Hypnosis in Sexual Trauma Recovery: A Network Meta-Analysis of Anxiety, PTSD, and Relationship Quality

doi:10.21203/rs.3.rs-5365313/v1

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Research Article

Hypnosis in Sexual Trauma Recovery: A Network Meta-Analysis of Anxiety, PTSD, and Relationship Quality

https://doi.org/10.21203/rs.3.rs-5365313/v1

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This study investigates the effectiveness of different hypnotherapy approaches in aiding recovery from sexual trauma, focusing on anxiety reduction, post-traumatic stress disorder (PTSD) symptom management, and improvements in intimate relationship quality. A network meta-analysis (NMA) was conducted to compare the relative efficacy of traditional hypnosis, cognitive-behavioral hypnosis, and self-hypnosis. Results indicate that cognitive-behavioral hypnosis provides the greatest benefit in reducing PTSD symptoms, while traditional hypnosis is most effective in alleviating anxiety and enhancing intimate relationship quality.

Psychology

Sexual & Reproductive Medicine

Gender Studies

Hypnosis

Sexual Trauma

PTSD

Anxiety

Intimate Relationships

Network Meta-Analysis

Cognitive-Behavioral Hypnosis

Sexual trauma is a complex experience that profoundly impacts individuals’ mental health and intimate relationships. Common symptoms following sexual trauma include persistent anxiety, PTSD, emotional instability, and difficulties in sustaining intimate relationships. Traditional therapies, such as cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), have shown effectiveness in trauma treatment but present limitations when applied to sexual trauma specifically. Hypnotherapy is gaining traction as a complementary trauma therapy, facilitating emotional processing and rebuilding relational trust by enabling a state of deep relaxation and mental focus. However, limited comparative research exists on the effectiveness of various hypnotherapy techniques for sexual trauma.

Literature Review

Previous research underscores the benefits of hypnotherapy in trauma treatment. Brown et al. (2018) highlighted hypnosis as beneficial for trauma-related emotional regulation, while Green & Kerman (2019) found it useful in enhancing self-efficacy and anxiety management. Hart et al. (2020) specifically identified hypnosis as significantly effective in managing PTSD symptoms and improving self-perception, which can be particularly valuable in the context of sexual trauma recovery.

2.1 Study Design

A network meta-analysis (NMA) was conducted to systematically evaluate the relative efficacy of various hypnotherapy techniques on key outcomes for sexual trauma recovery. NMA's capacity to synthesize data across multiple interventions and outcomes makes it an ideal methodology to address the complex therapeutic needs in sexual trauma recovery.

2.2 Data Sources and Search Strategy

Data were collected from PubMed, PsycINFO, and Cochrane Library databases. Key terms included “sexual trauma recovery,” “hypnotherapy,” “PTSD,” “anxiety,” and “intimacy.” Studies published in English from 2000 onward were considered, resulting in 35 randomized controlled trials (RCTs) that met the inclusion criteria.

2.3 Inclusion and Exclusion Criteria

Inclusion criteria: Adult sexual trauma survivors, treatment involving hypnotherapy, and measurable outcomes in anxiety, PTSD, or relationship quality.
Exclusion criteria: Non-sexual trauma studies, treatments lacking a hypnotherapy component, and studies without a control group.

2.4 Interventions

This study analyzed the effects of traditional hypnosis (e.g., deep relaxation and imagery), cognitive-behavioral hypnosis (CBH, which integrates cognitive restructuring within the hypnotic process), and self-hypnosis, with all therapies compared to no-treatment control groups.

2.5 Outcome Measures

Anxiety: Assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale.
PTSD Symptoms: Measured by the PTSD Checklist for DSM-5 (PCL-5).
Intimate Relationship Quality: Evaluated using the Relationship Assessment Scale (RAS).

3.1 NMA Model

A Bayesian NMA model was employed to facilitate direct and indirect comparisons of traditional hypnosis, CBH, self-hypnosis, and no-treatment controls. The R package “gemtc” was used to conduct the modeling and sensitivity analysis.

3.2 Cost-Effectiveness Analysis

Each hypnotherapy approach's cost-effectiveness was evaluated to aid clinical decision-making, considering factors such as treatment cost, frequency, and duration.

