The biobehavioral effects of relaxation guided imagery on maternal stress

Adv Mind Body Med. Winter 2009;24(4):12-22.


Purpose: The purpose of this pilot study was to investigate the effects of relaxation-guided imagery (R-GI) on perceived stress, anxiety, and corticotropin-releasing hormone (CRH) levels in pregnant African American women beginning in the second trimester.

Methods: This prospective, longitudinal study of 59 women used a controlled randomized experimental design with two groups conducted over 12 weeks. The intervention was a set of three R-GI CDs developed and sequenced to influence study outcomes. Study measures included the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory, and plasma CRH levels collected at three time points. Participants completed a daily Numeric Rating Scale of Stress (NRSS) and daily practice logs, which provided information on intervention use in the R-GI group.

Findings: State anxiety significantly decreased over time in the R-GI group, and it increased over time in the usual-care (UC) group. Although a significant difference was not found for perceived stress, as measured by the PSS, the R-GI group had a greater decrease in weekly Numeric Rating Scale of Stress NRSS scores over time compared to the UC group. The R-GI group also had significant decreases in NRSS scores before and after using R-GI. There were no significant differences in CRH levels between groups over time.

Conclusions: Findings support the feasibility and effectiveness of an R-GI intervention in reducing anxiety and daily stress levels in pregnant African American women beginning in the second trimester. The pilot study is an important first step in evaluating the effectiveness of R-GI as a primary prevention intervention to reduce preterm birth.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • African Americans
  • Anxiety / blood
  • Anxiety / therapy*
  • Corticotropin-Releasing Hormone / blood
  • Female
  • Humans
  • Imagery, Psychotherapy*
  • Pregnancy
  • Premature Birth / prevention & control*
  • Prospective Studies
  • Relaxation Therapy*
  • Stress, Psychological / blood
  • Stress, Psychological / therapy*
  • Young Adult


  • Corticotropin-Releasing Hormone