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Effects of imagery, critical thinking, and asthma education in adult asthmatics.

31 May

Contrary to hypothesis, researchers at Saybrook Graduate School in San Francisco find that physiological guided imagery for asthma improves symptoms and management behaviors in asthma sufferers better than a technique called Critical Thinking Asthma Management..

In a randomized, controlled, clinical trial, researchers from Saybrook Graduate School in San Francisco compared outcomes between biologically targeted imagery (BTI) and critical thinking asthma management (CTAM). Among 70 adults (53 women, 17 men) with asthma at Alaska Regional Hospital in Anchorage.

Participants were randomized to BTI (group 1, G1) or CTAM (group 2, G2) in a 2 x 2 x 4 design (BTI/CTAM x pretest/post-test x weeks [3 week averaged intervals of symptoms and peak flows]). Interventions were asthma education plus treatment (BTI or CTAM for two 2-hour sessions per week for 6 weeks). For BTI, data collection (symptoms, lung function) occurred preintervention (3 week baseline), during the intervention (6 weeks), and postintervention (6 weeks). For CTAM, data collection occurred at wait-list control (WLC) (12 weeks extended baseline), preintervention (3 weeks), during the intervention (6 weeks), and postintervention (6 weeks). The variables studied were asthma symptoms (wheezing, coughing, sleep, activity, attacks, peak flow) and self-report assessments of Profiles of Mood States (POMS-BI) (anxiety, hostility, depression, uncertainty, fatigue, confusion); Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire (KASE-AQ); Health Attribution Test (HAT) for locus of control (LoC); and the Revised Asthma Problem Behavior Checklist (RAPBC).

Analyses of pre- to post-tests revealed that the wait list condition (WLC) improved all POMS-BI scores except anxiety, increased internal LoC, and reduced problematic behaviors. Compared to WLC, the biologically targeted imagery reduced wheezing, anxiety, and chance LoC, and increased asthma knowledge, attitude, and self-efficacy. Compared to critcal thinking asthma management (CTAM), BTI reduced wheezing and chance LoC, increased internal LoC, and improved 6 POMS-BI scores. Compared to the extended baseline wait list group, CTAM increased asthma knowledge, attitude, self-efficacy, internal LoC, and peak flow.

The study concludes that both the biologically targeted imagery and the critcal thinking asthma management improved symptoms and asthma management more than record keeping. Contrary to hypothesis, the imagery condition produced better outcomes than the critical thinking intervention.

Citation: Freeman LW, Welton D. Effects of imagery, critical thinking, and asthma education on symptoms and mood state in adult asthma patients: a pilot study. Journal of Alternative and Complementary Medicine. 2005 Feb; 11 (1): pages 57-68.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award