tr
u
ctu
r
e
f
o
r
co
n
d
u
ctin
g
r
esear
ch
,
as
well
as
t
h
e
d
if
f
er
e
n
ce
in
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
14
,
No
.
5
,
Octo
b
er
20
25
:
4
1
2
9
-
413
9
4132
ty
p
es
o
f
ar
t
th
er
ap
y
.
Mo
r
eo
v
e
r
,
th
er
e
is
s
till
an
in
s
u
f
f
icien
t
n
u
m
b
er
o
f
ex
p
e
r
im
en
ts
.
Mo
s
t
o
f
th
e
co
n
d
u
cted
ex
p
er
im
en
ts
wer
e
r
a
n
d
o
m
ized
an
d
d
i
d
n
o
t
h
av
e
a
clea
r
s
am
p
le.
3.
M
E
T
H
O
D
3
.1
.
Resea
rc
h
des
ig
n a
nd
s
a
m
ple
T
h
e
r
esear
ch
em
p
lo
y
ed
a
r
an
d
o
m
ized
s
tu
d
y
to
ass
ess
th
e
i
m
p
ac
t
o
f
ar
t
th
er
ap
y
o
n
p
er
s
o
n
ality
an
d
p
r
o
f
ess
io
n
al
q
u
alities
.
T
h
e
ex
p
er
im
en
t
in
v
o
lv
ed
3
r
d
an
d
4
t
h
y
ea
r
s
tu
d
e
n
ts
o
f
t
h
e
Yela
b
u
g
a
I
n
s
titu
te
o
f
Kaz
a
n
Fed
er
al
Un
iv
er
s
ity
.
All
p
ar
ticip
an
ts
s
tu
d
ied
at
th
e
Dep
ar
tm
e
n
t
o
f
Ps
y
ch
o
lo
g
y
an
d
Ped
ag
o
g
y
.
T
h
e
a
g
e
o
f
th
e
r
esp
o
n
d
en
ts
r
a
n
g
ed
f
r
o
m
2
0
t
o
2
2
y
ea
r
s
.
T
h
e
s
tu
d
y
g
r
o
u
p
c
o
n
s
is
ted
o
f
1
0
7
p
ar
ticip
an
ts
.
T
h
e
s
am
p
le
s
ize
was
ca
lcu
lated
u
s
in
g
th
e
(
1
)
.
=
×
2
×
×
(
1
−
)
/
(
−
1
)
×
2
+
2
×
×
(
1
−
)
(
1
)
W
h
er
e
,
n
is
t
h
e
s
am
p
le
s
ize,
N
is
th
e
p
o
p
u
latio
n
s
ize
(
in
th
is
ca
s
e,
th
e
n
u
m
b
er
o
f
th
i
r
d
an
d
f
o
u
r
t
h
-
y
ea
r
s
tu
d
en
ts
at
th
e
Yela
b
u
g
a
I
n
s
titu
te
o
f
Kaz
an
Fed
er
al
Un
i
v
er
s
ity
)
,
Z
is
th
e
s
tan
d
ar
d
d
is
tr
ib
u
tio
n
co
ef
f
icien
t
f
o
r
th
e
s
am
p
le,
p
is
th
e
esti
m
at
ed
p
r
o
b
ab
ilit
y
/p
r
o
p
o
r
tio
n
o
f
in
d
iv
id
u
als
with
t
h
e
ch
a
r
ac
ter
is
tic
in
th
e
en
tire
p
o
p
u
latio
n
,
an
d
E
is
th
e
ac
ce
p
t
ab
le
m
ar
g
in
o
f
er
r
o
r
.
All
s
tu
d
en
ts
p
ar
ticip
atin
g
in
t
h
e
ex
p
er
im
en
t,
as
well
as
o
th
er
s
,
atten
d
ed
th
er
ap
y
s
ess
io
n
s
t
h
r
ee
tim
es
a
wee
k
af
te
r
th
eir
m
ain
s
tu
d
ie
s
.
An
ar
t
th
er
ap
y
s
p
ec
ialis
t
co
n
d
u
cted
all
s
ess
io
n
s
.
T
h
e
s
tu
d
en
ts
d
id
n
o
t
r
ec
eiv
e
ad
d
itio
n
al
p
s
y
ch
o
th
er
a
p
y
.
3
.2
.
E
x
perim
ent
a
nd
s
t
a
t
is
t
ica
l a
na
ly
s
is
B
ef
o
r
e
th
e
in
teg
r
atio
n
o
f
ar
t
t
h
er
ap
y
in
t
o
th
e
liv
es
o
f
s
tu
d
e
n
ts
,
th
e
r
esear
ch
er
s
test
ed
p
s
y
ch
o
lo
g
ical
im
b
alan
ce
in
d
icato
r
s
.
T
h
ey
in
clu
d
ed
t
h
e
B
ec
k
Dep
r
ess
io
n
I
n
v
en
to
r
y
,
th
e
Sp
ielb
e
r
g
er
-
K
h
a
n
in
An
x
iety
Scale,
th
e
Sch
r
ein
er
Stre
s
s
T
o
ler
an
c
e
T
est,
th
e
R
o
s
en
b
er
g
Self
-
E
s
teem
Scale,
an
d
B
o
y
k
o
’
s
E
m
o
tio
n
al
B
u
r
n
o
u
t
test
.
T
h
e
f
ir
s
t
test
(
B
ec
k
)
is
a
q
u
esti
o
n
n
air
e
th
at
in
clu
d
es
2
1
q
u
esti
o
n
s
with
4
a
n
s
wer
o
p
ti
o
n
s
ea
ch
.
T
h
e
test
ass
es
s
es
th
e
lev
el
o
f
a
p
er
s
o
n
’
s
d
ep
r
ess
iv
e
s
tate.
T
h
e
q
u
esti
o
n
s
co
n
ce
r
n
th
e
q
u
ality
o
f
s
leep
,
n
u
tr
itio
n
,
well
-
b
ein
g
,
s
ex
u
al
life
,
an
d
s
u
icid
al
ten
d
en
cies
[
29
]
.
T
h
e
Sp
ielb
er
g
er
-
Kh
a
n
in
An
x
iety
Scale
co
n
s
is
ts
o
f
2
0
q
u
esti
o
n
s
aim
ed
at
ass
ess
in
g
r
estl
ess
th
o
u
g
h
ts
,
ir
r
itab
ilit
y
,
an
d
m
o
o
d
lev
els
[
30
]
.
T
h
e
Sch
r
ein
er
test
is
an
ex
p
r
ess
d
iag
n
o
s
is
o
f
s
tr
ess
f
u
l
s
tates;
it
id
en
tifie
s
th
e
d
e
g
r
e
e
o
f
s
elf
-
r
eg
u
latio
n
a
n
d
e
m
o
ti
o
n
al
lab
ilit
y
d
u
r
i
n
g
th
e
ac
tio
n
o
f
v
a
r
io
u
s
tr
ig
g
er
in
g
s
itu
atio
n
s
[
31
]
.
T
h
e
R
o
s
en
b
er
g
test
is
a
tech
n
iq
u
e
f
o
r
id
e
n
tify
in
g
t
h
e
lev
el
o
f
s
elf
-
esteem
,
wh
ich
in
clu
d
es
1
0
q
u
esti
o
n
s
with
f
o
u
r
p
o
s
s
ib
le
an
s
wer
s
.
E
ac
h
an
s
wer
o
p
tio
n
is
a
s
s
es
s
ed
with
a
ce
r
tain
n
u
m
b
er
o
f
p
o
in
ts
.
M
o
r
e
p
o
in
ts
at
t
h
e
en
d
o
f
t
h
e
test
in
d
icate
h
ig
h
er
lev
els
o
f
s
elf
-
esteem
[
32
]
.
B
o
y
k
o
’
s
ass
ess
m
en
t
tech
n
iq
u
e
is
a
test
f
o
r
em
o
tio
n
al
b
u
r
n
o
u
t,
wh
ich
d
iag
n
o
s
es
th
e
l
ev
el
o
f
em
o
tio
n
al
r
esp
o
n
s
e
to
a
n
ir
r
itan
t.
