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Stress management training and relaxation imagery in the treatment of essential hypertension

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Abstract

The present study compared the effectiveness of three procedures in the treatment of 34 individuals with essential hypertension: (1) stress management training plus relaxation imagery, which consisted of an adaptation of existing stress management techniques in conjunction with extensive relaxation training using relaxation imagery; (2) relaxation imagery alone; and (3) weekly blood pressure checks. The relaxation imagery technique involved visualization of a relaxing image along with concentration on suggestions of relaxation, heaviness, and warmth. Treatment was individualized and lasted 8 weeks. Results indicated stress management plus relaxation imagery and relaxation imagery alone were significantly more effective than blood pressure checks in reducing systolic and diastolic blood pressures during treatment and in maintaining diastolic blood pressure reductions during follow-up. However, no significant differences were found between the two treatment procedures. Clinical implications of these findings are discussed.

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References

  • Benson, H., Shapiro, D., Tursky, B., and Schwartz, G. E. (1971). Decreased systolic blood pressure through operant conditioning techniques in patients with essential hypertension.Science 173: 740–742.

    PubMed  Google Scholar 

  • Benson, H., Beary, J. F., and Carol, M. P. (1974a). The relaxation response.Psychiatry 37: 37–46.

    PubMed  Google Scholar 

  • Benson, H., Rosner, B. A., Marzetta, B. R., and Klemchuk, H. M. (1974b). Decreased blood pressure in borderline hypertensive subjects who practice meditation.J. Chron. Dis. 27: 163–169.

    PubMed  Google Scholar 

  • Benson, H., Rosner, B. A., Marzetta, B. R., and Klemchuk, H. M. (1974c). Decreased blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response.Lancet 1: 289–291.

    PubMed  Google Scholar 

  • Blackwell, B., Hanenson, I., Bloomfield, S., Magenheim, H., Gartside, P., Nidich, S., Robinson, A., and Zigler, R. (1976). Transcendental meditation in hypertension: Individual response patterns.Lancet 1: 223–226.

    PubMed  Google Scholar 

  • Brauer, A. P., Horlick, L., Nelson, E., Farquhar, J. W., and Agras, W. S. (1979). Relaxation therapy for essential hypertension: A Veterans Administration outpatient study.J. Behav. Med. 2: 21–29.

    PubMed  Google Scholar 

  • Byassee, J. E. (1977). Essential hypertension. In Williams, R. B., and Gentry, W. D. (eds.),Behavioral Approaches to Medical Treatment, Ballinger, Cambridge, Mass.

    Google Scholar 

  • Byassee, J. E. Farr, S. P., and Meyer, R. G. (1976). Progressive relaxation and autogenic training in the treatment of essential hypertension, Unpublished manuscript.

  • Crowther, J. H. (1980). Protocols for relaxation imagery technique and stress management training, Unpublished manuscript, University of Vermont, Burlington.

    Google Scholar 

  • Deabler, H. L., Fidel, E., Dillenkoffer, R. L., and Elder, S. T. (1973). The use of relaxation and hypnosis in lowering high blood pressure.Am. J. Clin. Hypnosis 16: 75–83.

    Google Scholar 

  • Elder, S. T., and Eustis, N. K. (1975). Instrumental blood pressure conditioning in outpatient hypertensives.Behav. Res. Ther. 13: 185–188.

    PubMed  Google Scholar 

  • Elder, S. T., Ruiz, Z. R., Deabler, H. L., and Dillenkoffer, R. L. (1973). Instrumental conditioning of diastolic blood pressure in essential hypertensive patients.J. Appl. Behav. Anal. 6: 377–382.

    Google Scholar 

  • Frankel, B. L., Patel, D. J., Horwitz, D., Friedewald, W. T., and Gaardner, K. R. (1978). Treatment of hypertension with biofeedback and relaxation techniques.Psychosom. Med. 40: 276–293.

    PubMed  Google Scholar 

  • Goldfried, M. (1971). Systematic desensitization as training in self-control.J. Consult. Clin. Psychol. 37: 228–234.

    PubMed  Google Scholar 

  • Goldfried, M. R., and Trier, C. S. (1974). Effectiveness of relaxation as an active coping skill.J. Abnorm. Psychol. 83: 348–355.

    PubMed  Google Scholar 

  • Goldman, H., Kleinman, K., Snow, M., Bidus, D., and Korol, B. (1975). Relationship between essential hypertension and cognitive functioning: Effects of biofeedback.Psychophysiology 12: 569–573.

    PubMed  Google Scholar 

  • Jacobsen, E. (1938).Progressive Relaxation, University of Chicago Press, Chicago.

    Google Scholar 

  • Klumbies, G., and Eberhardt, G. (1966). Results of autogenic training in the treatment of hypertension. In Lopez Ibor, J. J. (ed.),IV World Congress of Psychiatry, Madrid, 5.-11. ix. 1966, Excerpta Medica, Amsterdam.

