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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Yang Zhang, Affiliated Psychological Hospital, Anhui Medical University, Hefei 230032, Anhui Province, China
Yang Zhang, The Fourth People’s Hospital, Hefei 230032, Anhui Province, China
Yang Zhang, Anhui Mental Health Center, Hefei 230032, Anhui Province, China
Yang Zhang, Xin-Xin Yang, Jing-Yi Luo, Meng Liang, Ni Li, Li-Jun Ma, Xiao-Ming Li, Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230032, Anhui Province, China
Qian Tao, Department of Psychology, School of Basic Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
Li-Jun Ma, Department of Psychology, Anqing Normal University, Anqing 246011, Anhui Province, China
Author contributions: Zhang Y, Yang XX, and Luo JY collected the data; Liang M, Li N, and Ma LJ undertook the statistical analysis; Tao Q modified the manuscript; Li XM designed the study and wrote the first draft of the manuscript; and all authors contributed to and approved the final manuscript.
Supported by the Anhui Natural Science Foundation, No. 1808085MH291; the Project of human Social Science of Anhui Province, No. SK2016A047; Grants for Scientific Research of BSKY from Anhui Medical University, No. XJ201826.
Institutional review board statement: The study was reviewed and approved by the Human Ethics Committee of the Anhui Medical University (Approval No. 2019H019).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao-Ming Li, PhD, Adjunct Professor, Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, Anhui Province, China. psyxiaoming@126.com
Received: September 24, 2021
Peer-review started: September 24, 2021
First decision: January 12, 2022
Revised: January 26, 2022
Accepted: May 14, 2022
Article in press: May 14, 2022
Published online: June 19, 2022
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.
Core Tip: We wanted to explore whether hypnosis and progressive muscle relaxation (PMR) could modify medical college students’ test anxiety and related attentional bias toward threatening stimuli. We found that hypnosis was more effective than PMR in reducing test anxiety in medical students, and hypnosis could modify attentional bias toward threatening stimuli, but PMR could not. These results suggest that attentional bias plays an important role in the treatment of test anxiety.