T
h
e
test
co
n
s
is
ts
o
f
8
4
q
u
esti
o
n
s
[
33
]
.
All
th
ese
test
s
d
eter
m
in
ed
th
e
le
v
el
o
f
p
s
y
ch
o
lo
g
ical
p
r
o
b
lem
s
o
f
th
e
r
esp
o
n
d
en
ts
.
All
in
s
tr
u
m
en
t
s
d
em
o
n
s
tr
ated
a
n
ad
e
q
u
ate
l
ev
el
o
f
r
eliab
ilit
y
,
with
C
r
o
n
b
ac
h
’
s
alp
h
a
v
alu
es
as:
0
.
8
1
f
o
r
t
h
e
B
ec
k
Dep
r
ess
io
n
I
n
v
en
to
r
y
,
0
.
7
9
f
o
r
T
h
e
Sp
ielb
er
g
er
-
Kh
a
n
in
An
x
iety
Scale,
0
.
8
3
f
o
r
th
e
Sch
r
ein
er
Stre
s
s
T
o
ler
an
ce
T
est,
0
.
8
8
f
o
r
th
e
R
o
s
en
b
er
g
Self
-
E
s
teem
Scale
,
an
d
0
.
7
7
f
o
r
B
o
y
k
o
’
s
E
m
o
tio
n
al
B
u
r
n
o
u
t
test
.
T
h
ese
to
o
ls
co
u
ld
s
h
o
w
th
e
e
f
f
ec
tiv
en
ess
o
f
ar
t
t
h
er
ap
y
in
ch
an
g
in
g
th
e
ab
o
v
e
f
ac
to
r
s
,
an
d
as a
r
es
u
lt,
in
th
e
f
o
r
m
atio
n
o
f
f
u
tu
r
e
p
r
o
f
ess
io
n
als.
B
ef
o
r
e
th
e
ex
p
er
im
e
n
t,
all
r
esp
o
n
d
e
n
ts
h
ad
to
co
m
p
lete
th
e
s
e
q
u
esti
o
n
n
air
es
to
d
eter
m
in
e
th
e
lev
el
an
d
v
ec
to
r
o
f
th
eir
p
s
y
c
h
o
lo
g
ical
p
r
o
b
lem
s
.
T
h
e
test
in
g
p
r
o
c
ed
u
r
e
to
o
k
p
lace
in
a
u
n
iv
er
s
ity
class
r
o
o
m
u
n
d
e
r
th
e
g
u
id
a
n
ce
o
f
a
p
s
y
ch
o
lo
g
is
t,
wh
o
s
u
b
s
eq
u
e
n
tly
ch
ec
k
ed
t
h
e
r
esu
lts
.
All
p
ar
ticip
an
ts
co
m
p
leted
test
s
u
s
in
g
p
r
in
ted
q
u
esti
o
n
n
ai
r
es.
T
h
e
m
o
d
el
o
f
th
e
r
a
n
d
o
m
ize
d
s
tu
d
y
im
p
lied
ar
t
th
e
r
ap
y
am
o
n
g
a
g
r
o
u
p
o
f
s
tu
d
en
ts
.
T
h
e
s
tu
d
y
last
ed
f
o
r
3
m
o
n
th
s
.
Am
o
n
g
all
ty
p
es
o
f
ar
t
th
er
a
p
y
,
th
e
m
eth
o
d
o
f
f
in
e
ar
t
wa
s
th
e
m
o
s
t
s
u
itab
le
f
o
r
t
h
e
s
tu
d
y
[
34
]
.
T
h
e
r
esp
o
n
d
en
ts
p
a
r
ticip
ated
in
g
r
o
u
p
s
ess
io
n
s
th
r
ee
tim
es
a
wee
k
f
o
r
2
h
o
u
r
s
u
n
d
er
th
e
g
u
id
an
ce
o
f
a
q
u
alif
ied
s
p
ec
i
alis
t
in
th
e
f
ield
o
f
p
s
y
ch
o
lo
g
y
.
T
h
e
s
tu
d
y
p
a
r
ticip
an
ts
d
r
ew
p
ictu
r
es
in
th
e
class
r
o
o
m
u
s
in
g
p
en
cils
,
o
il
p
ain
ts
,
wate
r
co
lo
r
s
,
an
d
g
o
u
ac
h
e.
E
ac
h
s
tu
d
en
t
co
u
ld
d
r
aw
w
h
at
th
ey
lik
ed
b
est.
T
h
e
m
ain
task
was
to
let
em
o
tio
n
s
o
u
t
o
n
p
ap
er
o
r
ca
n
v
as.
T
h
e
s
tu
d
en
ts
co
u
ld
u
s
e
an
y
c
o
lo
r
s
,
s
y
m
b
o
ls
,
an
d
im
ag
es
to
co
n
v
ey
th
eir
f
ee
lin
g
s
.
Ar
tis
tic
s
k
ills
wer
e
n
o
t
es
s
en
tial.
Af
ter
cr
ea
tin
g
th
e
p
ictu
r
e,
th
e
p
ar
ticip
an
ts
h
ad
to
ev
alu
ate
t
h
eir
wo
r
k
f
r
o
m
a
p
s
y
ch
o
lo
g
ical
p
o
in
t
o
f
v
i
ew.
T
h
e
ar
t
th
er
ap
is
t
wh
o
c
o
n
d
u
cted
th
e
s
ess
io
n
s
r
ec
o
r
d
e
d
an
d
c
o
r
r
ec
ted
t
h
e
r
esu
lts
.
T
h
e
ex
p
er
t
ex
p
lain
e
d
wh
y
ce
r
tain
im
ag
es
p
e
r
s
o
n
i
f
ied
an
em
o
tio
n
al
r
ea
ctio
n
to
a
p
ar
ticu
lar
tr
ig
g
er
.
Fu
r
th
er
,
th
e
s
tu
d
en
ts
o
f
th
e
Dep
ar
tm
en
t
o
f
Ps
y
ch
o
lo
g
y
an
d
Ped
ag
o
g
y
h
a
d
to
in
d
ep
e
n
d
en
tl
y
p
r
o
ce
s
s
th
e
r
ec
eiv
ed
in
f
o
r
m
atio
n
.
T
h
e
s
tu
d
y
was
h
eld
at
Kaz
an
Fed
er
al
Un
iv
er
s
ity
.
T
h
e
ex
p
er
im
e
n
t
u
s
ed
test
in
g
f
o
r
d
ep
r
ess
io
n
,
a
n
x
iety
,
em
o
tio
n
a
l
b
u
r
n
o
u
t,
s
elf
-
esteem
,
an
d
s
tr
ess
r
esis
tan
ce
two
m
o
r
e
tim
es
(
in
t
h
e
m
i
d
d
le
o
f
th
e
s
tu
d
y
(
th
e
s
ix
th
wee
k
)
an
d
at
th
e
en
d
o
f
th
e
th
ir
d
m
o
n
th
)
.
T
o
p
r
o
ce
s
s
th
e
o
b
tain
ed
d
ata
,
th
is
s
tu
d
y
u
tili
ze
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
P
ilo
t stu
d
y
o
n
th
e
u
s
e
o
f a
r
t th
era
p
y
tech
n
iq
u
es to
imp
r
o
ve
th
e
p
s
yc
h
o
-
emo
ti
o
n
a
l
… (
Ta
tig
u
l S
a
mu
r
a
to
v
a
)
4133
a
s
p
ec
ialized
p
r
o
g
r
am
f
o
r
s
tatis
tical
an
aly
s
i
s
ca
lled
S
PS
S
2
6
.
0
.
T
h
e
Mic
r
o
s
o
f
t
E
x
ce
l
2
0
1
9
s
o
f
twar
e
p
ac
k
ag
e
allo
wed
f
o
r
t
h
e
in
ter
p
r
etatio
n
an
d
v
is
u
aliza
tio
n
o
f
th
e
r
esu
lts
.
3
.3
.
L
im
it
a
t
io
ns
T
h
e
ex
p
er
im
e
n
t
h
ad
s
ev
er
al
lim
itatio
n
s
.
