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Research and Articles: 

Current Research and Hypnosis

"How deeply hypnotized did I get?"

Predicting self-reported hypnotic depth from a phenomenological assessment instrument.Pekala RJ, Kumar VK, Maurer R, Elliott-Carter NC, Moon E. Coatesville Veterans Administration Medical Center, Coatesville, Pennsylvania, USA.


Procedures for estimating hypnotic depth have been used for more than 70 years. This study predicted self-reported hypnotic depth from the phenomenological and behavioral variables of the Phenomenology of Consciousness Inventory-Hypnotic Assessment Procedure (PCI-HAP).


Participants were divided into 2 groups; 1 was used to generate regression equations, and the other group was used for cross-validation.

    Both imagery vividness during hypnosis (imagoic-suggestibility) and the PCI pHGS measure of hypnotic depth (hypnoidal state) accounted for most of the variance in elf-reported hypnotic depth. The above results, further supported by correlational and 3-D visual analyses, are consistent with other researchers' observations that ratings of hypnotic depth are a function of:

(a) alterations in subjective experience, and

(b) the perception of responsiveness to suggestions. The findings are also congruent with J. Holroyd's hypothesis that suggestibility and altered-state effects interact to 
produce hypnotic effects.

PMID: 16858905 [PubMed - indexed for MEDLINE]

Site link- 
ordinalpos=56&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.P ubmed_RVDocSum


Neuroscience of Hypnotizability

    Salient findings: A potentially groundbreaking study on the neuroscience of hypnotizability, a critical review of hypnosis' efficacy, and the neurophysiology of conversion disorder.Nash MR.University of Tennessee, Knoxville, Tennessee 37996-0900, USA. 
    Three papers of special interest to researchers and clinicians alike have recently appeared in the general scientific and medical literatures. Two of these papers are original research studies that employ brain-imaging technologies, one using Magnetic Resonance Imaging (MRI), the other position emission tomography (PET). A third paper is a comprehensive review of the empirical findings on the clinical use of hypnosis in pediatric oncology.

    The research study using MRI technology is extraordinary, because it is the first to document differences in brain morphology between high hypnotizable and low hypnotizable individuals.

    Arguably, if its findings replicate, the study could be one of the most important developments in scientific hypnosis since the genesis of the Stanford scales 45 years ago.


The PET study notes differences in brain activation during intentionally simulated and hypnotically experienced paralysis.

PMID: 15788246 [PubMed - indexed for MEDLINE] 
Site Link- 

Journal of American Medical Association 
The site has over 89 documents that have Hypnosis in them – just do a search and enjoy.

British Medical Journal has several articles with Hypnosis in the title.

Hypnosis for treatment of insomnia in school-age children: a retrospective chart review 
Ran D Anbar1 and Molly P Slothower1 
Department of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, NY, USA 
Corresponding author.  Ran D Anbar:; Molly P Slothower: 
Received April 25, 2006; Accepted August 16, 2006. 
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which 
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Non-drug psychotherapeutic options for skin disorders

Shenefelt, P.D (2006), Nondrug Psychotherapeutic Options for Skin Disorders Trends in Psychotherapy Research. Abelian, M. E. (Ed).  2006, pp. 33-51

(From the chapter) The skin and the nervous system develop side by side in the ectoderm of the fetus and remain intimately interconnected throughout life. 

Cutaneous innervation represents the largest sense organ of the body and is also vital to skin protection and health. There is a significant psychosomatic or behavioral component to many skin disorders. This interaction permits nondrug psychotherapeutic interventions that have positive impacts on many cutaneous diseases. 

Cognitive-behavioral techniques that address dysfunctional cognitions (thought patterns) or behaviors (actions) can be useful for skin disorders with a significant psychosomatic or behavioral component, such as the picking component of acne excoriee, scratching in atopic dermatitis, habits such as lip licking or biting, hyperhidrosis, lichen simplex chronicus, neurotic excoriations, onychotillomania, trichotillomania, and psychosomatic triggering or exacerbation of urticaria. 

Cognitive-behavioral methods can also desensitize individuals with needle phobia. Biofeedback has some limited usefulness in a few selected skin disorders. 

Galvanic skin resistance (GSR) feedback can be utilized for teaching control of hyperhidrosis. Skin temperature feedback allows individuals to learn how to warm the fingers for Raynaud's syndrome and scleroderma.

 Neurofeedback of electroencephalographic (EEG) spectral frequency is in its infancy but may prove useful for certain habit disorders that affect the skin, hair, or nails by picking, scratching, or other manipulation. 

Hypnosis has been found useful to treat a number of skin disorders including acne excoriee, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also help individuals feel more comfortable about having their skin diseases. Hypnotic relaxation utilizing self-guided imagery reduces anxiety and discomfort during dermatologic procedures. For resistant skin disorders, hypnoanalysis using ideomotor signaling and the affect bridge technique can often identify original incidents and promote healing. Subtle energy intuitive techniques are an almost lost art that have so far been relatively difficult to explore on a scientific basis. They are still utilized by various indigenous practitioners and shamans, and are sometimes capable of clearing or improving otherwise refractory skin disorders. A psychiatrist has described their modern use. This area has potential for significant future development. 

The Use of Hypnosis in Depression Treatments - Utilización de la hipnosis en el tratamiento de la depresión mayor Besterio-Gonzalez, J & Garcia-Cueto E (2000) The use of hypnosis in depression treatments/Utilización de la hipnosis en el tratamiento de la depresión mayor Psicothema. Vol 12(4), pp. 557-560

Studied the effectiveness of cognitive-behavioral therapy for the treatment of depression in 21 male and female adults (aged 18-65 yrs) with major depression diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. 

Data on sociodemographic variables and clinical and psychological symptoms were obtained by questionnaire. The Millon Clinical Multiaxial Inventory-II (MCMI-II) (Spanish version by A. Ávila-Espada and F. Jiménez Gómez, 1988) and the Suggestibility Scale (E. García-Cueto and Gordon, 1998) were used. Ss received cognitive-behavioral alone or in combination with relaxation training or hypnosis during 12 weekly sessions. The results indicate that cognitive-behavioral therapy is more effective when applied under hypnosis conditions than alone or under relaxation conditions.

This list is always growing.. we'll add any legitimate hypnosis research you'd like to contribute.

Saving Money With Hypnosis - San Francisco (Reuters Health) - Using hypnosis in the operating room could cut costs of some medical procedures in half, Harvard researchers reported Monday at the annual meeting of the American Psychological Association. 
"Doing hypnosis on the operating room table certainly makes sense, but unless it saves money, you will not be doing it," said study author Dr. Elvira V. Lang, associate professor of radiology and medicine at Beth Israel Deaconess Medical Center in Boston, Massachusetts. 

