Effectiveness of subliminal audio messages on depression and anxiety in women with hypertension: a quasi-experimental study
Social Determinants of Health,
Vol. 11 (2025),
1 Dey 2025
,
Page 1-9
https://doi.org/10.22037/sdh.v11i1.48724
Abstract
Background: Subliminal messages (auditory sub-threshold stimuli) are hidden messages embedded within musical notes that the conscious mind cannot perceive. The aim of this study was to examine the effectiveness of subliminal audio in reducing depression and anxiety in women with hypertension, with the goal of providing a foundation for future interventions and physiological evidence supporting sub-threshold perception.
Methods: This quasi-experimental study was conducted using purposive sampling on 30 hypertensive female patients who referred to Seyed-al-Shohada Hospital in Urmia, Iran. Participants were randomly assigned to intervention and control groups. After the pre-test, the intervention group listened to a subliminal audio file for 20 minutes daily over a six-week period. Depression and anxiety levels were assessed and compared before and after the intervention in both groups using the Beck Depression Inventory (BDI; scores ranging from 13 to 63) and the Beck Anxiety Inventory (BAI; scores ranging from 7 to 63).
Results: The intervention group showed a significant reduction in depression and anxiety scores following the six-week exposure to subliminal audio messages. Depression scores decreased from a mean of 29.13 (SD = 6.82) in the pre-test to 23.73 (SD = 6.76) in the post-test. Similarly, anxiety scores reduced from 17.6 (SD = 6.04) to 15.6 (SD = 7.20). In contrast, the control group exhibited no significant changes in either variable. ANCOVA results confirmed that the reduction in depression (F = 7.536, p = 0.011, η² = 0.218) and anxiety (F = 5.316, p = 0.029, η² = 0.165) in the intervention group remained statistically significant even after controlling for pre-test scores, indicating a moderate and clinically meaningful effect of the intervention.
Conclusion: The findings suggest that subliminal audio messages can be an effective non-pharmacological intervention for reducing depression and anxiety in patients with cardiovascular diseases.
- Anxiety
- Cardiovascular Diseases
- Depression
- Hypertension
- Subliminal Stimulation
How to Cite
References
Mardona Y, Karundeng JO, Kafiar RE. The Effect Combination of Five-Finger Hypnosis Therapy and Classical Music Therapy on Nursing Students' Anxiety: Quasy Experiment. Comprehensive Health Care. 2025;9(1):1-5. https://doi.org/10.37362/chc.v9i1.2
Faramarzi M, Khalatbari J, Abolmaali K, Ghorban Shiroudi G. The Effect of Group Cogni-tive-Behavioral Therapy on the Lifestyle of Patients with Hepatitis B. Journal of Client-Centered Nursing Care. 2022;8(4):243-252. https://jccnc.iums.ac.ir/article-1-373-en.html
Zhang J, Yin Y, Wen Y, Shi F, Wang J. Anxiety and depression in patients with pulmonary arterial hypertension in Northwest China: a cross-sectional study. Frontiers in Psychiatry. 2022;12(1):758120. https://doi.org/10.3389/fpsyt.2021.758120
Sabetfar N, Meschi F, Hosseinzade Taghvaei M. The effectiveness of mindfulness-based group therapy on perceived stress, emotional cognitive regulation, and self-care behaviors in patients with hypertension. Internal Medicine Today. 2021;27(2):246-263. https://imtj.gmu.ac.ir/browse.php?a_id=3613&sid=1&slc_lang=en&html=1
Valentino K, Edler K. The next generation of developmental psychopathology research: Including broader perspectives and becoming more precise. Dev Psychopathol. 2024;36(5):2104-2113. https://doi.org/10.1017/S0954579424000142
Ma F. Diagnostic and statistical manual of mental disorders-5 (DSM-5). InEncyclopedia of gerontology and population aging. Cham: Springer International Publishing;2021. https://doi.org/10.1007/978-3-030-22009-9_419
Asmand P, Mardani S, Kheiri S, Jazayeri SR, Solati K. Investigating the Effectiveness of Practicing Teachings of the Qur’an on Anxiety and Blood Pressure in Iranian Women with Primary Blood Pressure. medicine. 2019;4(3):30-37. https://www.quraniimed.com/article_192753.html?lang=en
Fariborzifar A, Hosseini H. A Narrative Review of Prevalence of Depression in Patients with Chronic Medical Illnesses in Mazandaran Province, Iran. Journal of Mazandaran University of Medical Sciences. 2018;28(162):187-201. https://jmums.mazums.ac.ir/article-1-10932-en.html
Yusim A, Grigaitis J. Efficacy of binaural beat meditation technology for treating anxiety symptoms: a pilot study. The Journal of nervous and mental disease. 2020;208(2):155-60. https://doi.org/10.1097/NMD.0000000000001070
Leisman G, Wallach J, Machado-Ferrer Y, Chinchilla-Acosta M, Meyer AG, Lebovits R, Donkin S. The effect of binaural pulse modulation (BPM) on brain state in depression and anxiety: a case series. Journal of Medical Case Reports. 2024;18(1):574-589. https://doi.org/10.1186/s13256-024-04888-3
Smith PK, McCulloch KC. Subliminal perception. Encyclopedia of human behavior;2025.
