Modality- and sequence-specific effects of guided imagery on stress and neuroendocrine markers in young adults: A pilot randomized crossover study.
7 affiliations
- 1School of Sports Sciences, Universiti Kebangsaan Malaysia, Bangi, Selangor, 43600 UKM, Malaysia.
- 2School of Sports Sciences, The University of Jordan, Queen Rania Street (University Street), Jubaiha, Amman, 11942, Jordan.
- 3Faculty of Health Science, Universiti Kebangsaan Malaysia, Bangi, Selangor, 43600 UKM, Malaysia.
- 4School of Medicine, The University of Jordan, Queen Rania Street (University Street), Jubaiha, Amman, 11942, Jordan.
- 5EA 7329, Institute for Research in Bio Medicine and Epidemiology of Sport (IRMES), INSEP, 11, Avenue Du Tremblay, Paris, 75012, France.
- 6INSERM UMR-S 1124, HealthFex, Université Paris Cité, 45 Rue des Saints-Pères, Paris, 75006, France.
- 7Laboratory of Biology and Molecular Genetics, Faculty of Medicine, University Salah Boubenider Constantine 3, New Town Ali Mendjeli, Constantine, Algeria.
Abstract
Background
Guided mental imagery interventions are increasingly used for stress reduction, but evidence comparing the effects of different imagery modalities remains limited. This pilot study examined modality-specific and sequence-dependent effects of calming and achievement imagery on perceived stress and neuroendocrine markers.Methods
Thirty-two male adults (18-25 years) completed a 5-day pilot randomized, counterbalanced crossover study. Participants were assigned to calming-then-achievement (CAG, n = 13), achievement-then-calming (ACG, n = 12), or a no-intervention control group (CG, n = 7). Biomarkers were assessed on Days 1, 3, and 5 in active groups and Days 1 and 5 in CG; perceived stress was assessed on Days 1 and 5.Results
Serotonin was significantly higher following achievement than calming imagery (calming - achievement: -66.5 ng/mL, 95% CI -123.2 to -9.8; p = .019; partial η² = .113), with a significant sequence effect (p = .014). Cortisol and β-endorphin showed no modality, period, or sequence effects. β-Endorphin increased over time (p < .001); cortisol showed no significant time, group, or interaction effects. Serotonin showed significant time, group, and time-by-group effects (all p < .001), including a marked increase in the untreated control group by Day 5. No significant effect of sequence or modality was found on perceived stress.Conclusions
These preliminary, hypothesis-generating results suggest achievement imagery may selectively engage serotonergic activity, while both modalities similarly engage the endogenous opioid system; no effect was found on cortisol or perceived stress. Given the pilot design, small sample, multiple outcomes, and the serotonin increase in the untreated control group, findings should be confirmed in adequately powered randomized trials.
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BibTeX
@article{anuar2026modality,
title = {{Modality- and sequence-specific effects of guided imagery on stress and neuroendocrine markers in young adults: A pilot randomized crossover study.}},
author = {Nurwina Anuar and Manal M Bayyat and Ibrahim M Dabayebeh and Shazli Ezzat Ghazali and Zainab H Abumuaili and Tala Al-Hadid and Haidar Djemai},
journal = {Comprehensive psychoneuroendocrinology},
year = {2026},
month = oct,
doi = {10.1016/j.cpnec.2026.100384},
url = {https://europepmc.org/article/MED/42908900},
note = {CC BY},
}
RIS
TY - JOUR
TI - Modality- and sequence-specific effects of guided imagery on stress and neuroendocrine markers in young adults: A pilot randomized crossover study.
AU - Nurwina Anuar
AU - Manal M Bayyat
AU - Ibrahim M Dabayebeh
AU - Shazli Ezzat Ghazali
AU - Zainab H Abumuaili
AU - Tala Al-Hadid
AU - Haidar Djemai
PY - 2026
DA - 2026/10/06
JO - Comprehensive psychoneuroendocrinology
DO - 10.1016/j.cpnec.2026.100384
UR - https://europepmc.org/article/MED/42908900
AB - Background Guided mental imagery interventions are increasingly used for stress reduction, but evidence comparing the effects of different imagery modalities remains limited. This pilot study examined modality-specific and sequence-dependent effects of calming and achievement imagery on perceived stress and neuroendocrine markers.Methods Thirty-two male adults (18-25 years) completed a 5-day pilot randomized, counterbalanced crossover study. Participants were assigned to calming-then-achievement (CAG, n = 13), achievement-then-calming (ACG, n = 12), or a no-intervention control group (CG, n = 7). Biomarkers were assessed on Days 1, 3, and 5 in active groups and Days 1 and 5 in CG; perceived stress was assessed on Days 1 and 5.Results Serotonin was significantly higher following achievement than calming imagery (calming - achievement: -66.5 ng/mL, 95% CI -123.2 to -9.8; p = .019; partial η² = .113), with a significant sequence effect (p = .014). Cortisol and β-endorphin showed no modality, period, or sequence effects. β-Endorphin increased over time (p < .001); cortisol showed no significant time, group, or interaction effects. Serotonin showed significant time, group, and time-by-group effects (all p < .001), including a marked increase in the untreated control group by Day 5. No significant effect of sequence or modality was found on perceived stress.Conclusions These preliminary, hypothesis-generating results suggest achievement imagery may selectively engage serotonergic activity, while both modalities similarly engage the endogenous opioid system; no effect was found on cortisol or perceived stress. Given the pilot design, small sample, multiple outcomes, and the serotonin increase in the untreated control group, findings should be confirmed in adequately powered randomized trials.
SN - 2666-4976
ER -