The National Institutes of Health National Center funded the research for Complementary and Alternative Medicine. The study followed 241 patients undergoing various medical procedures such as clearing blocked arteries. 

**All the patients were given standard medical care, including the option of self-medicating drugs for pain. 

**One-third was also given empathic attention from a health professional in addition to standard care. 

**Another third were given self-hypnotic relaxation techniques in addition to standard care as part of preparation for the procedure. 

Lang reported that the hypnotized group reported significantly less pain during the procedure. The hypnotized group also took significantly less time to complete their procedures and used half as 
much pain medication. Based on these and other findings, Lang calculated that the average 
cost for a procedure using standard care was $638, while the cost for a procedure using adjunct hypnosis would cost $300, cutting the cost by more than half. Even if hypnosis added nearly an hour to the preparation time, it would still save money, she said.  "Hypnosis in the operating room is feasible, it is effective and very resource-sensitive," Lang concluded.

Hypnosis Subjects See What They Believe: 

Scientists are admitting hypnosis makes people literally see what they believe by affecting the way their brains function.

Volunteers who had their brains scanned while under hypnosis showed they were not merely doing what they were told.  The scans revealed that when they were asked to see non-existent colours, they really saw them.

In the tests by the University of California a burst of activity was seen in the part of their brain responsible for perceiving colour.  The scientists carrying out the study believe it has important implications and a spokesman said: "There has been a whole argument that hypnosis is just an exaggerated form of social compliance - in other words, people just telling you what you want to hear."

The research team is now looking at how hypnosis can prevent pain.  One trial currently under way involves a group of children aged six to 12 with a suspected kidney disorder. It can only be investigated by inserting a catheter probe into the bladder without anaesthetic.

Under hypnosis, the children imagine they are enjoying a trip to Disneyland. "There is less crying, less pain as they are inserting the catheter, and the procedure takes 20 minutes less, which for a kid is a big difference," said the spokesman.

See this story on Ananova:

Scientific American Feature Article: July, 2001 

The Truth and the Hype of Hypnosis  -  By Michael R. Nash 
Though often denigrated as fakery or wishful thinking, hypnosis has been shown to be a real phenomenon with a variety of therapeutic uses -- especially in controlling pain... 
Read it at:

Hypnosis & Bone Fracture: 
The Harvard Medical School conducted research on the use of hypnosis to enhance physical healing. Twelve people with a recent bone fracture were divided into two groups. One group received hypnosis and the other group served as control. Both groups received standard orthopedic treatment. The hypnosis group had individual hypnotic sessions and listened to audio tapes designed to increase bone healing. Xray and orthopedic evaluations were made during the 12 weeks of the experiment.

The results showed a faster healing for the hypnosis group at week 9 of the experiment.   Xrays revealed a notable difference at the edge of the fracture at  week 6 of the experiment.  The hypnosis group also had better mobility and used less pain killers. The researchers conclude by saying that "despite a small sample size.... these data suggest that hypnosis may be capable of enhancing both anatomical and functional fracture healing, and that further investigation of hypnosis to accelerate healing is warranted."

The article was "Using hypnosis to accelerate the healing of bone  fractures: a randomized controlled pilot study", by Ginandes, CS,  Rosenthal, DI. Alternative Therapy Health Medicine, 1999,  March, 5(2), pp.67-75.

Experts Urge the Inclusion of Hypnosis and Biofeedback in the Medical Treatment of Chronic Pain and Insomnia: 

An expert panel assembled by the National Institutes of Health has announced their finding that the use of hypnosis, biofeedback, meditation, and other behavioral therapies should be used more widely for the treatment of chronic pain and insomnia. Further, the panel said those therapies should be reimbursed bv health insurance along with standard medical care. Read more.

Hypno-Birthing Research: 
The benefits of hypnotic analgesia as an adjunct to childbirth education were studied in 60 nulliparous women. Subjects were divided into high and low hypnotic susceptibility groups before receiving 6 sessions of childbirth education and skill mastery using an ischemic pain task. Half of the Subjects in each group received a hypnotic induction at the beginning of each session; the remaining control Subjects received relaxation and breathing exercises typically used in childbirth education.

Both hypnotic Subjects and highly susceptible Subjects reported reduced pain. Hypnotically prepared births had shorter Stage 1 labors, less medication, higher Apgar scores, and more frequent spontaneous deliveries than control Subjects' births. Highly susceptible, hypnotically treated women had lower depression scores after birth than women in the other three groups. We propose that repeated skill mastery facilitated the effectiveness of hypnosis in the study.

Weight Loss 
A study from the University of Connecticut, Storrs, suggests that long term results are better when hypnosis is part of the therapy package particularly if the patient is a believer in hypnosis.

Researchers analyzed 18 studies comparing a cognitive behavioral therapy, such as relaxation training, guided imagery, self monitoring or goal setting with the same therapy supplemented by hypnosis.  Those who received the hypnosis lost more weight than 90 percent of the non hypnosis, and maintained the weight loss two years after treatment ended.

The placebo effect may account for some of hypnosis's success, says Irving Kirsch, PhD professor of psychology.  Although therapeutic suggestion and relaxation training were used in both hypnotic and non hypnotic sessions, they worked much better when they were referred to as "hypnosis" techniques, he notes.

Hypnotic Visual Illusion Alters Color Processing in the Brain 

Stephen M. Kosslyn, Ph.D., William L. Thompson, B.A., Maria F. Costantini-Ferrando, Ph.D., Nathaniel M. Alpert, Ph.D. and David Spiegel, M.D.

Am J Psychiatry 2000 157: 1279-1284. The journal is online (but requires a subscription) at:

OBJECTIVE: This study was designed to determine whether hypnosis can modulate color perception. Such evidence would provide insight into the nature of hypnosis and its underlying mechanisms.

METHOD: Eight highly hypnotizable subjects were asked to see a color pattern in color, a similar gray-scale pattern in color, the color pattern as gray scale, and the gray-scale pattern as gray scale during positron emission tomography scanning by means of [15O]CO2. The classic color area in the fusiform or lingual region of the brain was first identified by analyzing the results when subjects were asked to perceive color as color versus when they were asked to perceive gray scale as gray scale.

RESULTS: When subjects were hypnotized, color areas of the left and right hemispheres were activated when they were asked to perceive color, whether they were actually shown the color or the gray-scale stimulus. These brain regions had decreased activation when subjects were told to see gray scale, whether they were actually shown the color or gray-scale stimuli. These results were obtained only during hypnosis in the left hemisphere, whereas blood flow changes reflected instructions to perceive color versus gray scale in the right hemisphere, whether or not subjects had been hypnotized.