First
ly
,
th
e
p
ar
ticip
an
ts
in
th
e
ex
p
er
im
en
t
h
ad
d
if
f
er
en
t
p
s
y
ch
o
lo
g
ical
b
lo
c
k
s
an
d
wer
e
at
d
if
f
er
en
t
lev
els
o
f
g
en
er
al
em
o
tio
n
al
s
tate.
Seco
n
d
ly
,
th
is
r
esear
ch
is
a
r
an
d
o
m
ize
d
s
tu
d
y
o
n
ar
t
th
er
ap
y
’
s
in
f
lu
en
c
e
o
n
f
u
t
u
r
e
ed
u
ca
tio
n
al
p
s
y
ch
o
l
o
g
is
ts
’
p
er
s
o
n
al
q
u
alities
.
T
h
er
ef
o
r
e,
th
e
ca
lcu
latio
n
o
f
a
ll
r
esu
lts
r
ests
o
n
th
e
ar
ith
m
eti
c
m
ea
n
f
o
r
th
e
en
tire
g
r
o
u
p
.
I
n
th
e
c
o
n
tex
t o
f
t
h
is
ex
p
er
im
en
t,
a
r
t
th
er
a
p
y
is
an
elem
en
t
o
f
s
elf
-
d
e
v
elo
p
m
e
n
t
f
o
r
m
aster
s
o
f
th
e
De
p
ar
tm
en
t
o
f
Ps
y
ch
o
lo
g
y
an
d
Ped
ag
o
g
y
.
T
o
u
s
e
th
is
tech
n
iq
u
e
an
d
o
b
tain
s
im
ilar
r
esu
lts
a
m
o
n
g
p
e
o
p
le
u
n
r
elate
d
to
p
s
y
ch
o
lo
g
y
,
it
m
ay
b
e
n
ec
ess
ar
y
to
in
clu
d
e
a
d
d
itio
n
a
l in
d
iv
id
u
al
s
ess
io
n
s
with
a
s
p
ec
ialis
t in
th
is
f
ield
.
4.
RE
SU
L
T
S
B
ef
o
r
e
an
aly
zin
g
th
e
r
esu
lts
,
it
is
n
ec
ess
ar
y
to
ev
alu
ate
th
e
d
ata
o
b
tain
ed
d
u
r
i
n
g
th
e
f
ir
s
t
test
in
g
o
f
th
e
ex
p
e
r
im
en
t
p
ar
ticip
an
ts
.
All
v
alu
es
ar
e
th
e
a
v
er
ag
e
r
e
s
u
lt
o
f
t
h
e
s
am
p
le.
T
h
u
s
,
b
as
ed
o
n
d
ata
f
r
o
m
th
e
B
ec
k
Dep
r
ess
io
n
I
n
v
en
to
r
y
,
t
h
e
lev
el
o
f
d
ep
r
ess
io
n
a
m
o
n
g
r
esp
o
n
d
en
ts
was
4
0
%.
T
h
e
Sp
ielb
er
g
er
-
Kh
a
n
in
An
x
iety
Scale
s
h
o
wed
th
at
th
e
av
er
ag
e
lev
el
o
f
an
x
iety
in
th
e
g
r
o
u
p
was
5
0
%.
E
m
o
tio
n
al
b
u
r
n
o
u
t
r
ea
ch
ed
4
5
%
o
n
av
er
a
g
e
in
th
e
s
am
p
le
(
B
o
y
k
o
’
s
test
)
.
T
h
e
r
ef
o
r
e
,
t
h
e
p
ar
ticip
a
n
ts
h
ad
ce
r
tain
p
r
o
b
lem
s
with
th
ese
cr
iter
ia.
Ho
wev
er
,
th
e
lev
el
o
f
s
tr
ess
r
esi
s
tan
ce
was
lo
w,
o
n
ly
3
0
%.
T
h
e
r
esu
lts
o
f
th
e
s
elf
-
esteem
test
wer
e
s
lig
h
tly
b
etter
an
d
wer
e
eq
u
a
l
to
3
5
%.
T
h
is
f
ac
t
in
d
icate
s
a
r
ath
er
lo
w
lev
el
o
f
s
elf
-
esteem
an
d
lo
w
-
s
tr
ess
to
ler
an
ce
.
Fig
u
r
e
1
s
h
o
ws all
t
h
e
d
ata.
Fig
u
r
e
1
.
T
h
e
r
esu
lts
o
f
th
e
f
ir
s
t te
s
tin
g
T
h
en
th
e
p
ar
ticip
an
ts
wo
r
k
ed
ac
co
r
d
in
g
to
th
e
co
n
d
itio
n
s
o
f
th
e
e
x
p
er
im
e
n
t
f
o
r
an
o
th
er
6
wee
k
s
.
Af
ter
s
o
m
e
tim
e,
th
e
r
esp
o
n
d
e
n
ts
ag
ain
p
ass
ed
th
e
s
am
e
test
s
.
T
h
e
r
esu
lt
s
h
o
wed
th
at
th
e
l
ev
el
o
f
d
ep
r
ess
io
n
o
n
th
e
B
ec
k
s
ca
le
d
ec
r
ea
s
ed
b
y
5
%
an
d
was
3
5
%.
T
h
e
in
itial
d
ata
o
n
th
e
a
n
x
iety
test
d
ec
r
ea
s
ed
b
y
1
0
%
an
d
was
eq
u
al
to
4
0
%.
T
h
e
lev
el
o
f
em
o
tio
n
al
b
u
r
n
o
u
t
a
m
o
n
g
r
esp
o
n
d
en
ts
d
ec
r
ea
s
ed
b
y
5
%
an
d
was
4
0
%
at
th
e
tim
e
o
f
th
e
test
.
T
h
e
in
d
icato
r
o
f
s
tr
ess
r
esi
s
tan
ce
in
cr
ea
s
ed
b
y
1
0
% a
f
ter
th
e
th
er
a
p
y
.
T
h
e
lev
el
o
f
s
elf
-
esteem
also
in
cr
ea
s
ed
b
y
1
0
%.
Fig
u
r
e
2
illu
s
tr
ates th
e
r
esu
lts
o
f
an
i
n
ter
im
s
tu
d
y
.
T
h
e
in
ter
im
s
tu
d
y
r
e
v
ea
led
a
d
ec
r
ea
s
e
in
th
e
lev
el
o
f
d
e
p
r
ess
io
n
,
an
x
iety
,
a
n
d
em
o
tio
n
a
l
b
u
r
n
o
u
t,
in
d
icatin
g
an
im
p
r
o
v
em
e
n
t
in
th
e
em
o
tio
n
al
s
tate
o
f
th
e
p
ar
ticip
an
ts
.
T
h
e
lev
el
o
f
s
tr
ess
to
ler
an
ce
an
d
s
elf
-
esteem
in
cr
ea
s
ed
d
u
r
in
g
t
h
e
ex
p
er
im
e
n
t
an
d
th
is
r
esu
lt
is
also
a
p
o
s
itiv
e
d
y
n
am
ic.
At
th
e
in
ter
im
s
tag
e,
th
e
ar
t
th
er
ap
y
h
ad
a
n
im
p
ac
t
o
n
th
e
em
o
tio
n
al
b
ac
k
g
r
o
u
n
d
a
n
d
im
p
r
o
v
e
d
th
e
in
n
er
q
u
alities
o
f
th
e
r
esp
o
n
d
en
ts
.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
De
p
re
ss
io
n
lev
e
l
A
n
x
iety
lev
e
l
Em
o
ti
o
n
a
l
b
u
rn
o
u
t
lev
e
l
S
tres
s
re
sista
n
c
e
S
e
lf
-
e
ste
e
m
P
er
ce
n
tag
e
Valu
es
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
14
,
No
.
5
,
Octo
b
er
20
25
:
4
1
2
9
-
413
9
4134
Fig
u
r
e
2
.
I
n
ter
im
test
in
g
Af
ter
an
o
th
e
r
m
o
n
th
an
d
a
h
alf
o
f
a
r
t
th
er
ap
y
s
ess
io
n
s
,
th
e
f
in
al
test
to
o
k
p
lace
.
