Randomized trial estimating effects of hypnosis versus progressive muscle relaxation on medical students' test anxiety and attentional bias

Yang Zhang; Xin-Xin Yang; Jing-Yi Luo; Meng Liang; Ni Li; Qian Tao; Li-Jun Ma; Xiao-Ming Li

doi:10.5498/wjp.v12.i6.801

Randomized trial estimating effects of hypnosis versus progressive muscle relaxation on medical students' test anxiety and attentional bias

World J Psychiatry. 2022 Jun 19;12(6):801-813. doi: 10.5498/wjp.v12.i6.801.

Authors

Yang Zhang¹, Xin-Xin Yang², Jing-Yi Luo², Meng Liang², Ni Li², Qian Tao³, Li-Jun Ma², Xiao-Ming Li⁴

Affiliations

¹ Affiliated Psychological Hospital, Anhui Medical University, Hefei 230032, Anhui Province, China.
² Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China.
³ Department of Psychology, School of Basic Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China.
⁴ Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China. psyxiaoming@126.com.

Abstract

Background: Test anxiety is prevalent among medical students and leads to impaired academic performance. Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.

Aim: To evaluate whether hypnosis and progressive muscle relaxation (PMR) could modify medical college students' test anxiety and attentional bias.

Methods: A total of 598 medical students were screened. The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale (TAS). Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group. Another 45 students with low TAS score were included, forming a baseline control group. The intervention was conducted weekly for 6 wk, and each session lasted approximately 30 min. The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal. Data were collected at the pretest, posttest, and 2-mo follow-up.

Results: Hypnosis group participants had a significantly lower TAS score at posttest (t = -21.827, P < 0.001) and at follow-up (t = -14.824, P < 0.001), compared to that at pretest. PMR group participants also had a significantly lower TAS score at posttest (t = -10.777, P < 0.001) and at follow-up (t = -7.444, P < 0.001), compared to that at pretest. At the posttest level, the hypnosis group had a significantly lower TAS score than the PMR group (t = -3.664, P < 0.001). At the follow-up level, the hypnosis group also had a significantly lower TAS score than the PMR group (t = -2.943, P = 0.004). Clinically significant improvement was found in both the hypnosis and PMR groups (hypnosis = 64.0%; PMR = 62.22%). Hypnosis was more effective than PMR in reducing test anxiety among medical college students. Hypnosis could modify attentional bias toward threatening stimuli, but PMR could not.

Conclusion: These results suggest that attentional bias plays an important role in test anxiety treatment.

Keywords: Attentional bias; Hypnosis; Progressive muscle relaxation; Randomized controlled trial; Test anxiety.

Publication types

Clinical Trial