CONCLUSIONS: Among highly hypnotizable subjects, observed changes in subjective experience achieved during hypnosis were reflected by changes in brain function similar to those that occur in perception. These findings support the claim that hypnosis is a psychological state with distinct neural correlates and is not just the result of adopting a role.

[Editorial Note:  This "just adopting a role," or "role playing to please the audience" theory is no longer held by most researchers for talented and motivated subjects/clients and hasn't been for a number of years.  The role taking theory of Sarbin for example is effectively a psychological state theory in most ways because it views hypnotic phenomena as mediated by "organismic involvement" in the role (basically what most practitioners call depth).   

This study is very useful because it shows things going on specifically in hypnosis vs. "just imagining," and so is a start in identifying the neurological differences between someone experiencing something in a hypnotic way and experiencing in a more casual way.  Given a way to establish the 'reality' of a hypnotic hallucination, this potentially also provides a way to distinguish between what is going on with "low" vs. "high" hypnotizable people.  The people involved in this particular study were all pre-selected as "highs," a common technique in research of this sort to maximize the effects seen. - Todd Stark]

Irritable Bowel Syndrome 
A British study of 18 adults with IBS published in The Lancet found that hypnosis "strikingly" reduced colonic motility, thus decreasing diarrhea and cramping (July 11, 1992).

Erectile Dysfunction 

In a controlled study of 79 men with impotence from no known organic cause, only hypnosis proved more effective than a placebo, boosting sexual function by 80 percent (British Journal of Urology, February 1996).

Preparing for Surgery 

A controlled study of 32 coronary bypass patients showed that those taught self-hypnosis pre- 
operatively were more relaxed after surgery and had less need for pain medication (Journal of Cardiovascular Surgery, February 1997).


A review panel appointed by the National Institutes of Health found "strong evidence" for the use of hypnosis in alleviating pain associated with cancer (Journal of the American Medical Association, July 24-31, 1996).

Self-Hypnosis Can Cut Stress and Boost Your Immune System 

A number of studies have suggested stress can hinder the body's immune system defenses. Now researchers say people may be able to fight back with the stress-relieving techniques of self-hypnosis.

In a study of medical students under exam-time stress, investigators found that those who received "hypnotic-relaxation training" did not show the same reduction in key immune system components that their untrained counterparts did.

The researchers looked at 33 medical and dental students during relatively low-stress periods and around the time of the first major exam of the term. Half of the students attended sessions where they learned to relax through self-hypnosis.

The investigators found that during exam time, the self-hypnosis students launched stronger immune responses compared with students who did not learn the technique. And the more often students practiced the relaxation strategy, the stronger their immune response.

In previous studies, the researchers found that stressful times may impair the body's wound-healing process and response to vaccination. They and other researchers have also found that relaxation techniques may combat these effects by relieving stress and boosting the immune system.

The data from this study provide encouraging evidence that interventions may reduce the immunological dysregulation associated with acute stressors.  Journal of Consulting and Clinical Psychology 2001;69

Relax and live longer 
by Emma Young

Patients with Hodgkin's disease or non-Hodgkin's lymphoma live longer if they receive relaxation and hypnotherapy treatment along with standard chemotherapy. Similar approaches has resulted in mixed results for other cancers.Leslie Walker of Hull University studied 63 patients with newly diagnosed cancers, all of whom were receiving chemotherapy and standard anti-nausea drugs. The patients were split into three groups. One group was given relaxation tapes, another received the tapes plus hypnotherapy to reinforce their effect. The third received neither. Walker followed up the patients 13 years after diagnosis. "We found that the patients who had received relaxation or relaxation and hypnotherapy lived significantly longer," he says.

New lease of life

On average, patients in the relaxation and hypnotherapy group lived an average of 10.7 years after diagnosis, patients who used only the tapes lived 8.7 years and patients with neither lived 7.8 years. But Walker stresses that the patients differed in age and the stage of disease when treatment started. So although the differences are significant, translating hypnotherapy plus relaxation into three extra years of life is not possible, he says. How the relaxation and hypnotherapy may increase survival is not clear. Other studies of cancer patients have found that similar treatments can boost levels of killer T cells. But researchers have not been able to link this rise with increased survival."Chemotherapy and radiotherapy tend to suppress immune system functioning, so small interventions may help patients be more resistant to these effects," Walker says.

This research was presented at the British Psychological Society's Centenary Conference in Glasgow, UK.  Submitted by Todd I. Stark,,

Hypnosis Trials 1976 - 1998

Agras WS. Horne M. Taylor CB. Expectation and the blood-pressure lowering effects of relaxation. Psychosomatic Med. 1982; 44(4):389-95 In a study of the blood-pressure-lowering effects of relaxation training in patients with essential hypertension, instructions concerning the relaxation procedure were varied so that one group was told to expect delayed blood-pressure-lowering and the other group immediate lowering. The systolic blood pressure decrease during the training period in the immediate lowering group was 17.0 mm Hg, compared with 2.4 mm Hg for the delayed group (p = 0.001). Diastolic blood pressure changes were not significantly different. Measures of therapy credibility and perceived relaxation failed to differentiate the groups. The implications of these findings for future research and for clinical practice are considered.

Aikins Murphy P. Alternative therapies for nausea and vomiting of pregnancy. Obstetrics & Gynecology 1998;91(1):149-55 OBJECTIVE: To review available evidence about the effectiveness of alternative therapies for nausea and vomiting of pregnancy. 

DATA SOURCES: MEDLINE and 13 additional US and international data bases were searched in 1996-1997 for papers that described use of alternative medicine in the treatment of pregnancy and pregnancy complications, specifically those addressing nausea, vomiting, and hyperemesis. Bibliographies of retrieved papers were reviewed to identify additional sources. 

METHODS OF STUDY SELECTION: All relevant English language clinical research papers were reviewed. Randomized clinical trials addressing specifically the use of nonpharmaceutical and nondietary interventions were chosen for detailed review. TABULATION, 

INTEGRATION, AND RESULTS: Ten randomized trials studying the effects of acupressure, ginger, and pyridoxine on nausea and vomiting of pregnancy were reviewed. Evidence of beneficial effects was found for these three interventions, although the data on acupressure are equivocal. Insufficient evidence was found for the benefits of hypnosis. Other interventions have not been studied. CONCLUSION: There is a dearth of research to support or to refute the efficacy of a number of common remedies for nausea and vomiting of pregnancy. The best-studied alternative remedy is acupressure, which may afford relief to many women; ginger and vitamin B6 also may be beneficial. [References: 36]

Allison DB. Faith MS. Hypnosis as an adjunct to cognitive-behavioral psychotherapy for obesity: a meta-analytic reappraisal. Journal of Consulting & Clinical Psychology 1996;64(3):513-6 I. Kirsch, G. Montgomery, and G. Sapirstein (1995) meta-analyzed 6 weight-loss studies comparing the efficacy of cognitive-behavior therapy (CBT) alone to CBT plus hypnotherapy and concluded that "the addition of hypnosis substantially enhanced treatment outcome" (p.214). Kirsch reported a mean effect size (expressed as d) of 1.96. After correcting several transcription and computational inaccuracies in the original meta-analysis, these 6 studies yield a smaller mean effect size (.26). Moreover, if 1 questionable study is removed from the analysis, the effect sizes become more homogeneous and the mean (.21) is no longer statistically significant. It is concluded that the addition of hypnosis to CBT for weight loss results in, at most, a small enhancement of treatment outcome.

