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Can verbal suggestions strengthen the effects of a relaxation intervention?

(2019) PLOS ONE. 14(8).
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Abstract
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.
Keywords
STRESS-MANAGEMENT INTERVENTION, RESPONSES, PLACEBO, REACTIVITY, REDUCTION, PANAS

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MLA
Schakel, Lemmy, et al. “Can Verbal Suggestions Strengthen the Effects of a Relaxation Intervention?” PLOS ONE, vol. 14, no. 8, Public Library Science, 2019.
APA
Schakel, L., Veldhuijzen, D. S., van Middendorp, H., Manai, M., Meeuwis, S. H., Van Dessel, P., & Evers, A. W. M. (2019). Can verbal suggestions strengthen the effects of a relaxation intervention? PLOS ONE, 14(8).
Chicago author-date
Schakel, Lemmy, Dieuwke S. Veldhuijzen, Henriet van Middendorp, Meriem Manai, Stefanie H. Meeuwis, Pieter Van Dessel, and Andrea W. M. Evers. 2019. “Can Verbal Suggestions Strengthen the Effects of a Relaxation Intervention?” PLOS ONE 14 (8).
Chicago author-date (all authors)
Schakel, Lemmy, Dieuwke S. Veldhuijzen, Henriet van Middendorp, Meriem Manai, Stefanie H. Meeuwis, Pieter Van Dessel, and Andrea W. M. Evers. 2019. “Can Verbal Suggestions Strengthen the Effects of a Relaxation Intervention?” PLOS ONE 14 (8).
Vancouver
1.
Schakel L, Veldhuijzen DS, van Middendorp H, Manai M, Meeuwis SH, Van Dessel P, et al. Can verbal suggestions strengthen the effects of a relaxation intervention? PLOS ONE. 2019;14(8).
IEEE
[1]
L. Schakel et al., “Can verbal suggestions strengthen the effects of a relaxation intervention?,” PLOS ONE, vol. 14, no. 8, 2019.
@article{8629700,
  abstract     = {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.},
  articleno    = {e0220112},
  author       = {Schakel, Lemmy and Veldhuijzen, Dieuwke S. and van Middendorp, Henriet and Manai, Meriem and Meeuwis, Stefanie H. and Van Dessel, Pieter and Evers, Andrea W. M.},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keywords     = {STRESS-MANAGEMENT INTERVENTION,RESPONSES,PLACEBO,REACTIVITY,REDUCTION,PANAS},
  language     = {eng},
  number       = {8},
  pages        = {17},
  publisher    = {Public Library Science},
  title        = {Can verbal suggestions strengthen the effects of a relaxation intervention?},
  url          = {http://dx.doi.org/10.1371/journal.pone.0220112},
  volume       = {14},
  year         = {2019},
}

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