Can verbal suggestions strengthen the effects of a relaxation intervention?
Open accessAbstract
Short stress management interventions such as relaxation therapy have demonstrated preliminary effectiveness in reducing stress-related problems. A promising tool to strengthen the effectiveness of relaxation-based interventions is the use of verbal suggestions, as previous research provided evidence that verbal suggestions can induce positive outcome expectancies, facilitate adaptive responses to stress and improve health outcomes. The present experimental proof-of-concept study aimed to investigate the effects of a brief relaxation intervention and specifically the role of verbal suggestions on stress-related outcomes assessed by self-report questionnaires and psychophysiological data. 120 participants (mean age = 22.1 years) were randomized to one of four intervention conditions: a brief relaxation intervention plus verbal suggestions condition, a brief relaxation intervention only condition, a verbal suggestions only condition, and a control condition. Afterwards, participants were subjected to a psychosocial stress challenge to assess reactivity to a stressful event. Immediately after both relaxation interventions (with and without verbal suggestions), lower self-reported state anxiety was found compared to the control condition, but no differences were observed in response to the stressor. The verbal suggestions only condition did not impact state anxiety. No significant effects were found for verbal suggestion interventions on cortisol, alpha amylase, heart rate and skin conductance. This is the first study investigating the role of verbal suggestions in the effectiveness of a brief relaxation intervention. Although this experimental proof-of-concept study provides support for the effectiveness of a brief relaxation intervention in lowering state anxiety directly after the intervention, the effects did not impact the response to a subsequent stressor and we did not observe any evidence for the add-on effectiveness of verbal suggestions. The effectiveness of brief relaxation interventions on stress responses should be investigated further in future research by incorporating interventions that are tailored to the specific stress challenge and various types of verbal suggestions.
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Previous research has found verbal suggestions to not always be beneficial with regards to psychological outcomes, such as relaxation.
“Previous research has found verbal suggestions to not always be beneficial with regards to psychological outcomes, such as relaxation (Schakel et al., 2019).”
From Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations (2024) · cites this paper as Schakel et al., 2019
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Statistical power analyses using G∗Power 3.1: tests for correlation and regression analyses
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009) · Behavior Research Methods · doi:10.3758/brm.41.4.1149 · Cited by 37,615 · see citing works
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
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
Kirschbaum, C., Pirke, K.-M., & Hellhammer, D. H. (2008) · Neuropsychobiology · doi:10.1159/000119004 · Cited by 6,093 · see citing works
(1988) · Cited by 4,111 · see citing works
Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00108-7 · Cited by 3,638 · see citing works
Psychological stress and the human immune system: a meta-analytic study of 30 Years of inquiry
Segerstrom, S. C., & Miller, G. E. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.4.601 · Cited by 3,334 · see citing works
Marteau, T. M., & Bekker, H. (1992) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1992.tb00997.x · Cited by 3,238 · see citing works
Effects of occupational stress management intervention programs: A meta-analysis.
Richardson, K. M., & Rothstein, H. R. (2008) · Journal of Occupational Health Psychology · doi:10.1037/1076-8998.13.1.69 · Cited by 1,374 · see citing works
Biological and psychological markers of stress in humans: Focus on the Trier Social Stress Test
Allen, A. P., Kennedy, P. J., Cryan, J. F., Dinan, T. G., & Clarke, G. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.11.005 · Cited by 734 · see citing works
The Numeric Rating Scale for Clinical Pain Measurement: A Ratio Measure?
Hartrick, C. T., Kovan, J. P., & Shapiro, S. (2003) · Pain Practice · doi:10.1111/j.1530-7085.2003.03034.x · Cited by 677 · see citing works
Implications of placebo and nocebo effects for clinical practice: Expert consensus
Evers, A. W. M., Colloca, L., Blease, C., Annoni, M., Atlas, L. Y., Benedetti, F., Bingel, U., Büchel, C., Carvalho, C., Colagiuri, B., et al. (2018) · Psychotherapy and Psychosomatics · doi:10.1159/000490354 · Cited by 562 · see citing works
Self-citationCreswell, J. D., Pacilio, L. E., Lindsay, E. K., & Brown, K. W. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.02.007 · Cited by 376 · cited 1× · see citing works
“Most relaxation interventions involve multiple sessions, but there is also some initial support for the effectiveness of brief (2 to 3 sessions) interventions [7, 8].”
