Effect of Hypnosis on Anxiety: Results from a Randomized Controlled Trial with Women in Postmenopause

Abstract

Anxiety is common, yet often under-treated, among women in postmenopause. This study examined the effect of a hypnotic intervention designed to reduce hot flashes, on anxiety levels of postmenopausal women. Anxiety was assessed using the State-Trait Anxiety Inventory, the Hospital Anxiety and Depression Scale-Anxiety subscale, and a visual analog scale. Additionally, hypnotizability was tested as a moderator of anxiety reductions. Significant reductions in anxiety were found from baseline to endpoint and follow-up and hypnosis was superior to the control condition. Additionally, ratings of Current Anxiety decreased from pre-session to post-session at each weekly visit and the pre-session scores reduced continuously. Hypnotizability was found to moderate anxiety reductions, but regardless of hypnotizability level participants, on average, experienced significant symptom improvement from baseline scores. These data provide initial support for the use of hypnosis to reduce symptoms of anxiety among postmenopausal women.
Trial registration: This study was registered at ClinicalTrials.gov on February 11, 2011 under Identifier number NCT01293695 (https://clinicaltrials.gov/ct2/show/NCT01293695?term=Elkins&cond=hot+flashes&draw=2&rank=2).

Full text

Vol:.(1234567890)
Journal of Clinical Psychology in Medical Settings (2021) 28:868–881
https://doi.org/10.1007/s10880-021-09810-3
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Effect ofHypnosis onAnxiety: Results fromaRandomized Controlled
Trial withWomen inPostmenopause
R.LynaeRoberts1 · JoshuaR.Rhodes1· GaryR.Elkins1
Accepted: 27 July 2021 / Published online: 17 August 2021
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021
Abstract
Anxiety is common, yet often under-treated, among women in postmenopause. This study examined the effect of a hypnotic
intervention designed to reduce hot flashes, on anxiety levels of postmenopausal women. Anxiety was assessed using the
State-Trait Anxiety Inventory, the Hospital Anxiety and Depression Scale-Anxiety subscale, and a visual analog scale.
Additionally, hypnotizability was tested as a moderator of anxiety reductions. Significant reductions in anxiety were found
from baseline to endpoint and follow-up and hypnosis was superior to the control condition. Additionally, ratings of Current
Anxiety decreased from pre-session to post-session at each weekly visit and the pre-session scores reduced continuously.
Hypnotizability was found to moderate anxiety reductions, but regardless of hypnotizability level participants, on average,
experienced significant symptom improvement from baseline scores. These data provide initial support for the use of hypnosis
to reduce symptoms of anxiety among postmenopausal women.
Trial registration: This study was registered at ClinicalTrials.gov on February 11, 2011 under Identifier number
NCT01293695 (https:// clini caltr ials. gov/ ct2/ show/ NCT01 293695? term= Elkin s& cond= hot+ flash es& draw= 2& rank=2).
Keywords Hypnosis· Anxiety· Menopause· Postmenopause· Structured attention
Abbreviations
HRT Hormone replacement therapy
CBT Cognitive behavioral therapy
HADS-A Hospital Anxiety and Depression Scale, Anxi-
ety Subscale
STAI-S State-Trait Anxiety Inventory, State Subscale
STAI-T State-Trait Anxiety Inventory, Trait Subscale
VAS Visual Analog Scale
EHS Elkins Hypnotizability Scale
Anxiety can manifest as disorders or specific phobias, but
the term anxiety can also refer to general feelings of worry,
restlessness, dread and physical symptoms like increased
heart rate or rapid breathing, which may or may not reach
criteria to be categorized as an anxiety disorder. Diagnostic
criteria for anxiety disorders in the Diagnostic and Statistical
Manual of Mental Disorders, 5th Edition (DSM-5) contain
specifications that symptoms last for a certain number of
months, are not attributable to comorbid medical condi-
tions, comprise a minimum number of components, and
severely impact functioning (American Psychiatric Asso-
ciation, 2013). However, troublesome symptoms often do
not fit all criteria and are therefore not classified as clinically
significant.
Data from studies of the epidemiological, neurological,
and psychological effects of anxiety suggest that even when
symptoms are not clinically diagnosed, there may be harmful
effects. The presence of anxiety increases risks for comor-
bidities, may worsen the outcomes of existing conditions
(Haller etal., 2014; Okasha, 2009), and is a risk factor for
development of more severe anxiety, highlighting the need
for early interventions (Kertz & Woodruff-Borden, 2011;
Rucci etal., 2003). Subclinical anxiety is also associated
with structural and functional neurological changes that are
similar to alterations seen in clinically diagnosed anxiety
disorders (Besteher etal., 2017; Ng etal., 2012). Subthresh-
old or subclinical general anxiety has a lifetime prevalence
of approximately 20% (Haller etal., 2014).
* R. Lynae Roberts
Lynae_Roberts@baylor.edu
1 Department ofPsychology & Neuroscience, Baylor
University, 801 Washington Avenue, Suite 260, Waco,
TX76701, USA
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