Empathy at school project: Effects of didactics of emotions® on emotional competence, cortisol secretion and inflammatory profile in primary school children. A controlled longitudinal psychobiological study

Abstract

Background: There is mounting evidence of the presence of chronic stress among children during primary school: girls and boys under the age of 15 years often experience anxiety, irritability and sleeping problems with negative consequences on scholastic climate and the spread of bullying and dropping out of school. The promotion of emotion regulation within school environment through innovative didactic methodologies represents a valuable tool for teachers and parents to reduce emotional distress and associated risk behaviours and to promote wellbeing.

Aim: Our research aims to explore the psychological and biological consequences of teaching emotional training in an experimental group of Italian Primary School children.

Methods: A sample of pupils (81 children aged between 6 and 8) was divided into an experimental group (33 subjects) and a control group (30 subjects). A further advanced group of 18 subjects, who have experienced the method in the previous school year, was also included. The experimental study lasted one school year (from October 2021 to May 2022). The following psychological tests were administered to all groups: TEC (Test of Emotion Comprehension) to measure the children's different emotional abilities and the Projective test (PT) 'A person in the rain', to identify the coping skills of children in a stressful condition. Morning salivary cortisol, IL-6 and TNF-alpha assays were conducted in all three groups. Psychological and biological tests were administered at the beginning of the study and at the end of the study.

Results: The MR-Anova model for TEC score showed that there was not a significant group effect [Fgroup = 2.24, p = 0.114]. Pairwise comparisons showed that mean score significantly increased only in the Experimental group (pB < 0.001) and at the end of the project there was a significant difference between Experimental group and Control group (pB = 0.012). The mean score of PT test increased significantly from baseline to the end of the project for the Experimental group (pB < 0.001) and for the Advanced group (pB = 0.004). At the end of the project, there were significant differences between the Experimental group and the Control group (pB = 0.004) and between the Advanced group and the Control group (pB < 0.001). Salivary cortisol analysis revealed a significant effect between subjects [Fgroup = 9.66; p < 0.001] and significant effects within subjects with the main effect of the time [Ftime = 35.41; p < 0.001] and the significant interaction "time x group" [Ftimexgroup = 3.38; p = 0.040]. Pairwise comparisons showed that cortisol levels decreased significantly over time only in the Experimental group (pB < 0.001). Regarding to IL-6 levels, there was not a significant effect between subjects [Fgroups = 0.0481; p = 0.953]. The mean level decreased significantly for each group from baseline to post project (pB < 0.001). With respect to TNF-alpha levels, the mean levels decreased over time for all groups (pB = 0.006 for Experimental group; pB < 0.001 either for the Advanced or Control group).

Conclusion: the results documented in the experimental groups who experienced didactics of emotion for at least one school year show a significant increase in children's ability to cope with reality, stress and anxiety, and an improvement of their emotional competence. Meanwhile, a significant reduction in the amount of salivary cortisol was observed in the experimental group at the end of the scholastic year; meantime a stable reduced amount of salivary cortisol in advanced group throughout the project was also observed. These findings show that an intervention through an emotional education program is able to regulate interpersonal skills and the stress axis response.

Keywords: Coping; Cortisol; Didactics of emotion; PNEI; Stress.

Fig. 1

TEC score by group and time. Data (log data) represented as estimated marginal means. Bars are confidential intervals (95%CI). nE = 29; nA = 18; nC = 26. The analysis denotes a significant increase from baseline to the end of the project in the Experimental group; at post-project, a significant difference between Experimental and Control group (pB < 0.05).

Fig. 2

Projective Test score by group and time. Data (log data) represented as estimated marginal means. Bars are confidential intervals (95%CI). nE = 29; nA = 18; nC = 26. Analysis denotes: i) a significant increase from baseline to the end of the project for Experimental group (pB < 0.001) and for the Advanced group (pB = 0.004); ii) at post-project time, a significant difference between Experimental and Control group (pB = 0.004) and between Advanced and Control group (pB=<0.001).

Fig. 3

Cortisol levels by group and time. Data (log data) represented as estimated marginal means. Bars are confidential intervals (95%CI). nE = 29; nA = 17; nC = 21. Analysis denotes: i) a significant difference between pre and post project for the Experimental group (pB < 0.05); ii) a significant difference at the post-project between Experimental and Control group and Advanced and Control group (pB < 0.05).

Fig. 4

IL-6 levels by group and time. Data (log data) represented as estimated marginal means. Bars are confidential intervals (95%CI). nE = 12; nA = 9; nC = 12. Analysis denotes significant difference between pre and post project for both the Experimental group (pB < 0.001) and the Control group group (pB < 0.001) and the Advanced group (pB < 0.001).

Fig. 5

TNF-alpha levels by group and time. Data (log data) represented as estimated marginal means. Bars are confidential intervals (95%CI). nE = 12; nA = 9; nC = 12. Analysis denotes significant difference between pre and post project for all three groups: Experimental group (pB = 0.006); Control group group (pB < 0.001); Advanced group (pB < 0.001).

Fig. 6

The paraventricular hypothalamic nucleus is the cerebral structure that activates the stress response. It is divided into three sectors: magnocellular, which releases oxytocin and arginine vasopressin; parvocellular, which releases CRH; the neurons projecting towards the brain stem, where the neurovegetative nuclei are located, in particular in the locus coeruleus and in the rostral ventromedial medulla, where the control nuclei of the sympathetic nervous system are located. Activation of neural pathways afferent to CRH neurons in the PVN causes a rapid calcium influx that stimulates the fusion of CRH-containing vesicles to the cell membrane and subsequent release CRH. Depending on the type of stressor, individual or even all areas of the paraventricular nucleus (PVN) are activated. For example, a life-threatening stress event, like hemorrhage, activates all PVN neurons. The magnocellular sector receives inputs related to volume, blood tonicity and fluid state. In the parvocellular sector, on the other hand, physiological and systemic inputs arrive at the parvocellular sector through the solitary nucleus and some circumventricular organs, but also emotional ones, which come from the cortical, limbic or sensory and nociceptive areas. The subcortical areas, which are emotionally activated, send projections to the bed nucleus of the stria terminalis (BNST), which then acts as a centre for the projection of emotional signals from the limbic to the PVN. The other fundamental route that brings emotional stress to the paraventricular nucleus is the one coming from the amygdala. The end result of the stress response is the release of cortisol and catecholamines; cortisol, through negative feedback on the pituitary and hypothalamus, regulates the activity of the axis. Reprinted with permission from Ref. Bottaccioli & Bottaccioli 2020, p. 136, Copyright 2020, Edra