Phase II randomized controlled trial of hypnosis versus progressive muscle relaxation for body image after breast or gynecologic cancer
Abstract
Background Sexual dysfunction, fueled by body image stress, is prevalent in women with a history of breast or gynecologic cancer. Preliminary data support that mind-body connections may improve sexual health outcomes through improving body image.Objective This randomized controlled trial compared hypnosis to progressive muscle relaxation (PMR). The primary outcome was body image at week 6 as measured by the Impact of Treatment Scale for women who have or have had breast or gynecologic cancer.Interventions/methods Consented participants were randomized 2:1 to hypnosis or PMR. Both arms consisted of three face-to-face sessions delivered by a trained therapist. Sessions were every 2 weeks for 6 weeks; participants practiced at home between sessions using an audio recording.Results Eighty-seven women were randomized, 59 to hypnosis and 28 to PMR. Both groups reported significant improvements on body image over time (within group effect size Cohen's d = 0.49-0.75) with no significant difference between groups (p = 0.15). Secondary outcomes were not significantly different between groups. The hypnosis group improved more in sexual satisfaction and sexual interest while the PMR group improved more in positive affect.Conclusions Interventions facilitating mind-body connections such as hypnosis and PMR may help to improve body image. This study suggests that stress relieving strategies of hypnosis and PMR may contribute to providing a re-connection to one's body, improved positive affect, and overall better sexual health.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Limited controlled evidence from oncology populations suggests improvements in sexual interest as secondary outcomes, but generalizability remains uncertain.
“Limited controlled evidence from oncology populations suggests improvements in sexual interest as secondary outcomes (31), but generalizability remains uncertain.”
From Mindfulness and clinical hypnotherapy in sexual desire disorders: mechanisms, psychophysiological pathways, and integrative therapeutic sequencing (2026) · cites this paper as [31]
Cites
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433 · see citing works
Bluethmann, S. M., Mariotto, A. B., & Rowland, J. H. (2016) · Cancer Epidemiology, Biomarkers & Prevention · doi:10.1158/1055-9965.epi-16-0133 · Cited by 1,146 · see citing works
Body Image and Female Sexual Functioning and Behavior: A Review
Woertman, L., & van den Brink, F. (2012) · The Journal of Sex Research · doi:10.1080/00224499.2012.658586 · Cited by 423 · see citing works
Sexuality after breast cancer: A review
Gilbert, E., Ussher, J. M., & Perz, J. (2010) · Maturitas · doi:10.1016/j.maturitas.2010.03.027 · Cited by 418 · see citing works
Carter, J., Lacchetti, C., Andersen, B. L., Barton, D. L., Bolte, S., Damast, S., Diefenbach, M. A., DuHamel, K. N., Florendo, J., Ganz, P. A., et al. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2017.75.8995 · Cited by 369 · see citing works
Self-citationAndersen, B. L., Cyranowski, J. M., & Espindle, D. M. (1999) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.76.4.645 · Cited by 353 · see citing works
Predictors of Sexual Health in Women After a Breast Cancer Diagnosis
Ganz, P. A., Desmond, K. A., Belin, T. R., Meyerowitz, B. E., & Rowland, J. H. (1999) · Journal of Clinical Oncology · doi:10.1200/jco.1999.17.8.2371 · Cited by 351 · see citing works
Handbook of hypnotic suggestions and metaphors
Hammond, D. C. (1990) · Norton eBooks · Cited by 349 · see citing works
A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer.