    Google Scholar 

  • Kristt, D. A., and Engel, B. T. (1975). Learned control of blood pressure in patients with high blood pressure.Circulation 51: 370–378.

    PubMed  Google Scholar 

  • Kroger, W. S. (1977).Clinical and Experimental Hypnosis, J. B. Lippincott, Philadelphia.

    Google Scholar 

  • Love, W. A., Montgomery, D. D., and Moeller, T. A. (1973). Working paper number one, Unpublished manuscript, Nova University.

  • Meichenbaum, D. H. (1977).Cognitive-Behavior Modification, Plenum Press, New York.

    Google Scholar 

  • Montgomery, D. D., Love, W. A., and Moeller, T. A., (1974). Working paper number two, Unpublished manuscript, Nova University.

  • Patel, C. H. (1973). Yoga and biofeedback in the management of hypertension.Lancet 2: 1053–1055.

    PubMed  Google Scholar 

  • Patel, C. H. (1975). 12-Month follow-up of yoga and biofeedback in the management of hypertension.Lancet 1: 62–65.

    PubMed  Google Scholar 

  • Patel, C. H., and North, W. R. S. (1975). Randomized controlled trial of yoga, and biofeedback in management of hypertension.Lancet 2: 93–95.

    PubMed  Google Scholar 

  • Patel, C., Marmot, M. G., and Terry, D. J. (1981). Controlled trial of biofeedback-aided behavioral methods in reducing mild hypertension.Br. Med. J. 282: 2005–2008.

    Google Scholar 

  • Pollack, A. D., Weber, M. A., Case, D. B., and Laragh, J. H. (1977). Limitations of transcendental meditation in the treatment of essential hypertension.Lancet 1: 71–73.

    PubMed  Google Scholar 

  • Schultz, J. H., and Luthe, W. (1959).Autogenic Training: A Psychophysiological Approach in Psychotherapy, Grune & Stratton, New York.

    Google Scholar 

  • Schwartz, G. E., and Shapiro, D. (1973). Biofeedback and essential hypertension. Current findings and theoretical concerns.Semin. Psychiat. 5: 493–503.

    Google Scholar 

  • Seer, P. (1979). Psychological control of essential hypertension: Review of the literature and methodological critique.Psychol. Bull. 86: 1015–1043.

    PubMed  Google Scholar 

  • Shoemaker, J. E., and Tasto, D. L. (1975). The effects of muscle relaxation on blood pressure of essential hypertensives.Behav. Res. Ther. 13: 29–43.

    PubMed  Google Scholar 

  • Stone, R. A., and DeLeo, J. (1976). Psychotherapeutic control of hypertension.N. Engl. J. Med. 294: 80–84.

    PubMed  Google Scholar 

  • Stoyva, J., and Budzynski, T. (1974). Cultivated low arousal—An antistress response? In DiCara, L. V. (ed.),Limbic and Autonomic Nervous System Research, Plenum, New York.

    Google Scholar 

  • Suinn, R. M. (1974). Behavior therapy for cardiac patients.Behav. Ther. 5: 569–571.

    Google Scholar 

  • Suinn, R. (1975). The cardiac stress management program.Card. Rehab. 5: 38–43.

    Google Scholar 

  • Suinn, R. M. (1977). Type A behavior pattern. In Williams, R. B., and Gentry, W. D. (eds.),Behavioral Approaches to Medical Treatment, Ballinger, Cambridge, Mass.

    Google Scholar 

  • Suinn, R. M., and Bloom, L. J. (1978). Anxiety management training for Pattern A behavior.J. Behav. Med. 1: 25–35.

    PubMed  Google Scholar 

  • Suinn, R. M., Brock, L., and Edie, C. A. (1975). Behavior therapy for Type A patients.Am. J. Cardiol. 36: 269.

    PubMed  Google Scholar 

  • Surwit, R. S., Shapiro, D., and Good, M. I. (1978). Comparison of cardiovascular biofeedback, neuromuscular feedback, and meditation in the treatment of borderline hypertension.J. Consult. Clin. Psychol. 46: 252–263.

    Article  PubMed  Google Scholar 

  • Taylor, C. B., Farquhar, J. W., Nelson, E., and Agras, S. (1977). Relaxation therapy and high blood pressure.Arch. Gen. Psychiat. 34: 339–342.

    PubMed  Google Scholar 

  • Yates, F. (1933). The analysis of replicated experiments when field results are incomplete.Empire J. Exp. Agr. 1: 129–142.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, Kent State University, 44242, Kent, Ohio

    Janis H. Crowther

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  1. Janis H. Crowther
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This study is based on a doctoral dissertation completed in partial fulfillment of the requirements for a Ph.D. degree from the University of Vermont. The author wishes to thank Harold Leitenberg, Ph.D., for his supervision of this research.

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Crowther, J.H. Stress management training and relaxation imagery in the treatment of essential hypertension. J Behav Med 6, 169–187 (1983). https://doi.org/10.1007/BF00845379

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