I
ts
r
esu
lts
s
h
o
wed
a
d
ec
r
ea
s
e
in
d
ep
r
ess
io
n
b
y
an
o
th
er
1
0
%.
As
a
r
esu
lt,
th
e
lev
el
o
f
d
ep
r
ess
io
n
was
2
5
%.
T
h
e
an
x
iety
in
d
icato
r
d
ec
r
ea
s
ed
b
y
1
0
%
an
d
was
3
0
%.
T
h
e
lev
el
o
f
em
o
tio
n
al
b
u
r
n
o
u
t
also
d
ec
r
ea
s
ed
b
y
1
0
%
an
d
b
ec
am
e
3
0
%.
At
th
e
s
am
e
tim
e,
s
tr
ess
r
esis
tan
ce
in
cr
ea
s
ed
to
5
0
%
(
+1
0
%
o
f
th
e
p
r
e
v
io
u
s
r
esu
lt).
T
h
e
l
ev
el
o
f
s
elf
-
esteem
th
is
tim
e
in
cr
ea
s
ed
b
y
o
n
ly
5
% a
n
d
was e
q
u
al
to
5
0
% in
to
t
al.
Fig
u
r
e
3
s
h
o
ws th
e
d
iag
r
a
m
with
th
e
r
esu
lts
.
Fig
u
r
e
3
.
T
h
e
r
esu
lts
o
f
th
e
f
in
al
test
in
g
B
ased
o
n
all
th
e
d
ata
o
b
tain
ed
,
o
n
e
ca
n
n
o
tice
th
e
e
f
f
ec
tiv
en
ess
o
f
ar
t
th
er
a
p
y
s
ess
io
n
s
in
th
e
p
er
s
o
n
ality
d
ev
el
o
p
m
en
t
o
f
f
u
tu
r
e
teac
h
er
s
-
p
s
y
ch
o
lo
g
is
ts
.
I
n
th
e
co
u
r
s
e
o
f
th
e
s
tu
d
y
,
th
er
e
was
an
in
cr
ea
s
e
in
th
e
m
o
tiv
atio
n
f
o
r
s
elf
-
d
e
v
elo
p
m
en
t
am
o
n
g
r
esp
o
n
d
en
ts
,
as
s
h
o
wn
b
y
a
s
u
r
v
ey
o
f
p
ar
tic
ip
an
ts
.
On
e
o
f
th
e
r
esp
o
n
d
en
ts
s
aid
:
“
Th
is
tech
n
iq
u
e
r
ea
lly
o
p
e
n
ed
my
ey
es
to
s
o
me
in
tern
a
l
p
r
o
b
lems
th
a
t
I
h
a
d
b
ee
n
s
u
p
p
r
ess
in
g
fo
r
a
lo
n
g
time.
Mo
s
t
imp
o
r
ta
n
tly,
it
ta
u
g
h
t
me
h
o
w
to
w
o
r
k
w
ith
th
em.
I
h
a
ve
r
ea
lly
in
c
r
ea
s
ed
mo
tiva
tio
n
fo
r
s
elf
-
d
ev
elo
p
me
n
t th
a
n
ks to
a
r
t th
era
p
y
.
”
(
Vic
to
r
)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
De
p
re
ss
io
n
lev
e
l
A
n
x
iety
lev
e
l
Em
o
ti
o
n
a
l
b
u
rn
o
u
t
lev
e
l
S
tres
s
re
sista
n
c
e
S
e
lf
-
e
ste
e
m
P
er
ce
n
tag
e
Valu
es
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
De
p
re
ss
io
n
lev
e
l
A
n
x
iety
lev
e
l
Em
o
ti
o
n
a
l
b
u
rn
o
u
t
lev
e
l
S
tres
s
re
sista
n
c
e
S
e
lf
-
e
ste
e
m
P
er
ce
n
tag
e
Valu
es
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
P
ilo
t stu
d
y
o
n
th
e
u
s
e
o
f a
r
t th
era
p
y
tech
n
iq
u
es to
imp
r
o
ve
th
e
p
s
yc
h
o
-
emo
ti
o
n
a
l
… (
Ta
tig
u
l S
a
mu
r
a
to
v
a
)
4135
“
A
r
t
th
era
p
y
h
elp
ed
me
t
o
d
is
tr
a
ct
myself
f
r
o
m
va
r
io
u
s
d
is
tu
r
b
in
g
th
o
u
g
h
ts
.
Th
a
n
k
s
to
it,
I
lea
r
n
ed
to
d
iffer
en
tia
te
my
emo
tio
n
s
a
n
d
a
cc
ep
t
th
em.
I
b
eg
a
n
to
feel
c
o
n
fid
en
t,
a
n
d
I
b
ec
a
me
mo
tiva
ted
to
imp
r
o
ve
my
p
s
yc
h
o
lo
g
ica
l skills
.
”
(
Alex
an
d
r
a)
T
h
er
e
wer
e
also
m
an
y
m
o
r
e
p
o
s
itiv
e
co
m
m
en
ts
f
r
o
m
th
e
p
ar
ticip
an
ts
o
f
th
e
p
r
o
g
r
am
.
T
h
is
f
ac
t
in
d
icate
s
an
in
c
r
ea
s
e
in
t
h
e
m
o
tiv
atio
n
o
f
s
tu
d
en
ts
to
tak
e
p
ar
t
in
ar
t
th
er
a
p
y
p
r
ac
tices
an
d
f
u
r
th
er
d
ev
elo
p
th
em
s
elv
es
in
th
e
p
r
o
f
ess
io
n
.
T
h
u
s
,
th
er
ap
y
b
ased
o
n
ar
t
ef
f
ec
tiv
ely
id
en
tifie
s
p
r
o
b
lem
s
an
d
s
tab
ilizes
th
e
p
s
y
ch
o
lo
g
ical
s
tate.
Mo
r
eo
v
e
r
,
it
in
cr
ea
s
es
m
o
tiv
atio
n
f
o
r
f
u
r
th
er
s
elf
-
d
e
v
elo
p
m
e
n
t.
All
th
ese
f
ac
to
r
s
ar
e
im
p
o
r
tan
t f
o
r
th
e
f
o
r
m
atio
n
o
f
p
er
s
o
n
ality
an
d
th
e
d
ev
elo
p
m
en
t o
f
p
r
o
f
ess
io
n
al
co
m
p
eten
c
ies.
5.
DIS
CU
SS
I
O
N
Scien
tis
ts
f
r
o
m
th
e
Un
iv
er
s
ity
o
f
Yo
r
k
h
a
v
e
s
tu
d
ied
t
h
e
in
d
icato
r
s
o
f
s
u
cc
ess
an
d
d
if
f
icu
lties
ass
o
ciate
d
with
s
tu
d
y
in
g
at
p
s
y
ch
o
lo
g
ical
f
ac
u
lties
.
T
h
e
in
d
i
ca
to
r
s
r
ev
ea
led
a
h
ig
h
lev
el
o
f
n
eu
r
o
tic
d
is
o
r
d
er
s
am
o
n
g
s
tu
d
en
ts
,
as
well
as
l
o
w
s
elf
-
esteem
,
wh
ich
le
d
to
th
e
im
p
o
s
to
r
p
h
e
n
o
m
e
n
o
n
.
T
h
es
e
f
ac
to
r
s
c
o
m
p
licate
th
e
p
ath
to
th
e
s
u
cc
ess
o
f
a
p
er
s
o
n
in
th
e
p
r
o
f
ess
io
n
.
T
h
er
ef
o
r
e,
o
n
e
ca
n
c
o
n
clu
d
e
ab
o
u
t
th
e
im
p
o
r
tan
ce
o
f
th
er
ap
y
f
o
r
em
o
tio
n
al
tr
au
m
a,
in
clu
d
in
g
th
r
o
u
g
h
ar
t
t
h
er
ap
y
.
T
h
e
r
esu
lts
s
h
o
wed
a
s
ig
n
if
ican
t
p
o
s
itiv
e
in
f
lu
en
ce
o
f
th
is
m
eth
o
d
o
n
p
s
y
ch
o
lo
g
y
s
tu
d
en
ts
[
35
]
.