Amigo I, Cuesta V, Fernandez A, Gonzalez A The effect of verbal instructions on blood pressure measurement. Journal of Hypertension 1993 Mar;11(3):293-6 AIM: 

To determine whether orally delivered instructions can modify the intensity and direction of blood pressure and heart rate fluctuation. METHODS: The blood pressure of 120 subjects, 60 hypertensive and 60 normotensive, was measured before and after oral instructions. The normotensive subjects were selected from a sample of university students and the hypertensive patients were selected at a routine medical screening. Each sample of 60 subjects was randomly divided into four groups of 15. Each subject was left seated alone in a room for 5 min. The researcher then measured the subjects' blood pressure and heart rate. Following this, each group of normotensives and hypertensives was told that their blood pressure would diminish, or that it would not change or that it would increase. The control group was given no instructions. After 5 min the blood pressure and heart were measured again. RESULTS: In the normotensive and hypertensive groups who were told that their blood pressure would increase, systolic blood pressure increased by 4.3 and 2.5 mmHg, respectively. In the groups who were told that their blood pressure would decrease, systolic pressure fell by 7.8 and 7.4 mmHg, respectively. Those who were told that no change would occur showed a systolic pressure decrease of 3.5 and 1.8 mmHg, respectively. 

In the control groups systolic blood pressure decreased by 5.6 and 4.2 mmHg, respectively. CONCLUSIONS: These results show that oral instructions are a source of variation in the assessment of blood pressure and emphasize the need for 24-h blood pressure monitoring to eliminate this type of variation.

Anderson JA, Basker MA, Dalton R Migraine and hypnotherapy International Journal of Clinical & Experimental Hypnosis 1975;23(1):48-58 Compared the treatment of migraine by hypnosis and autohypnosis with the treatment of migraine by the drug prochlorperazine (Stemetil). Random allocation of 47 patients was made to one or other prophylactic measure, followed by monthly assessments and independent evaluation of 1 yr of continuous care. 

Criteria of improvement were the number of attacks/month, number who had Grade 4 attacks, and complete remission. Results show that the number of attacks and the number who suffered blinding attacks were significantly lower for the group receiving hypnotherapy than for the group receiving prochlorperazine. For the group on hypnotherapy, these 2 measures were significantly lower when on hypnotherapy than when on previous treatment. Prochlorperazine seemed about as effective as previous treatment. 10 out of 23 patients on hypnotherapy achieved complete remission during the last 3 mo of the trial, compared to only 3 out of 24 on prochlorperazine. It is concluded that further trials of hypnotherapy are justified against some other treatment not solely associated with the ingestion of tablets. (German, French, & Spanish summaries)

Anderson JA. Dalton ER. Basker MA. Insomnia and hypnotherapy. Journal of the Royal Society of Medicine 1979;72(10):734-9

Andreychuk T, Scriver C Hypnosis and biofeedback in the treatment of migraine headache Int J Clin Exp Hypn 1975; 23: 172-3

Anonymous. Hypnosis for asthma--a controlled trial. A report to the Research Committee of the British Tuberculosis Association. BMJ 1968;4(623):71-6 Investigated the use of hypnosis in the treatment of asthma in patients, 10-60 yr. old with paroxysmal attacks of wheezing or tight chest capable of relief by bronchodilators. 1 group was given hypnosis monthly and used autohypnosis daily for 1 yr. Comparisons were made with a control group prescribed a specially devised set of breathing exercises aimed at progressive relaxation. Treatment was randomly allocated and Subjects were treated by physicians in 9 centers. Results were assessed by daily diary recordings of wheezing and the use of bronchodilators, and by monthly recordings of forced expiratory volume (FEV) and vital capacity (VC). Independent clinical assessments were made by physicians unaware of Subjects' treatment. 176 out of 252 patients completed the program. Both treatment groups showed some improvement. Among men the assessments of wheezing score and use of bronchodilators showed similar improvement in the 2 groups; among women, however, those treated by hypnosis showed improvement similar to that observed in the men, but those given breathing exercises made much less progress, the difference between the 2 groups reaching statistical significance. Changes in FEV and VC between the control and hypnosis groups were closely similar. Independent clinical assessors considered the asthma to be better in 59% of the hypnosis group and in 43% of the controls, the difference being significant. There was little difference between the sexes. Physicians with previous experience of hypnosis obtained significantly better results than did those without such experience.

Ashton C Jr. Whitworth GC. Seldomridge JA. Shapiro PA. Weinberg AD.Michler RE. Smith CR. Rose EA. Fisher S. Oz MC. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. Journal of Cardiovascular Surgery 1997;38(1):69-75 

OBJECTIVE: The role of complementary medicine techniques has generated increasing interest in today's society. The purpose of our study was to evaluate the effects of one technique, self-hypnosis, and its role in coronary artery bypass surgery. We hypotesize that self-hypnosis relaxation techniques will have a positive effect on the patient's mental and physical condition following coronary artery bypass surgery. 

EXPERIMENTAL DESIGN: A prospective, randomized trial was conducted. Patients were followed beginning one day prior to surgery until the time of discharge from the hospital. 

SETTING: The study was conducted at Columbia Presbyterian Medical Center, a large tertiary care teaching institution. 

PATIENTS: All patients undergoing first-time elective coronary artery bypass surgery were eligible. A total of 32 patients were randomized into two groups. 

INTERVENTIONS: The study group was taught self-hypnosis relaxation techniques preoperatively, with no therapy in the control group. MEASURES: Outcome variables studied included anesthetic requirements, operative parameters, postoperative pain medication requirements, quality of life, hospital stay, major morbidity and mortality. RESULTS: Patients who were taught self-hypnosis relaxation techniques were significantly more relaxed postoperatively compared to the control group (p=0.032). Pain medication requirements were also significantly less in patients practising the self-hypnosis relaxation techniques that those who were noncompliant (p=0.046). No differences were noted in intraoperative parameters, morbidity or mortality. 

