Researchers from Virginia Commonwealth University’s School of Nursing in Richmond, VA, explored the effects of relaxation-guided imagery on stress, anxiety, and corticotropin-releasing hormone (CRH) levels in pregnant African American women beginning their second trimester.

The prospective, longitudinal pilot study of 59 women used a controlled, randomized experimental design with the two groups conducted over 12 weeks. The intervention was a set of three relaxation guided imagery CDs developed and sequenced to influence study outcomes. The control group was usual care patients.

Study measures included the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory, and plasma CRH levels collected at three time points.  In addition, participants completed a daily Numeric Rating Scale of Stress (NRSS) and daily practice logs, which provided information on intervention use in the relaxation guided imagery group.

Results revealed that state anxiety significantly decreased over time in the relaxation guided imagery group, while it increased over time in the usual-care group. Although a significant difference was not found for perceived stress, as measured by the PSS, the relaxation guided imagery group had a greater decrease in weekly Numeric Rating Scale of Stress NRSS scores over time, as compared to the Usual Care controls. The imagery group also had significant decreases in NRSS scores before and after using imagery. There were no significant differences in CRH levels between groups over time.

Findings support the feasibility and effectiveness of an Relaxation-Guided Imagery intervention in reducing anxiety and daily stress levels in pregnant African American women beginning in the second trimester. This pilot study is an important first step in evaluating the effectiveness of Relaxation Guided Imagery as a primary prevention intervention to reduce premature birth.

Citation:  Jallo N, Bourguignon C, Taylor AG, Ruiz J, Goehler L. The biobehavioral effects of relaxation guided imagery on maternal stress. Adv Mind Body Med. 2009 Winter;24(4):12-22.