Similar
ly
,
th
e
s
cien
tis
ts
in
v
esti
g
ated
th
e
m
en
tal
an
d
em
o
tio
n
al
s
tate
o
f
s
tu
d
e
n
ts
an
d
d
em
o
n
s
tr
ated
th
e
r
elev
a
n
ce
o
f
th
is
is
s
u
e.
As
f
o
r
th
e
d
if
f
e
r
en
ce
s
,
th
e
ex
p
er
im
en
t
c
o
n
d
u
cted
at
th
e
Un
iv
er
s
ity
o
f
Yo
r
k
in
clu
d
ed
n
o
t
o
n
ly
a
r
t
th
er
ap
y
b
u
t
a
co
m
p
r
eh
en
s
iv
e
ap
p
r
o
ac
h
to
p
s
y
ch
o
lo
g
ical
ass
is
tan
ce
.
I
n
an
o
t
h
er
ex
p
er
im
en
t,
s
cien
ti
s
ts
f
r
o
m
Flo
r
id
a
d
escr
ib
ed
a
n
d
p
r
o
v
ed
th
e
e
f
f
ec
tiv
en
ess
o
f
ar
t
th
er
ap
y
in
s
tr
ess
r
ed
u
ctio
n
am
o
n
g
c
o
lleg
e
s
tu
d
en
ts
.
T
h
e
a
u
th
o
r
s
s
h
o
wed
t
h
at
ar
t
th
er
ap
y
is
an
e
f
f
ec
tiv
e
a
n
d
co
m
m
er
cially
av
ailab
le
tech
n
i
q
u
e
[
36
]
.
T
h
e
s
im
ilar
ity
o
f
th
e
s
tu
d
ies
lie
s
in
th
e
an
aly
s
i
s
o
f
th
e
in
f
lu
en
ce
o
f
ar
t
tech
n
o
lo
g
ies
o
n
th
e
p
s
y
ch
o
lo
g
ical
s
tate
o
f
s
tu
d
e
n
ts
.
T
h
e
s
cien
tis
ts
f
r
o
m
Flo
r
id
a
,
as
well
as
th
e
au
th
o
r
s
o
f
th
is
ex
p
er
im
en
t,
co
n
f
ir
m
ed
th
e
p
o
s
itiv
e
d
y
n
a
m
ics
o
f
ar
t
t
h
er
a
p
y
.
Stu
d
ies
co
n
d
u
cted
in
C
r
o
atia
h
av
e
f
o
u
n
d
a
p
o
s
itiv
e
ef
f
ec
t
o
f
ar
t
o
n
th
e
c
en
ter
s
o
f
th
e
r
ig
h
t
ce
r
eb
r
al
h
e
m
is
p
h
er
e.
Du
r
in
g
th
e
cr
ea
tiv
e
p
r
o
ce
s
s
,
th
e
r
ig
h
t
h
em
is
p
h
er
e
ac
tiv
ates
ad
d
itio
n
al
n
eu
r
al
c
o
n
n
ec
tio
n
s
,
wh
i
ch
ar
e
r
esp
o
n
s
ib
le
f
o
r
im
ag
in
atio
n
,
s
ea
r
ch
f
o
r
s
o
lu
tio
n
s
,
an
d
s
y
n
th
esis
,
as
well
as
f
o
r
m
etap
h
o
r
ical
th
in
k
in
g
[
37
]
.
T
h
e
ex
p
e
r
im
en
t
s
h
o
wed
th
e
p
r
ac
tical
ef
f
ec
t
o
f
ar
t
th
er
a
p
y
o
n
h
u
m
an
em
o
tio
n
s
,
as
s
h
o
wn
in
th
e
cu
r
r
en
t
s
tu
d
y
.
T
h
e
d
if
f
e
r
en
ce
s
co
n
ce
r
n
ed
th
e
r
esear
ch
co
n
tex
t: scien
tis
ts
f
r
o
m
C
r
o
atia
f
o
cu
s
ed
o
n
n
e
u
r
o
b
io
lo
g
y
.
I
n
th
e
Neth
er
lan
d
s
,
s
cien
tis
ts
ag
r
ee
d
o
n
th
e
ef
f
ec
tiv
e
n
ess
o
f
ar
t
th
er
a
p
y
o
n
an
x
iety
.
E
x
p
er
im
en
ts
p
r
o
v
e
d
an
in
cr
ea
s
e
in
s
tr
ess
r
esis
tan
ce
an
d
co
n
tr
o
l
o
f
em
o
tio
n
s
[
38
]
.
T
h
e
co
m
m
o
n
f
ea
tu
r
e
o
f
th
e
e
x
p
er
im
e
n
ts
is
th
e
co
n
f
ir
m
e
d
p
o
s
itiv
e
in
f
lu
en
ce
o
f
ar
t
th
e
r
ap
y
o
n
a
n
x
i
ety
an
d
s
tr
ess
r
esis
tan
ce
in
b
o
th
ca
s
es.
C
h
in
ese
au
th
o
r
d
escr
ib
ed
an
ex
p
e
r
im
en
t
aim
ed
at
tr
ea
tin
g
d
e
p
r
ess
io
n
th
r
o
u
g
h
a
r
t
th
er
a
p
y
.
Ov
e
r
all,
th
e
r
esu
lt
was
s
atis
f
ac
to
r
y
.
Ho
wev
er
,
ac
co
r
d
in
g
to
th
e
co
n
clu
s
io
n
s
o
f
th
e
s
c
ien
tis
ts
,
th
er
e
was
a
n
ee
d
f
o
r
ad
d
itio
n
al
r
esear
ch
[
39
]
.
T
h
e
d
if
f
er
e
n
ce
b
etwe
e
n
th
e
r
esu
lts
o
f
t
h
is
s
tu
d
y
a
n
d
th
e
C
h
in
ese
ex
p
er
im
en
t
m
ay
b
e
d
u
e
to
th
e
r
an
d
o
m
ize
d
ty
p
e
o
f
r
esear
c
h
.
T
h
e
r
esu
lts
d
o
n
o
t c
laim
to
b
e
ac
cu
r
ate
in
d
icato
r
s
.
B
ased
o
n
th
e
ex
p
er
ien
ce
o
f
o
th
er
r
esear
ch
er
s
,
th
e
p
r
esen
ce
o
f
ar
t
th
er
ap
y
in
v
ar
io
u
s
s
p
h
er
es
o
f
life
is
ess
en
tial.
I
t
allo
ws
p
eo
p
le
to
r
ed
u
ce
th
e
in
f
lu
en
ce
o
f
n
e
g
ativ
e
p
s
y
ch
o
l
o
g
ical
f
ac
to
r
s
th
at
d
estro
y
p
er
s
o
n
ality
.
T
h
e
d
if
f
er
en
ce
b
etwe
en
th
ese
d
ata
m
ay
b
e
d
u
e
to
th
e
ar
ea
s
o
f
ap
p
licatio
n
o
f
t
h
e
m
et
h
o
d
o
lo
g
y
.
H
o
wev
er
,
b
o
t
h
s
tu
d
ies
co
n
f
ir
m
th
is
co
n
clu
s
io
n
.
Alth
o
u
g
h
th
e
d
ev
elo
p
m
en
t
o
f
p
er
s
o
n
al
q
u
alities
th
r
o
u
g
h
ar
t
th
er
ap
y
is
n
o
t
a
f
u
lly
s
tu
d
ied
to
p
ic,
it
is
p
o
s
s
ib
le
to
d
is
cu
s
s
s
o
m
e
r
esu
lts
.
A
cc
o
r
d
in
g
to
th
e
d
ata
f
r
o
m
t
h
is
s
tu
d
y
,
ar
t
th
er
a
p
y
r
eliev
es
d
ep
r
ess
io
n
,
an
x
iety
,
a
n
d
em
o
tio
n
al
b
u
r
n
o
u
t.
I
n
ad
d
i
tio
n
,
it
in
cr
ea
s
es
s
tr
ess
to
ler
an
ce
an
d
s
elf
-
esteem
.