CONCLUSION: This study demonstrates the beneficial effects self-hypnosis relaxation techniques on patients undergoing coronary artery bypass surgery. It also provides a framework to study complementary techniques and the limitations encountered.

Ashton RC Jr. Whitworth GC. Seldomridge JA. Shapiro PA. Michler RE.Smith CR. Rose EA. Fisher S. Oz MC. The effects of self-hypnosis on quality of life following coronary artery bypass surgery: preliminary results of a prospective, randomized trial. Journal of Alternative & Complementary Medicine 1995;1(3):285-90 The effects of complementary techniques and alternative medicine on allopathic therapies is generating much interest and research. To properly evaluate these techniques, well controlled studies are needed to corroborate the findings espoused by individuals practicing complementary medicine therapies. To this end, we evaluated the role of one of these therapies, self-hypnosis relaxation techniques, in a prospective, randomized trial to study its effects on quality of life after coronary artery bypass surgery. Subjects were randomized to a control group or a study group. Study group patients were taught self-hypnosis relaxation techniques the night prior to surgery. 

The control group received no such treatment. Patients then underwent routine cardiac management and care. The main endpoint of our study was quality of life, assessed by the Profile of Moods Scale. Results demonstrated that patients undergoing self-hypnosis the night prior to coronary artery bypass surgery were significantly more relaxed than the control group (p = 0.0317). Trends toward improvement were also noted in depression, anger, and fatigue. 

This study demonstrates the beneficial effects of self-hypnosis relaxation techniques on coronary surgery. This study also identifies endpoints and a study design that can be used to assess complementary medicine therapies. Results of this preliminary investigation are encouraging and demonstrate a need for further well-controlled studies.

Attias J, Shemesh Z, Sohmer H, Gold S, Shoham C, Faraggi D Comparison between self-hypnosis, masking and attentiveness for alleviation of chronic tinnitus. Audiology 1993;32(3):205-12 The efficacy of self-hypnosis (SH), masking (MA) and attentiveness to the patient's complaints (AT) in the alleviation of tinnitus was evaluated. Forty-five male patients close in age with chronic tinnitus related to acoustic trauma were assigned to three matched subgroups: SH, AT or MA. 

The therapeutic stimuli in the SH and MA sessions, recorded on audio cassettes, were given to the patients for use when needed. SH significantly reduced the tinnitus severity; AT partially relieved the tinnitus; MA did not have any significant effect.

Aydin S. Ercan M. Caskurlu T. Tasci AI. Karaman I. Odabas O. Yilmaz Y. Agargun MY. Kara H. Sevin G. 

Acupuncture and hypnotic suggestions in the treatment of non-organic male sexual dysfunction. Scandinavian Journal of Urology & Nephrology 1997;31(3):271-4 We have examined the effects of acupuncture and hypnotic suggestions, and compared them with placebo in the treatment of male sexual dysfunction with no detectable organic cause. The study comprised 15 men (mean age 36.7 +/- 10.43 years) who received acupuncture treatment, 16 men (mean age 38.4 +/- 10.75 years) who underwent hypnosis (mean age 35.3 +/- 11.52 years) and 29 men (mean age 36.2 +/- 11.38 years) who served as controls. They were interviewed periodically; the patients' reports were verified by interviewing their partners. Men who received placebo had a 43-47% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of acupuncture and hypnotic suggestions were 60% and 75% respectively. Although the improvement was not statistically significant, treatment with acupuncture could be used as an adjuvant therapy in non-organic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.

Aydin S. Odabas O. Ercan M. Kara H. Agargun MY. 

Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction. British Journal of Urology. 1996;77(2):256-60 OBJECTIVE: To examine the effects of hypnotic suggestions or the administration of testosterone or trazodone to impotent men with no detectable organic cause for the impotence. 

PATIENTS AND METHODS: The study comprised 79 men in whom clinical and laboratory examinations revealed no organic cause for their impotence: 20 men (mean age 38.7 +/- 11.47 years) received testosterone, 21 men (mean age 39.5 +/- 10.73 years) received trazodone, 20 men (mean age 34.2 +/- 11.69 years) underwent hypnosis and 18 men (mean age 39.1 +/- 11.46 years) served as controls. They were assessed by interview 4, 6 and 8 weeks after starting treatment: the patient's reports were verified by interviewing their partners. 

RESULTS: Men who received a placebo had a 39% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of testosterone and trazodone treatment and hypnotic suggestions were 60%, 67% and 80%, respectively. 

CONCLUSION: Although the improvement was not statistically significant, treatment with testosterone and trazodone could be used as an adjuvant therapy in nonorganic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.

Baltar Lopez E La autorrelajacion como medio para reducir la algestesia en pruebas diagnosticas dolorosas Natura Medicatrix 1995;41:12-8 It taked place a study of painful perception and psycho-emotional component in two groups of patients in a random selection. It was made bone marrow biopsy and iliac crest myelogram in the patients. In the control group received a session of hypnosis of forty minutes; in this session were trained in autohypnosis technique to be applied in the moment of the painful tests. The comparison of outcomes shows a significant reduction of algesthesia and unpleasant emotions in the experimental group. 

The application of this technique was workable, effective and inexpensive.

Banerjee S. Srivastav A. Palan BM. 

and self-hypnosis in the management of nocturnal enuresis: a comparative study with imipramine therapy. American Journal of Clinical Hypnosis 1993;36(2):113-9 Various therapeutic modalities have been used for treating enuresis due to the lack of a single identifiable cause. We carried out a comparative study of imipramine and direct hypnotic suggestions with imagery used for the management of functional nocturnal enuresis. Enuretic children, ranging in age from 5 to 16 years, underwent 3 months of therapy with imipramine (N = 25) or hypnosis (N = 25). After termination of the active treatment, the hypnosis group continued practicing self-hypnosis daily during the follow-up period of another 6 months. Of the patients treated with imipramine, 76% had a positive response (all dry beds); for patients treated with hypnotic strategies, 72% responded positively. At the 9-month follow-up, 68% of patients in the hypnosis group maintained a positive response, whereas only 24% of the imipramine group did. Hypnosis and self-hypnosis strategies were found to be less effective in younger children (5-7 years old) compared to imipramine treatment. The treatment response was not related to the hypnotic responsivity of the patient in either group.

Barabasz AF. Treatment of insomnia in depressed patients by hypnosis and cerebral electrotherapy. 