Borsook D, Youssef AM, Barakat N, Sieberg CB, Elman I. Subliminal (latent) processing of pain and its evolution to conscious awareness. Neuroscience & Biobehavioral Reviews. 2018;88(1):1-5. https://doi.org/10.1016/j.neubiorev.2018.02.015
Maleki B, Khajei H. The Self-Esteem Manipulation and variability of Cardiovascular Performance. Journal of Psychological Studies. 2016;12(1):141-157. https://psychstudies.alzahra.ac.ir/article_2259_en.html
Kaewlue A, Banharak S, Panpanit L, Chanaboon S. The Effectiveness of a Multi-Sensory Sleep-Promotion Program on Sleep Quality among Hospitalized Older Adults of Thailand: a Quasi-Experimental Study. Behavioral Sleep Medicine. 2023;21(5):540-555. https://doi.org/10.1080/15402002.2022.2136671
Chitra G, Kanchana K, Nirmala T. A Quasi Experimental Study to Evaluate the Effectiveness of Audio-Visual Education on Anxiety among patients undergoing Coronary Angiography at selected hospital, Coimbatore. International Journal of Advances in Nursing Management. 2022;10(4):351-356. https://doi.org/10.52711/2454-2652.2022.00078
Bousbiat I. The Digital Heartbeat: A Qualitative Descriptive Study on Women’s Views of Xi-Care in Preventive Cardiovascular Diseases in Primary Care;2024. https://escholarship.mcgill.ca/concern/theses/pn89dd30b
Ölçücü MT, Yılmaz K, Karamık K, Okuducu Y, Özsoy Ç, Aktaş Y, Çakır S, Ateş M. Effects of listening to binaural beats on anxiety levels and pain scores in male patients undergoing cystoscopy and ureteral stent removal: a randomized placebo-controlled trial. Journal of endourology. 2021;35(1):54-61. https://doi.org/10.1089/end.2020.0353
Borgeat F, Boissonneault J, Chaloult L, Elie R. Psychophysiological responses to subliminal auditory suggestions for activation. Perceptual and Motor Skills. 1989;69(3):947-53. https://doi.org/10.1177/00315125890693-145
Farrar S, Stopa L, Turner H. Self-imagery in individuals with high body dissatisfaction: The effect of positive and negative self-imagery on aspects of the self-concept. Journal of Behavior Therapy and Experimental Psychiatry. 2015;46(1):8-13. https://doi.org/10.1016/j.jbtep.2014.07.011
Lewis N. Experiences of upward social comparison in entertainment contexts: Emotions, state self-esteem, and enjoyment. The Social Science Journal. 2021;58(3):339-354. https://doi.org/10.1016/j.soscij.2019.04.011
Shabahang R, Soltany R, Nikogoftar M, Hakimjavady M. Effect of subliminal presentation of emotional faces on mood. Social Psychology Research. 2017;7(27):35-48. https://www.socialpsychology.ir/article_67109_en.html?lang=en
Feulner L, Sermchaiwong T, Rodland N, Galarneau D. Efficacy and safety of psychedelics in treating anxiety disorders. Ochsner Journal. 2023;23(4):315-28. https://doi.org/10.31486/toj.23.0076
Maddah M, Kiyani R, Asghari M. The effectiveness of subliminal stimulation on the obsessive-compulsive disorder symptoms based on cultural issues in women. Journal of Woman Cultural Psychology. 2023;14(56):17-31. https://doi.org/10.22034/jwcp.2023.705392
Funk AJ, Tucker L, Vieira K, Bowman T. Subliminal Priming with Positive Auditory Stimuli Significantly Improves Self-Esteem and Emotional Well-Being. European Journal of Medical and Health Sciences. 2022;4(6):77-84. https://doi.org/10.24018/ejmed.2022.4.6.1328
- Abstract Viewed: 1985 times
- PDF Downloaded: 230 times