T
h
e
s
u
r
v
ey
o
f
p
a
r
ticip
an
ts
r
ev
ea
led
th
at
ar
t
th
er
ap
y
s
tab
ilized
th
eir
em
o
tio
n
al
b
ac
k
g
r
o
u
n
d
an
d
in
cr
ea
s
ed
th
ei
r
m
o
tiv
atio
n
f
o
r
s
elf
-
d
e
v
elo
p
m
en
t.
An
aly
zin
g
th
e
p
r
esen
ted
p
ap
er
,
o
n
e
ca
n
ad
m
it
th
e
ef
f
ec
tiv
en
ess
o
f
ar
t
th
er
ap
y
tech
n
i
q
u
es
as
a
to
o
l
to
co
m
b
at
v
ar
i
o
u
s
d
is
o
r
d
er
s
(
d
ep
r
ess
io
n
,
an
x
iety
,
a
n
d
b
u
r
n
o
u
t)
.
Mo
r
e
o
v
er
,
ar
t
th
er
ap
y
ca
n
f
o
s
ter
s
elf
-
d
ev
elo
p
m
en
t
an
d
h
elp
u
n
d
er
s
tan
d
i
n
n
er
em
o
tio
n
s
.
T
h
e
o
b
tain
e
d
r
e
s
u
lts
s
u
g
g
est
th
at
ar
t
th
er
ap
y
allo
ws
p
a
r
ticip
an
ts
to
u
n
d
er
s
tan
d
th
eir
p
r
o
b
lem
s
.
Du
e
to
g
o
o
d
d
is
tr
ac
tin
g
an
d
r
elax
in
g
ef
f
ec
ts
,
ar
t
th
er
ap
y
also
e
f
f
ec
tiv
ely
r
e
g
u
l
ates
em
o
tio
n
al
b
ac
k
g
r
o
u
n
d
.
Pre
v
io
u
s
s
tu
d
ies
s
h
o
wed
th
at
t
h
is
ty
p
e
o
f
t
h
er
ap
y
d
ev
elo
p
s
th
e
ce
n
ter
s
o
f
th
e
r
i
g
h
t
ce
r
eb
r
al
h
em
is
p
h
e
r
e.
C
o
n
s
eq
u
en
tly
,
in
d
iv
id
u
als
im
p
r
o
v
e
th
eir
im
ag
in
atio
n
,
as we
ll a
s
th
eir
ab
ilit
ies to
s
ee
p
r
o
s
p
ec
ts
an
d
s
o
lv
e
p
r
o
b
lem
s
th
at
r
eq
u
ir
e
a
cr
ea
tiv
e
ap
p
r
o
ac
h
.
Ho
wev
er
,
th
is
s
tu
d
y
,
lik
e
m
o
s
t
o
th
er
s
,
is
r
an
d
o
m
ized
.
T
h
er
e
f
o
r
e,
th
er
e
a
r
e
s
o
m
e
n
u
a
n
ce
s
r
eg
ar
d
in
g
th
e
ac
cu
r
ac
y
o
f
th
e
r
esu
lts
.
F
o
r
ex
am
p
le,
in
th
is
ex
p
e
r
im
e
n
t,
p
s
y
ch
o
lo
g
ical
p
r
o
b
lem
s
w
er
e
d
if
f
er
en
t
f
o
r
all
p
ar
ticip
an
ts
in
th
e
g
r
o
u
p
.
T
h
e
d
eg
r
ee
an
d
s
ev
er
ity
o
f
th
e
p
r
o
b
lem
s
also
r
ec
eiv
ed
in
s
u
f
f
icien
t
atten
tio
n
.
Mo
s
t
o
f
th
e
s
tu
d
ies
o
n
th
is
to
p
ic
al
s
o
co
n
d
u
cted
r
an
d
o
m
ized
ex
p
er
im
en
ts
,
wh
ich
f
ailed
t
o
a
d
d
r
ess
m
an
y
asp
ec
ts
[
38
]
,
[
39
]
.
Ad
d
itio
n
al
s
tu
d
ies
with
m
o
r
e
ac
cu
r
ate
f
o
cu
s
g
r
o
u
p
s
ca
n
h
av
e
m
o
r
e
r
eliab
le
r
e
s
u
lts
.
Nev
er
th
eless
,
in
ter
m
s
o
f
th
e
s
u
cc
ess
f
u
l
d
e
v
elo
p
m
en
t
o
f
an
ed
u
ca
ti
o
n
al
p
s
y
ch
o
lo
g
is
t,
ar
t
th
er
ap
y
p
r
o
v
e
d
to
b
e
an
ef
f
ec
tiv
e
s
tr
ateg
y
.
T
h
is
tech
n
iq
u
e
ca
n
s
er
v
e
as
an
ad
d
itio
n
al
th
e
r
ap
y
f
o
r
d
ep
r
ess
io
n
,
g
en
er
alize
d
a
n
x
iety
d
is
o
r
d
er
,
a
n
d
em
o
tio
n
al
b
u
r
n
o
u
t.
At
t
h
e
s
a
m
e
tim
e,
in
th
is
s
tu
d
y
,
th
e
ar
t
th
er
ap
y
s
ess
io
n
s
in
v
o
lv
ed
a
g
r
o
u
p
o
f
p
eo
p
le
with
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
2
5
2
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8
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2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
14
,
No
.
5
,
Octo
b
er
20
25
:
4
1
2
9
-
413
9
4136
k
n
o
wled
g
e
in
t
h
e
f
ield
o
f
p
s
y
ch
o
lo
g
y
.
T
h
er
ef
o
r
e,
f
u
ll
-
f
led
g
ed
ar
t
t
h
er
ap
y
m
ay
r
eq
u
ir
e
a
d
d
itio
n
al
in
d
i
v
id
u
al
co
n
s
u
ltatio
n
s
with
a
s
p
ec
ialis
t in
p
s
y
ch
o
lo
g
y
.
T
h
e
im
p
lem
en
tatio
n
o
f
ar
t
t
h
er
ap
y
tech
n
iq
u
es
ca
n
b
ec
o
m
e
a
cr
u
cial
co
m
p
o
n
en
t
o
f
ed
u
ca
tio
n
al
p
o
licies
aim
ed
at
s
u
p
p
o
r
tin
g
s
tu
d
en
ts
’
m
en
tal
h
ea
lth
.
E
d
u
ca
tio
n
al
in
s
titu
tio
n
s
,
in
clu
d
in
g
u
n
iv
er
s
ities
,
co
lleg
es,
an
d
s
ec
o
n
d
ar
y
s
ch
o
o
ls
,
s
h
o
u
ld
co
n
s
id
er
in
teg
r
atin
g
a
r
t
th
er
a
p
y
in
to
th
eir
p
r
o
g
r
am
s
to
cr
ea
te
a
s
u
p
p
o
r
tiv
e
en
v
ir
o
n
m
en
t
th
at
f
o
s
ter
s
n
o
t
o
n
l
y
th
e
ac
ad
em
ic
b
u
t
also
th
e
em
o
tio
n
al
d
ev
elo
p
m
en
t
o
f
s
tu
d
en
ts
.
T
h
is
in
teg
r
atio
n
co
u
ld
in
v
o
lv
e
r
eg
u
lar
a
r
t
th
er
ap
y
s
ess
io
n
s
,
s
p
ec
ialized
co
u
r
s
es,
o
r
tr
ain
i
n
g
f
o
r
b
o
th
teac
h
er
s
an
d
s
tu
d
en
ts
.
E
d
u
ca
tio
n
al
s
p
ec
ialis
ts
s
h
o
u
ld
tak
e
th
ese
f
in
d
in
g
s
in
to
ac
co
u
n
t
wh
e
n
d
ev
el
o
p
in
g
an
d
r
ef
in
i
n
g
cu
r
r
icu
la.
I
n
v
estme
n
ts
in
ar
t th
er
ap
y
co
u
ld
b
ec
o
m
e
a
s
ig
n
if
ican
t p
ar
t o
f
s
tr
ateg
ies to
r
ed
u
ce
s
tr
es
s
an
d
b
u
r
n
o
u
t
am
o
n
g
s
tu
d
e
n
ts
,
wh
ich
ar
e
k
e
y
f
ac
to
r
s
in
en
h
a
n
cin
g
th
e
o
v
e
r
all
ef
f
ec
tiv
en
ess
o
f
th
e
ed
u
ca
tio
n
al
s
y
s
tem
.