American Journal of Clinical Hypnosis 1976;19(2):120-2 Investigated the influence of suggestion on recovery in the treatment of sleep disturbances by cerebral electrotherapy (CET). 60 adult psychiatric outpatients (diagnostic classification--mild depressive neurosis) were randomly assigned to 4 groups. Group A received CET only; Group B received a CET placebo; Group C received CET with hypnosis; and Group D received a CET placebo with hypnosis. Group A reported a significantly higher recovery than Group B, Group C a significantly higher recovery than Group A, and Group D a significantly higher recovery than Group B. No significant differences were found between Group C and Group D or between Group A and Group D. 

Findings support suggestion via passive hypnosis with CET as a powerful variable in the treatment of sleep disturbances with depressed patients.

Barber TX. Wilson SC. Hypnosis, suggestions, and altered states of consciousness: experimental evaluation of the new cognitive-behavioral theory and the traditional trance-state theory of "hypnosis". Annals of the New York Academy of Sciences 1977; 296:34-47 Sixty-six subjects were tested on a new scale for evaluating "hypnotic-like" experiences (The Creative Imagination Scale), which includes ten standardized test-suggestions (e.g. suggestions for arm heaviness, finger anesthesia, time distortion, and age regression). 

The subjects were randomly assigned to one of three treatment groups (Think- With Instructions, trance induction, and Control), with 22 subjects to each group. The new Cognitive-Behavioral Theory predicted that subjects exposed to preliminary instructions designed to demonstrate how to think and imagine along with the suggested themes (Think-With Instructions) would be more responsive to test-suggestions for anesthesia, time distortion, age regression, and so on, than subjects exposed to a trance- induction procedure. On the other hand, the traditional Trance State Theory predicted that a trance induction would be more effective than Think-With Instructions in enhancing responses to such suggestions. Subjects exposed to the Think-With Instructions obtained significantly higher scores on the test-suggestions than those exposed either to the traditional trance-induction procedure or to the control treatment. Scores of subjects who received the trance-induction procedure were not significantly different from those of the subjects who received the control treatment. 

The results thus supported the new Cognitive- Behavioral Theory and contradicted the traditional Trance State Theory of hypnosis. Two recent experiments, by De Stefano and by Katz, confirmed the above experimental results and offered further support for the Cognitive-Behavioral Theory. In both recent experiments, subjects randomly assigned to a "Think-With Instructions" treatment were more responsive to test-suggestions than those randomly assigned to a traditional trance-induction treatment.

Barkley RA. Hastings JE. Jackson TL. The effects of rapid smoking and hypnosis in the treatment of smoking behavior. International Journal of Clinical & Experimental Hypnosis 1977;25(1):7-17. 29 young adult volunteers were assigned to one of 3 treatment conditions and treated for their cigarette smoking over a 2-wk period. These conditions were group rapid smoking, group hypnosis, and an attention-placebo control group. All treatments produced significant reductions in average daily smoking rates during the treatment phase, but all Subjects returned to near baseline levels of smoking by the 6-wk follow-up. The rapid smoking and hypnosis groups did not differ from the control group in smoking rates at treatment termination or at the 6-wk follow-up. They also did not differ from the control group in the number of Subjects abstaining from smoking by treatment termination but did differ at follow-up. Eventually, at the 9-mo follow-up, only Subjects from the rapid smoking condition had significantly more abstainers than the control group. 

Results suggest that rapid smoking can work as effectively in group procedures as previous individualized approaches had demonstrated. Group hypnosis, while less effective than some previous individualized approaches had indicated, was only marginally less effective than the rapid smoking procedure. The use of abstinence rates as opposed to average rates of smoking is strongly recommended as the best measure of treament effectiveness for future research in this area. (German, French & Spanish summaries)

Beaugerie L. Burger AJ. Cadranel JF. Lamy P. Gendre JP. Le QuintrecY. Modulation of orocaecal transit time by hypnosis. Gut 1991;32(4):393-4 The ability of hypnosis to modulate the orocaecal transit time of 10 g lactulose was tested in six healthy volunteers. Orocaecal transit time was measured by the hydrogen breath test during three periods in random order. During the control period the subjects remained throughout the test in a semirecumbent position without moving. During the hypnotic relaxation period subjects were hypnotised before lactulose ingestion and were instructed to experience relaxation till the orocaecal transit time had elapsed. During the acceleration suggestion period subjects were hypnotised before lactulose ingestion and were repeatedly instructed to imagine the acceleration of lactulose through the intestine until transit time had elapsed. The mean orocaecal transit time was significantly longer during the hypnotic relaxation period (mean (SEM) 133 (8) min) than during the control period (93 (13) min). The mean orocaecal transit time during the acceleration suggestion period was 105 (26) minutes and was not significantly different from the mean transit time during the control period. The individual values during the acceleration suggestion period were scattered. We conclude that lactulose orocaecal transit time is delayed during hypnotic relaxation.

Bennett HL. Davis HS. Giannini JA. Non-verbal response to intraoperative conversation. British Journal of Anaesthesia 1985;57(2):174-9 In a double-blind study, 33 patients (herniorraphy, cholecystectomy and orthopaedic) were randomly assigned to either suggestion or control groups. Under known clinical levels of nitrous oxide and enflurane or halothane anaesthesia, suggestion patients were exposed to statements of the importance of touching their ear during a postoperative interview. Compared with controls, suggestion patients did touch their ear (tetrachoric correlation 0.61, P less than 0.001) and they did so more frequently (Mann-Whitney U test, P less than 0.02). All suggestion patients were completely amnesic for the intraoperative spoken suggestion, despite inquiries which included hypnotic regression to the operation.

Benson H. Frankel FH. Apfel R. Daniels MD. Schniewind HE. Nemiah JC. Sifneos PE. Crassweller KD. Greenwood MM. Kotch JB. Arns PA. Rosner B. Treatment of anxiety: a comparison of the usefulness of self-hypnosis and a meditational relaxation technique. An overview. Psychotherapy & Psychosomatics. 1978;30(3-4):229-42 We have investigated prospectively the efficacy of two nonpharmacologic relaxation techniques in the therapy of anxiety. A simple, meditational relaxation technique (MT) that elicits the changes of decreased sympathetic nervous system activity was compared to a self- hypnosis technique (HT) in which relaxation, with or without altered perceptions, was suggested. 32 patients with anxiety neurosis were divided into 2 groups on the basis of their responsivity to hypnosis: moderate-high and low responsivity. The MT or HT was then randomly assigned separately to each member of the two responsivity groups. Thus, 4 treatment groups were studied: moderate-high responsivity MT; low responsivity MT; moderate-high responsivity HT; and low responsivity HT. The low responsivity HT group, by definition largely incapable of achieving the altered perceptions essential to hypnosis, was designed as the control group. Patients were instructed to practice the assigned technique daily for 8 weeks. Change in anxiety was determined by three types of evaluation: psychiatric assessment; physiologic testing; and self-assessment. There was essentially no difference between the two techniques in therapeutic efficacy according to these evaluations. Psychiatric assessment revealed overall improvement in 34% of the patients and the self-rating assessment indicated improvement in 63% of the population. Patients who had moderate-high hypnotic responsivity, independent of the technique used, significantly improved on psychiatric assessment (p = 0.05) and decreased average systolic blood pressure from 126.1 to 122.5 mm Hg over the 8-week period (p = 0.048). The responsivity scores at the higher end of the hypnotic responsivity spectrum were proportionately correlated to greater decreases in systolic blood pressure (p = 0.075) and to improvement by psychiatric assessment (p = 0.003). 

