Relaxation-induced anxiety in an agoraphobic population.

Abstract

Considerable evidence suggests that relaxation can paradoxically increase anxiety in certain populations (1). A recent investigation suggests that agoraphobic patients who experience such symptoms as depeisonalization or derealization are particularly sensitive to such adverse effects (2). This study indicated that these patients tended to experience relaxation-induced anxiety in response to a relaxation sequence that involved passive suggestion and imagery. The present study investigated whether a modified form of progressive relaxation using simple tension-relaxation exercises might be more effective for these patients. It was hypothesized that such a technique might circumvent the reported problems of fear of loss of control prompted by passive suggestion. Two groups of 14 patients fulfilling the DSM 111 criteria of agoraphobia with panic attack were selected for this study. They mere also required to have experienced symptoms of depersonalization or derealization in the four months prior to selection. Such symptoms are common in this disorder. Patients were randomly assigned to a group receiving suggestion-imagery (Group S) and progressive relaxation (Group PR).. While the former group received passive hypnotic suggestion, the latter group rece~ved instructions to tense and relax the various major muscle groups sequentially. Instructions for both groups were taped and lasted 30 min. Prior to and after the session, basal heart rate and subjective anxiety were assessed. Anxiety was assessed using the state version of the Spielberger State-Trait Anxiety Inventory (3). A 7-point questionnaire designed to assess negative side effects was administered after the session.