Brotto, L. A., Heiman, J. R., Goff, B., Greer, B., Lentz, G. M., Swisher, E., Tamimi, H., & Van Blaricom, A. (2008) · Archives of Sexual Behavior · doi:10.1007/s10508-007-9196-x · Cited by 278 · see citing works
Andersen, B. L., & Cyranowski, J. M. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.67.6.1079 · Cited by 272 · see citing works
Assessing the Clinical Significance of Single Items Relative to Summated Scores
Sloan, J. A., Aaronson, N. K., Cappelleri, J. C., Fairclough, D. L., & Varricchio, C. G. (2002) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)62218-0 · Cited by 256 · see citing works
Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis
Elkins, G. R., Barabasz, A. F., Council, J. R., & Spiegel, D. (2015) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.2015.1011465 · Cited by 226 · see citing works
Self-citationClinical Hypnosis: Principles and Applications
Crasilneck, H. B., & Hall, J. (1989) · Medical Entomology and Zoology · Cited by 194 · see citing works
Sexual functioning in breast cancer survivors experiencing body image disturbance
Boquiren, V. M., Esplen, M. J., Wong, J., Toner, B., Warner, E., & Malik, N. (2016) · Psycho-Oncology · doi:10.1002/pon.3819 · Cited by 180 · see citing works
Prevalence and correlates of sexual morbidity in long-term breast cancer survivors
Raggio, G. A., Butryn, M. L., Arigo, D., Mikorski, R., & Palmer, S. C. (2014) · Psychology & Health · doi:10.1080/08870446.2013.879136 · Cited by 153 · see citing works
The clinical significance of quality of life assessments in oncology: a summary for clinicians
Sloan, J. A., Frost, M. H., Berzon, R., Dueck, A., Guyatt, G., Moinpour, C., Sprangers, M., Ferrans, C., Cella, D., & Clinical Significance Consensus Meeting Group (2006) · Supportive Care in Cancer · doi:10.1007/s00520-006-0085-y · Cited by 149 · see citing works
Kalaitzi, C., Papadopoulos, V. P., Michas, K., Vlasis, K. G., Skandalakis, P. N., & Filippou, D. K. (2007) · Journal of Surgical Oncology · doi:10.1002/jso.20811 · Cited by 125 · see citing works
A review of research linking body image and sexual well-being
Gillen, M. M., & Markey, C. H. (2018) · Body Image · doi:10.1016/j.bodyim.2018.12.004 · Cited by 111 · see citing works
Perz, J., Ussher, J. M., & Gilbert, E. (2013) · BMC Cancer · doi:10.1186/1471-2407-13-270 · Cited by 92 · see citing works
Body change stress for women with breast cancer: The breast-impact of treatment scale
Frierson, G. M., Thiel, D. L., & Andersen, B. L. (2006) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm3201_9 · Cited by 70 · see citing works
Lewis‐Smith, H., Diedrichs, P. C., Rumsey, N., & Harcourt, D. M. (2018) · Psycho-Oncology · doi:10.1002/pon.4870 · Cited by 64 · see citing works
A meta-synthesis of women's symptoms experience and breast cancer
Denieffe, S., & Gooney, M. (2010) · European Journal of Cancer Care · doi:10.1111/j.1365-2354.2010.01223.x · Cited by 59 · see citing works
Construct validity of the PROMIS® sexual function and satisfaction measures in patients with cancer
Flynn, K. E., Reeve, B. B., Lin, L., Cyranowski, J. M., Bruner, D. W., & Weinfurt, K. P. (2013) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-11-40 · Cited by 53 · see citing works
Li, S., Li, L., Zheng, H. X., Wang, Y., Zhu, X., Yang, Y., Yang, Y., & He, J. (2018) · Archives of Women s Mental Health · doi:10.1007/s00737-018-0860-z · Cited by 24 · see citing works
Developing a Hypnotic Relaxation Intervention to Improve Body Image: A Feasibility Study
Cieslak, A., Elkins, G. R., Banerjee, T., et al. (2016) · Oncology nursing forum · doi:10.1188/16.onf.e233-e241 · Cited by 8 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Stompe, T., Ritter, N., & Kostenwein, W. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1798650
- Authors
- Barton, D. L., Brooks, T. M., Cieslak, A., Elkins, G. R., Clark, P. M., Baydoun, M., Smith, A. B., & Van Poznak, C. H.
- Affiliations
- University of Michigan (US)
- Baylor University (US)
- University of Calgary (CA)
- Corresponding author
- Barton, Debra L.
- Venue
- Breast Cancer Research and Treatment
- Published
- 2019-08-09
- Volume
- 178
- Issue
- 2
- Pages
- 357-365
- ISSN
- 0167-6806 (ISSN-L)
- 1573-7217
- OpenAlex
- W2967410501
- Cited by
- 18
- References
- 25
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 6 · 2021: 1 · 2020: 1
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Breast Cancer Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Breast Cancer Research Foundation
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- hypnosis, progressive muscle relaxation, body image, breast cancer survivors, gynecologic cancer survivors, sexual dysfunction, sexual satisfaction, sexual interest, positive affect, mind-body interventions, stress reduction
- MeSH terms
- Autogenic Training, Body Image, Breast Neoplasms, Female, Genital Neoplasms, Female, Humans, Hypnosis, Quality of Life, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