There was, however, no consistent relation between hypnotic responsivity and the other assessments made, such as diastolic blood pressure, oxygen consumption, heart rate and the self-rating questionnaires. The meditational and self-hypnosis techniques employed in this investigation are simple to use and effective in the therapy of anxiety.

Blankfield RP. Zyzanski SJ. Flocke SA. Alemagno S. Scheurman K. Taped therapeutic suggestions and taped music as adjuncts in the care of coronary-artery-bypass patients. American Journal of Clinical Hypnosis. 1995;37(3):32-42 

A randomized, single-blinded, placebo-controlled trial examined the benefits of taped therapeutic suggestions and taped music in coronary-artery-bypass patients. Sixty-six patients listened to either suggestion tapes or music tapes, intraoperatively and postoperatively; 29 patients listened to blank tapes intraoperatively and listened to no tapes postoperatively. Half the patients who listened to a tape found it helpful. There were no significant differences between groups in length of SICU or postoperative hospital stay, narcotic usage, nurse ratings of anxiety and progress, depression, activities of daily living, or cardiac symptoms. There were no significant differences in these same outcomes between the patients who were helped by the tapes and the patients not helped. These results suggest that if taped therapeutic suggestions have a measurable effect upon cardiac surgery patients, demonstrating this effect will require more detailed patient evaluations to identify subgroups of patients responsive to this type of intervention.

Block RI. Ghoneim MM. Sum Ping ST. Ali MA. Efficacy of therapeutic suggestions for improved postoperative recovery presented during general anesthesia. Anesthesiology 1991;75(5):746-55 

There have been claims that the postoperative course of patients may be improved by presentation during general anesthesia of therapeutic suggestions which predict a rapid and comfortable postoperative recovery. This study evaluated the effectiveness of such therapeutic suggestions under double-blind and randomized conditions. A tape recording predicting a smooth recovery during a short postoperative stay without pain, nausea, or vomiting was played during anesthesia to about half the patients (N = 109), while the remaining, control patients were played a blank tape instead (N = 100). The patients were primarily undergoing operations on the fallopian tubes, total abdominal hysterectomy, vertical banding gastroplasty, cholecystectomy, and ovarian cystectomy or myomectomy. The anesthesia methods consisted of either isoflurane with 70% nitrous oxide in oxygen to produce end-tidal concentrations of 1.0, 1.3, or 1.5 MAC; or 70% nitrous oxide in oxygen combined with high or low doses of opioids. Assessments of the efficacy of the therapeutic suggestions in the recovery room and throughout the postoperative hospital stay included: the frequency of administration of analgesic and antiemetic drugs; opioid doses; the incidence of fever; nausea, retching, and vomiting; other gastrointestinal and urinary symptoms; ratings of pain; ratings of anxiety; global ratings of the patients' physical and psychological recoveries by the patients and their nurses; and length of postoperative hospital stay. There were no meaningful, significant differences in postoperative recovery of patients receiving therapeutic suggestions and controls. These negative results were not likely to be due to insensitivity of the assessments of recovery, as they showed meaningful interrelations among themselves and numerous differences in recovery following different types of surgery. Widespread utilization of therapeutic suggestions as a routine operating room procedure seems premature in the absence of adequate replication of previously published positive studies.

Boeke S. Bonke B. Bouwhuis-Hoogerwerf ML. Bovill JG. Zwaveling A. Effects of sounds presented during general anaesthesia on postoperative course. British Journal of Anaesthesia 1988;60(6):697-702 In a double-blind, randomized study, patients undergoing cholecystectomy were administered one of four different sounds during general anaesthesia: positive suggestions, nonsense suggestions, seaside sounds or sounds from the operating theatre. The effect of these sounds on the postoperative course was examined to assess intraoperative auditory registration. No differences were found between the four groups in postoperative variables.

Bonke B, Schmitz PI, Verhage F, Zwaveling 

A Clinical study of so-called unconscious perception during general anaesthesia British Journal of Anaesthesia 1986;58(9):957-64 Ninety-one patients undergoing biliary tract surgery were randomly assigned to one of three treatment groups in which different sounds were administered, by means of earphones, in a double-blind design. The effects of the administration of positive suggestions, noise or operating theatre sounds on the postoperative course were studied. Results showed that exposure to positive suggestions during general anaesthesia, as compared with noise or operating theatre sounds, protected patients older than 55 yr against prolonged postoperative stay in hospital.

Bonke B. Van Dam ME. Van Kleff JW. Slijper FM. 

Implicit memory tested in children during inhalation anaesthesia. Anaesthesia 1992;47(9):747-9 Memory for stimuli presented during inhalation anaesthesia was tested in 80 children undergoing eye surgery. Two groups were exposed, in a random double-blind study, to repeated neutral phrases including either the colour orange or green. A postoperative colouring task was used as a test of implicit memory to detect any preference for the colour named under anaesthesia. No colour preference attributable to implicit memory could be demonstrated. One patient had a distinct preference for the named colour. No patient remembered any intra-operative events.

Bornstein PH. Devine DA. Covert modeling-hypnosis in the treatment of obesity. Psychotherapy: Theory, Research Practice 1980;17(3):272-276. Investigated the efficacy of a covert modeling/hypnosis treatment package in the control of obesity. 48 overweight female volunteers (who had been administered the Harvard Group Scale of Hypnotic Susceptibility, Eating Patterns Questionnaire, and Rotter's Internal-External Locus of Control Scale) were randomly assigned to 1 of the following groups: (a) covert modeling/hypnosis, (b) covert modeling, (c) no-model scene control, and (d) minimal treatment (where Subjects received a shortened version of the covert modeling/hypnosis procedure following an 8-wk no-treatment period). Results indicate a significant effect for weight loss from pretreatment to follow-up across all groups combined. Proportion weight loss measures indicated significantly greater weight loss only for the covert modeling/hypnosis group as compared to the no-model controls. Implications for combining behavior therapy and hypnotic techniques are discussed.

