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A Randomized Controlled Trial to Evaluate the Effect of Metaphors on Anxiety Symptoms Among Chinese Graduate Students: The Mediation Effect of Worry

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Listed:
  • Jinghan Hu

    (CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences
    City University of Hong Kong)

  • Xiaoyu Zhang

    (CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences)

  • Ruonan Li

    (CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences
    University of Chinese Academy of Sciences)

  • Jianxin Zhang

    (CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences)

  • Wencai Zhang

    (CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences)

Abstract

Psychotherapists use metaphors frequently regardless of their orientation. However, few studies examined the unique effectiveness of metaphors on anxiety. This randomized controlled trial assigned 94 graduate students at risk of generalized anxiety disorder (GAD) into either a metaphorical group (n = 31), a literal group (n = 33), or a no-intervention control group (n = 30). The metaphorical group used metaphors in the form of metaphorical stories, whereas the literal group used literal language to present the same anxiety-related materials over four 1-hour weekly sessions. All participants received measurements assessing worry, GAD, anxiety symptoms, and life satisfaction at baseline (T1), postintervention (T2), 1-week (T3), and 4-week follow-up (T4). Participants in the two intervention groups freely recalled the four session topics at postintervention. Both the metaphorical (T3 and T4) and the literal groups (T4) significantly enhanced life satisfaction. The metaphorical group significantly alleviated anxiety symptoms (T2 and T3), while the other two groups showed no such improvements. Further, the reduction of worry from baseline to postintervention mediated the relationship between the metaphorical intervention and GAD and anxiety symptoms. The participants in the metaphorical group recalled the session topics more accurately than those in the literal group. The metaphorical intervention alleviated anxiety symptoms and enhanced life satisfaction and memory about the intervention. Worry plays a mediating role between metaphorical intervention and anxiety. Future studies should enhance metaphorical intervention’s effectiveness and explore its effects on worry and memory.

Suggested Citation

  • Jinghan Hu & Xiaoyu Zhang & Ruonan Li & Jianxin Zhang & Wencai Zhang, 2023. "A Randomized Controlled Trial to Evaluate the Effect of Metaphors on Anxiety Symptoms Among Chinese Graduate Students: The Mediation Effect of Worry," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 18(2), pages 849-867, April.
    • Handle: RePEc:spr:ariqol:v:18:y:2023:i:2:d:10.1007_s11482-022-10107-2
    DOI: 10.1007/s11482-022-10107-2
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    References listed on IDEAS

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    1. Matilda Berg & Gerhard Andersson & Alexander Rozental, 2020. "Knowledge About Treatment, Anxiety, and Depression in Association With Internet-Based Cognitive Behavioral Therapy for Adolescents: Development and Initial Evaluation of a New Test," SAGE Open, , vol. 10(1), pages 21582440198, January.
    2. Paul H Thibodeau & Lera Boroditsky, 2011. "Metaphors We Think With: The Role of Metaphor in Reasoning," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-11, February.
    3. Xinshu Zhao & John G. Lynch & Qimei Chen, 2010. "Reconsidering Baron and Kenny: Myths and Truths about Mediation Analysis," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 37(2), pages 197-206, August.
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