T
h
e
ex
p
er
ien
ce
o
f
u
s
in
g
a
r
t
th
er
a
p
y
ca
n
b
e
v
alu
ab
le
in
d
ev
elo
p
in
g
n
ew
ap
p
r
o
ac
h
es
to
ed
u
ca
tio
n
th
at
ad
d
r
ess
s
tu
d
en
ts
’
em
o
tio
n
al
n
ee
d
s
an
d
p
r
o
m
o
te
t
h
eir
h
o
lis
tic
d
ev
elo
p
m
en
t.
T
h
er
ef
o
r
e,
th
e
p
r
ac
tica
l
s
ig
n
if
ican
ce
o
f
t
h
e
o
b
tain
ed
r
esu
lts
lies
in
th
e
p
o
ten
tial
to
im
p
r
o
v
e
th
e
q
u
ality
o
f
e
d
u
ca
tio
n
th
r
o
u
g
h
th
e
im
p
lem
en
tatio
n
o
f
a
r
t
th
er
ap
y
tec
h
n
iq
u
es,
wh
ich
wil
l
co
n
tr
ib
u
te
to
g
r
ea
ter
em
o
tio
n
al
s
tab
ilit
y
an
d
p
r
o
f
ess
io
n
al
r
ea
d
in
ess
o
f
f
u
tu
r
e
s
p
ec
ialis
t
s
.
6.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
im
p
lem
e
n
ted
ar
t
t
h
er
ap
y
in
a
f
o
cu
s
g
r
o
u
p
o
f
s
tu
d
en
ts
f
r
o
m
t
h
e
Dep
ar
tm
e
n
t
o
f
Ps
y
ch
o
lo
g
y
an
d
Ped
ag
o
g
y
.
T
h
e
r
esu
lts
o
f
th
e
ex
p
er
im
en
t
s
h
o
we
d
a
d
e
cr
ea
s
e
in
th
e
d
ep
r
ess
io
n
lev
el
b
y
an
av
er
a
g
e
o
f
1
5
%.
T
h
e
lev
el
o
f
an
x
iety
d
ec
r
ea
s
ed
b
y
2
0
%,
wh
ile
a
d
ec
r
ea
s
e
in
em
o
tio
n
al
b
u
r
n
o
u
t
was
b
y
1
5
%.
I
n
t
u
r
n
,
t
h
e
in
d
icato
r
s
o
f
s
tr
ess
r
esis
tan
ce
an
d
s
elf
-
esteem
i
n
cr
ea
s
ed
b
y
2
0
%
an
d
1
5
%,
r
esp
ec
tiv
el
y
.
T
h
u
s
,
th
er
a
p
y
b
ased
o
n
f
in
e
ar
t
r
ed
u
ce
d
an
d
r
eg
u
lated
th
e
lev
el
o
f
n
e
g
ativ
e
e
m
o
tio
n
s
.
I
n
a
d
d
itio
n
,
th
e
p
ar
ticip
an
ts
n
o
ted
an
in
cr
ea
s
e
in
m
o
tiv
atio
n
f
o
r
s
elf
-
d
ev
elo
p
m
en
t
an
d
s
elf
-
r
ea
lizatio
n
.
T
h
is
co
n
clu
s
io
n
s
u
g
g
ests
th
e
p
o
s
s
ib
le
u
s
e
o
f
ar
t
th
er
ap
y
in
m
an
y
ar
ea
s
o
f
l
if
e.
Fo
r
ex
am
p
le,
ar
t
tech
n
o
lo
g
y
th
er
ap
y
ca
n
s
er
v
e
as
an
ad
d
itio
n
al
s
tr
ateg
y
to
r
ed
u
ce
a
n
x
iety
,
d
ep
r
ess
iv
e
s
p
ec
tr
u
m
d
is
o
r
d
er
s
,
an
d
em
o
tio
n
al
b
u
r
n
o
u
t.
T
h
e
tech
n
iq
u
e
c
an
in
cr
ea
s
e
s
tr
ess
to
ler
an
ce
b
y
r
eg
u
latin
g
th
e
r
e
lease
o
f
s
tr
es
s
n
eu
r
o
tr
an
s
m
itter
s
.
Ar
t
th
er
ap
y
is
also
a
w
id
ely
u
s
ed
to
o
l
in
th
e
f
ield
o
f
p
alliativ
e
ca
r
e
f
o
r
ter
m
in
ally
ill
p
eo
p
le.
I
n
th
e
co
n
t
ex
t
o
f
th
is
s
tu
d
y
,
th
is
th
er
ap
y
ca
n
b
e
an
ef
f
ec
tiv
e
m
eth
o
d
f
o
r
h
ig
h
s
ch
o
o
l
an
d
u
n
iv
er
s
ity
s
tu
d
e
n
ts
.
T
h
e
m
eth
o
d
o
lo
g
y
is
h
ig
h
ly
v
alu
a
b
le
f
o
r
th
is
in
d
u
s
tr
y
.
B
y
in
cr
ea
s
in
g
m
o
tiv
atio
n
,
ar
t
th
e
r
ap
y
h
elp
s
p
eo
p
le
n
o
t
o
n
ly
t
o
b
alan
ce
th
eir
e
m
o
tio
n
al
s
tate
b
u
t
also
to
d
ec
id
e
o
n
f
u
r
th
er
d
ev
el
o
p
m
en
t
.
T
h
is
asp
ec
t
is
d
ec
is
iv
e
in
th
e
e
d
u
ca
tio
n
o
f
f
u
tu
r
e
s
p
ec
ialis
ts
in
an
y
f
ield
o
f
ac
tiv
ity
.
I
n
th
e
f
u
tu
r
e
,
th
ese
s
p
ec
ialis
ts
wi
ll m
ak
e
an
in
v
alu
ab
le
co
n
tr
ib
u
tio
n
to
th
e
d
ev
elo
p
m
en
t o
f
s
o
c
iety
.
Ho
wev
er
,
th
er
e
ar
e
v
er
y
f
ew
s
tu
d
ies
with
ac
cu
r
ate
r
esu
lts
in
th
is
ar
ea
.
T
h
er
ef
o
r
e,
th
e
r
e
is
an
u
r
g
en
t
n
ee
d
f
o
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ad
d
itio
n
al
s
tu
d
y
in
t
h
e
ap
p
licatio
n
o
f
a
r
t
tech
n
o
lo
g
ies
in
th
is
d
ir
ec
tio
n
.
I
t
is
n
e
ce
s
s
ar
y
to
co
n
d
u
ct
v
ar
io
u
s
g
r
o
u
p
ex
p
er
im
en
ts
with
s
am
p
les
co
v
er
in
g
o
th
er
t
ar
g
et
ar
ea
s
(
f
o
r
ex
a
m
p
le,
s
tu
d
en
ts
o
f
tech
n
ical,
m
ed
ical,
o
r
h
u
m
a
n
itar
ian
u
n
i
v
er
s
ities
,
as
well
as
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
)
.
H
o
wev
er
,
t
h
ese
p
ar
ticip
an
ts
m
ay
r
eq
u
ir
e
a
d
d
itio
n
al
i
n
d
iv
id
u
al
s
ess
io
n
s
with
an
ar
t
th
er
a
p
y
s
p
ec
ialis
t.
An
o
th
er
task
is
to
d
if
f
er
en
tiate
r
esear
c
h
s
am
p
les
in
to
s
u
b
g
r
o
u
p
s
ac
c
o
r
d
in
g
t
o
th
e
m
ai
n
p
s
y
c
h
o
lo
g
ical
b
lo
ck
s
an
d
p
r
o
b
lem
s
.