BackgroundAssessing Subjective Well-Being in the Old-Old
Kercher, K. (1992) · Research on Aging · doi:10.1177/0164027592142001 · Cited by 349 · see citing works
Sharma, M., & Rush, S. E. (2014) · Journal of Evidence-Based Complementary & Alternative Medicine · doi:10.1177/2156587214543143 · Cited by 342 · see citing works
How placebo responses are formed: a learning perspective
Colloca, L., & Miller, F. G. (2011) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2010.0398 · Cited by 323 · see citing works
Gaab, J., Blättler, N., Menzi, T., Pabst, B., Stoyer, S., & Ehlert, U. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00069-0 · Cited by 309 · see citing works
McRae‐Clark, A. L., Saladin, M. E., Brady, K. T., Upadhyaya, H. P., Back, S. E., & Timmerman, M. A. (2006) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.778 · Cited by 217 · see citing works
Role of expectations in health
Colloca, L., & Miller, F. G. (2011) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328343803b · Cited by 161 · see citing works
Are open‐Label Placebos Ethical? Informed Consent and Ethical Equivocations
Blease, C. R., Colloca, L., & Kaptchuk, T. J. (2016) · Bioethics · doi:10.1111/bioe.12245 · Cited by 129 · see citing works
Reactivity and Vulnerability to Stress-Associated Risk for Upper Respiratory Illness
Cohen, S., Hamrick, N., Rodriguez, M. S., Feldman, P. J., Rabin, B. S., & Manuck, S. B. (2002) · Psychosomatic Medicine · doi:10.1097/00006842-200203000-00014 · Cited by 118 · see citing works
Transient responses of inflammatory cytokines in acute stress.
Yamakawa, K., Matsunaga, M., Isowa, T., Kimura, K., Kasugai, K., Yoneda, M., Kaneko, H., & Ohira, H. (2009) · Biological Psychology · doi:10.1016/j.biopsycho.2009.05.001 · Cited by 107 · see citing works
Effect of Relaxation Therapy on Cardiac Events After Myocardial Infarction: A 5-Year Follow-Up Study
van Dixhoorn, J. J., & Duivenvoorden, H. J. (1999) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-199905000-00005 · Cited by 81 · see citing works
Clinical effectiveness of stress-reduction techniques in patients with hypertension
Nagele, E., Jeitler, K., Horvath, K., Semlitsch, T., Posch, N. A. S., Herrmann, K., Grouven, U., Hermanns, T., Hemkens, L. G., & Siebenhofer, A. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000298 · Cited by 52 · see citing works
Placebo and nocebo effects on itch: effects, mechanisms, and predictors
Bartels, D. J. P., van Laarhoven, A. I. M., van de Kerkhof, P. C. M., & Evers, A. W. M. (2015) · European Journal of Pain · doi:10.1002/ejp.750 · Cited by 48 · see citing works
Self-citationChanging psychobiological stress reactions by manipulating cognitive processes
Rohrmann, S., Hennig, J., & Netter, P. (1999) · International Journal of Psychophysiology · doi:10.1016/s0167-8760(99)00036-7 · Cited by 46 · see citing works
Peerdeman, K. J., van Laarhoven, A. I. M., Donders, A. R. T., Hopman, M. T. E., Peters, M. L., & Evers, A. W. M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0139563 · Cited by 31 · see citing works
Self-citationEnhancing Placebo Effects in Somatic Symptoms Through Oxytocin
Skvortsova, A., Veldhuijzen, D. S., van Middendorp, H., den Bergh, O. V., & Evers, A. W. M. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000571 · Cited by 27 · see citing works
Self-citationCruess, D. G., Finitsis, D. J., Smith, A.-L., Goshe, B. M., Burnham, K., Burbridge, C., & O'Leary, K. E. (2015) · International Journal of Stress Management · doi:10.1037/a0039130 · Cited by 21 · see citing works
Manipulation of Physiological and Emotional Responses to Stress in Repressors and Sensitizers
Rohrmann, S., Hennig, J., & Netter, P. (2002) · Psychology and Health · doi:10.1080/08870440290025795 · Cited by 20 · see citing works
The effects of a gamified approach avoidance training and verbal suggestions on food outcomes
Schakel, L., Veldhuijzen, D. S., van Middendorp, H., Dessel, P. V., Houwer, J. D., Rafael Bidarra, E., & Evers, A. W. M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0201309 · Cited by 20 · see citing works
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Research works printed but not linked: 1
- [22]Van der Ploeg H. De zelf-beoordelings vragenlijst (STAI-DY). Tijdschr Psychiatr. 1982; 24: 576– 88.
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Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations
Bos, D. P. A., Keesman, M., Roggeveen, A., Vase, L., Evers, A. W. M., & Peerdeman, K. J. (2024) · Behavior Therapy · doi:10.1016/j.beth.2024.03.004 · Cited by 5 · see citing works
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- Authors
- Schakel, L., Veldhuijzen, D. S., Middendorp, H. V., Manaï, M., Meeuwis, S. H., Dessel, P. V., & Evers, A. W. M.
- Affiliations
- Leiden University (NL)
- Ghent University (BE)
- Corresponding author
- Schakel, Lemmy
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-08-07
- Volume
- 14
- Issue
- 8
- Pages
- e0220112
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6685619
- OpenAlex
- W2964405579
- Cited by
- 5
- References
- 31
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Leiden Repository (Leiden University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Funders
- European Research Council (ERC-2013-CoG-617700_EXPECT HEAL-TH)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (016.Vici.170.152)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- verbal suggestion, relaxation intervention, stress management, state anxiety, cortisol, alpha-amylase, heart rate, skin conductance, stress reactivity
- MeSH terms
- Adolescent, Adult, alpha-Amylases, Anxiety, Female, Galvanic Skin Response, Heart Rate, Humans, Hydrocortisone, Male, Relaxation Therapy, Saliva, Suggestion, Treatment Outcome, Young Adult, Self Report
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