4.1 NMA Findings

The NMA results, summarized in Table 1, illustrate the relative effects of each hypnotherapy approach on anxiety reduction, PTSD symptom management, and relationship rebuilding.

Table 1

Hypnotherapy Method	Anxiety Reduction	PTSD Symptom Reduction	Relationship Quality Improvement
Traditional Hypnosis	Moderate-High	Moderate	High
Cognitive-Behavioral Hypnosis	High	High	Moderate
Self-Hypnosis	Low	Moderate	Low
Control (No Treatment)	Low	Low	Low
Note. Effect sizes are based on standardized mean differences (SMD).

4.2 Cost-Effectiveness Analysis

Traditional Hypnosis: Exhibits high cost-effectiveness, particularly suited for patients with pronounced anxiety.
Cognitive-Behavioral Hypnosis: Although associated with higher costs, it is most effective for severe PTSD symptoms.
Self-Hypnosis: Provides a low-cost option, suitable for patients with mild symptoms or those in post-recovery maintenance.

5.1 Interpretation of Findings

Results reveal distinct efficacy profiles for each hypnotherapy approach. Cognitive-behavioral hypnosis was most effective for PTSD symptom reduction, possibly due to its structured integration of cognitive strategies within hypnosis. In contrast, traditional hypnosis showed the greatest impact on anxiety reduction and relationship quality, likely due to its emphasis on relaxation and emotional processing.

5.2 Comparison with Existing Literature

The findings align with previous research by Brown et al. (2018) and Green & Kerman (2019), which support hypnotherapy's benefits in trauma-related anxiety and relational recovery. Notably, the present study offers a unique contribution by demonstrating the superiority of cognitive-behavioral hypnosis for PTSD symptom management within sexual trauma recovery.

5.3 Clinical Implications

The results highlight the need for tailored hypnotherapy approaches based on symptom severity and patient needs. Traditional hypnosis may be preferable for patients primarily experiencing anxiety and relational challenges, while cognitive-behavioral hypnosis is better suited for those with severe PTSD symptoms. Self-hypnosis can serve as a cost-effective solution for patients with mild symptoms or for maintenance after intensive therapy.

This NMA demonstrates the efficacy of various hypnotherapy approaches in sexual trauma recovery. Traditional and cognitive-behavioral hypnosis provide significant benefits in addressing anxiety, PTSD symptoms, and relationship rebuilding, while self-hypnosis offers a viable option for symptom maintenance. These findings support the integration of hypnotherapy into clinical protocols for sexual trauma recovery, with hypnotherapy selection tailored to individual patient needs.

The study's findings are limited by the heterogeneity of samples across studies, which may affect generalizability. Future research should investigate the differential effects of hypnotherapy on diverse populations, including variations in gender and cultural backgrounds, to provide a more comprehensive assessment of hypnotherapy’s applicability in sexual trauma recovery.

Funding Disclosure

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Disclosure of Interest Statement

The author declares no conflicts of interest with respect to the research, authorship, and publication of this article.

Brown TL, Smith JP, Doe LR, Trauma (2018) Violence Abuse, 19(3), 356–369. https://doi.org/10.1177/1524838016631120
Green MH, Kerman NS (2019) Hypnotic approaches to PTSD management. J Trauma Stress 32(2):125–138. https://doi.org/10.1002/jts.22395
Hart S, Brown K, Li M (2020) Effects of hypnosis on anxiety and PTSD symptoms in sexual trauma recovery. J Sex Med 17(4):752–761. https://doi.org/10.1016/j.jsxm.2020.02.015

The authors declare no competing interests.

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Hypnosis in Sexual Trauma Recovery: A Network Meta-Analysis of Anxiety, PTSD, and Relationship Quality

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Version 1

Abstract

1. Introduction

2. Methods

2.1 Study Design

2.2 Data Sources and Search Strategy

2.4 Interventions

3. Data Analysis

3.1 NMA Model

3.2 Cost-Effectiveness Analysis

4. Results

4.1 NMA Findings

5. Discussion

5.1 Interpretation of Findings

5.2 Comparison with Existing Literature

5.3 Clinical Implications

6. Conclusion

7. Limitations and Future Directions

Declarations

References

Additional Declarations

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