An
i
n
d
iv
id
u
alize
d
s
tu
d
y
o
f
a
g
r
o
u
p
with
a
p
r
ed
o
m
in
an
ce
o
f
d
ep
r
ess
iv
e
d
is
o
r
d
e
r
,
an
x
iet
y
,
em
o
tio
n
al
b
u
r
n
o
u
t,
an
d
in
cr
ea
s
ed
p
er
ce
p
tio
n
o
f
s
tr
ess
wo
u
ld
p
r
esen
t
m
o
r
e
ac
cu
r
ate
r
esu
lts
.
Acc
o
r
d
in
g
ly
,
s
u
ch
s
tu
d
ies
m
u
s
t
u
s
e
a
tailo
r
ed
th
er
ap
y
p
r
o
g
r
am
an
d
c
o
n
s
id
er
v
ar
io
u
s
n
u
a
n
ce
s
.
An
a
n
aly
s
is
o
f
th
e
d
ata
o
n
p
eo
p
le
with
lo
w
s
elf
-
esteem
wo
u
ld
also
p
r
esen
t
v
alu
ab
le
c
o
n
clu
s
io
n
s
.
Fu
r
th
er
r
esear
ch
ca
n
p
r
o
v
id
e
m
o
r
e
r
es
o
u
r
ce
s
f
o
r
im
p
r
o
v
in
g
a
n
d
cr
ea
tin
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n
ew
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eth
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d
s
o
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ar
t
th
er
ap
y
.
T
h
e
cu
r
r
e
n
t
s
tu
d
y
d
id
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o
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co
llect
d
ata
o
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th
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p
s
y
ch
o
lo
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ical
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tate
o
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esp
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d
en
ts
af
ter
th
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ex
p
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im
en
t.
T
h
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e
is
a
n
ee
d
f
o
r
ad
d
itio
n
al
s
tu
d
ies to
clar
i
f
y
t
h
ese
f
in
d
in
g
s
.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
is
r
esear
ch
h
as
b
ee
n
s
u
p
p
o
r
ted
b
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th
e
E
u
r
asian
Natio
n
al
Un
iv
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s
ity
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am
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af
ter
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Gu
m
ilev
a
Stra
teg
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Aca
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p
Pro
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r
am
.
F
UNDING
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NF
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M
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h
is
r
esear
ch
h
as
b
ee
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f
u
n
d
e
d
b
y
th
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Scien
ce
C
o
m
m
ittee
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f
th
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Min
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Scien
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d
Hig
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ca
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(
Gr
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AP1
9
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7
6
8
9
3
“
E
d
u
ca
tio
n
al
a
n
d
m
eth
o
d
o
lo
g
ical
p
r
o
v
is
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n
o
f
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ad
itio
n
al
Kaz
a
k
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ar
t
an
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m
o
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t
s
tu
d
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s
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ac
co
r
d
in
g
to
a
g
r
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m
en
t
N
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.
2
6
9
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3
-
2
5
d
ate
d
Au
g
u
s
t
3
th
,
2
0
2
3
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.
Evaluation Warning : The document was created with Spire.PDF for Python.
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4137
AUTHO
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CAL AP
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th
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s
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at
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k
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with
d
u
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s
tan
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s
.
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in
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t
h
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C
o
m
m
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o
f
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k
h
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et
Utem
is
o
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W
est Ka
za
k
h
s
tan
U
n
iv
er
s
ity
(
Pro
to
c
o
l N
o
3
5
6
9
o
f
Ma
y
1
3
,
2
0
2
4
)
.
DATA AV
AI
L
AB
I
L
I
T
Y
T
h
e
au
th
o
r
s
co
n
f
ir
m
th
at
th
e
d
ata
s
u
p
p
o
r
tin
g
th
e
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
ar
e
av
ailab
le
with
in
th
e
ar
ticle
[
an
d
/o
r
its
s
u
p
p
lem
en
tar
y
m
ater
ials
]
.
RE
F
E
R
E
NC
E
S
[
1
]
G
.
K
h
a
z
h
g
a
l
i
y
e
v
a
,
A
.
G
u
r
a
,
O
.
Er
e
m
e
e
v
a
,
a
n
d
E.
B
e
l
y
a
e
v
a
,
“
S
o
c
i
a
l
a
d
j
u
st
men
t
o
f
o
n
l
i
n
e
l
e
a
r
n
e
r
s
i
n
a
m
u
l
t
i
c
u
l
t
u
r
a
l
e
n
v
i
r
o
n
me
n
t
(
A
j
u
st
e
so
c
i
a
l
d
e
l
o
s
e
s
t
u
d
i
a
n
t
e
s
d
e
u
n
p
r
o
g
r
a
ma
e
n
l
í
n
e
a
e
n
u
n
e
n
t
o
r
n
o
mu
l
t
i
c
u
l
t
u
r
a
l
)
,
”
C
u
l
t
u
re
a
n
d
Ed
u
c
a
t
i
o
n
,
v
o
l
.
3
5
,
n
o
.
2
,
p
p
.
3
0
9
–
3
4
1
,
A
p
r
.
2
0
2
3
,
d
o
i
:
1
0
.
1
0
8
0
/
1
1
3
5
6
4
0
5
.
2
0
2
3
.
2
1
7
7
0
0
7
.
[
2
]
A
.
P
r
i
n
z
,
H
.
Ze
e
b
,
A
.
E.
F
l
a
n
i
g
a
n
,
A
.
R
e
n
k
l
,
a
n
d
K
.
A
.
K
i
e
w
r
a
,
“
C
o
n
v
e
r
sa
t
i
o
n
s
w
i
t
h
F
i
v
e
H
i
g
h
l
y
S
u
c
c
e
ssf
u
l
F
e
mal
e
Ed
u
c
a
t
i
o
n
a
l
P
sy
c
h
o
l
o
g
i
st
s
:
P
a
t
r
i
c
i
a
A
l
e
x
a
n
d
e
r
,
C
a
r
o
l
D
w
e
c
k
,
Ja
c
q
u
e
l
y
n
n
e
E
c
c
l
e
s,
M
a
r
e
i
k
e
K
u
n
t
e
r
,
a
n
d
Ta
mara
v
a
n
G
o
g
,
”
E
d
u
c
a
t
i
o
n
a
l
Psy
c
h
o
l
o
g
y
R
e
v
i
e
w
,
v
o
l
.
3
3
,
n
o
.
2
,
p
p
.
7
6
3
–
7
9
5
,
Ju
n
.
2
0
2
1
,
d
o
i
:
1
0
.
1
0
0
7
/
s
1
0
6
4
8
-
0
2
0
-
0
9
5
5
2
-
y.
[
3
]
A
.
E.
F
l
a
n
i
g
a
n
,
K
.
A
.
K
i
e
w
r
a
,
a
n
d
L.
Lu
o
,
“
C
o
n
v
e
r
s
a
t
i
o
n
s wi
t
h
F
o
u
r
H
i
g
h
l
y
P
r
o
d
u
c
t
i
v
e
G
e
r
ma
n
E
d
u
c
a
t
i
o
n
a
l
P
sy
c
h
o
l
o
g
i
s
t
s:
F
r
a
n
k
F
i
sc
h
e
r
,
H
a
n
s
G
r
u
b
e
r
,
H
e
i
n
z
M
a
n
d
l
,
a
n
d
A
l
e
x
a
n
d
e
r
R
e
n
k
l
,
”
Ed
u
c
a
t
i
o
n
a
l
Psy
c
h
o
l
o
g
y
Re
v
i
e
w
,
v
o
l
.
3
0
,
n
o
.
1
,
p
p
.
3
0
3
–
3
3
0
,
M
a
r
.
2
0
1
8
,
d
o
i
:
1
0
.
1
0
0
7
/
s
1
0
6
4
8
-
0
1
6
-
9
3
9
2
-
0.
[
4
]
R
.
B
o
k
o
c
h
a
n
d
N
.
H
a
ss
-
C
o
h
e
n
,
“
Ef
f
e
c
t
i
v
e
n
e
ss
o
f
a
S
c
h
o
o
l
-
B
a
se
d
M
i
n
d
f
u
l
n
e
ss
a
n
d
A
r
t
Th
e
r
a
p
y
G
r
o
u
p
P
r
o
g
r
a
m,”
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19
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[
22
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[
23
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[
24
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[
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[
27
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[
28
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[
29
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[
30
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[
31
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