Boutin GE. Tosi DJ. Modification of irrational ideas and test anxiety through rational stage directed hypnotherapy RSDH. Journal of Clinical Psychology 1983;39(3):382-91 Examined the effects of four treatment conditions on the modification of Irrational Ideas and test anxiety in female nursing students. The treatments were Rational Stage Directed Hypnotherapy, a cognitive behavioral approach that utilized hypnosis and vivid-emotive-imagery, a hypnosis-only treatment, a placebo condition, and a no-treatment control. The 48 Ss were assigned randomly to one of these treatment groups, which met for 1 hour per week for 6 consecutive weeks with in-vivo homework assignments also utilized. Statistically significant treatment effects on cognitive, affective, behavioral, and physiological measures were noted for both the RSDH and hypnosis group at the posttest and at a 2-month follow-up. Post-hoc analyses revealed the RSDH treatment group to be significantly more effective than the hypnosis only group on both the post- and follow-up tests. The placebo and control groups showed no significant effects either at post-treatment or at follow-up.

Bregman NJ. McAllister HA. Role of suggestions in digital skin temperature: implications for temperature biofeedback research. International Journal of Neuroscience 1985;27(1-2):115-20 The purpose of the present experiment was to explore the role suggestions and assessment procedures play in affecting digital skin temperature. Four different types of suggestions were given subjects (warm, cool, pseudo (electronic terms), and no suggestions). Twenty-five subjects were randomly assigned to the four experimental conditions. The data were analyzed by three popular assessment procedures typically found in the literature. As predicted, subjects displayed significant decreases in skin temperature each day regardless of the training condition they were in. The assessment procedures produced differential results.

Brodeur JB, Kurtz RM, Strube MJ Hypnotic susceptibility order effects in walking analgesia Int J Clin Exp Hypn 1998 Jul;46(3):240-9 This study reexamined Spanos, Hodgins, Stam, and Gwynn's (1984) contention that susceptibility testing order effects generated a relationship between walking analgesia pain reduction and level of hypnotic responsiveness. Undergraduate volunteers with no previous hypnosis experience were randomly assigned to 2 groups. Group 1 (n = 69) first received a cold pressor pain protocol, and then was administered the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C). Group 2 (n = 69) was administered the SHSS:C prior to the cold pressor pain protocol. Our findings do not support Spanos, Hodgins et al.'s contention that sucsceptibility testing order effects generate the often reported relationship between walking analgesia and level of hypnotic responsiveness. We found significant partial correlation coefficients between the SHSS:C and nonhypnotic pain reduction regardless of order of susceptibility testing. Implications regarding the adequacy of design-generated expectancies to explain hypnotic analgesia phenomena were examined.

Bruck M. Ceci SJ. Francoeur E. Barr R. "I hardly cried when I got my shot:" Influencing children's reports about a visit to their pediatrician. Child Development 1995;66(1):193-208 We examined, in 2 phases, the influence of postevent suggestions on children's reports of their visits to a pediatrician. Phase 1 examined the effect of giving one of 3 types of feedback to 5-year-old children immediately following their Diphtheria Pertussis Tetanus (DPT) inoculation. Children were given pain-affirming feedback (the shot hurt), pain-denying feedback (the shot did not hurt), or neutral feedback (the shot is over). 1 week later, they did not differ in their reports concerning how much the shot hurt or how much they cried. In Phase 2, the same children were visited approximately 1 year after their inoculation. During 3 separate visits, they were either given additional pain-denying or neutral feedback. 

They were also given misleading or nonmisleading information about the actions of the pediatrician and the assistant. Children given pain-denying feedback reported that they cried less and that the shot hurt less than did children given neutral feedback. Those who were given misleading information about the actions of the assistant and the pediatrician made more false allegations about their actions than did children who were not given this information. These results challenge the view that suggestibility effects are confined to peripheral, nonaction events; in this study children's reports about salient actions involving their own bodies in stressful conditions were influenced.

Buchser E. Burnand B. Sprunger AL. Clemence A. Lepage C. Martin Y.Chedel D. Guex P. Sloutskis D. Rumley R. Hypnosis and self-hypnosis, administered and taught by nurses, for the reduction of chronic pain: a controlled clinical trial. Schweizerische Medizinische Wochenschrift - Supplementum 1994;62:77-81 Hypnosis is a technique whereby an individual can reach a particular state, quite unrelated to sleep, characterized by aroused, attentive and focused concentration. Although there are numerous clinical applications of hypnosis, there are virtually no controlled clinical trials to support its effectiveness. We propose a controlled randomized clinical trial comparing a "control" group of chronic pain patients treated by a programme including conventional oral medication combined with various nerve blocks and/or spinal administration of drugs, with a "treatment" group having a similar treatment programme plus hypnosis carried out by nurses. Outcome measurements include mainly the variation of pain intensity, the amount of analgesic drug consumption, spontaneous physical activity, and the change in health-related quality of life. The assessment of the outcome variable is done at the initial workup, weekly for the first 3 weeks, and at 6 and 12 weeks. A follow-up survey is conducted at 6 months.

Campbell DF. Dixon JK. Sanderford LD. Denicola MA. Relaxation: its effect on the nutritional status and performance status of clients with cancer. Journal of the American Dietetic Association 1984;84(2):201-4 Relaxation was used to promote normal food consumption patterns among persons with cancer. As part of a larger study, 22 persons with cancer were randomly assigned to receive instruction and reinforcement in a relaxation technique to be used preprandially. The relaxation procedure included four components: (a) deep abdominal breathing, (b) tensing and relaxing of various body parts, (c) relaxation by autosuggestion, and (d) voluntary image control. Twelve clients complied with relaxation instructions in part, and 10 did not.

Among compliers, 75% experienced desirable weight change over a six-week period. Performance status, measured by the Karnofsky scale, improved for 33% and worsened for 17% over eight weeks. Research has shown relaxation to be an effective measure in relation to pain, hypertension, and other conditions. These preliminary results now suggest that relaxation may also be effective in treating the eating problems of the person with cancer, leading to improvement in weight and performance status.

Cochrane G. Friesen J. Hypnotherapy in weight loss treatment. Journal of Consulting & Clinical Psychology 1986;54(4):489-92 Investigated the effects of hypnosis as a treatment for weight loss among women. The sample consisted of 60 women (aged 20-65 yrs) who were at least 20% overweight and were not in any other treatment program. Six client variables (suggestibility, self-concept, quality of family origin, age of obesity onset, education level, and socioeconomic status (SES)) and 1 process variable (multimodal imagery) were analyzed in relation to the dependent variable (weight loss). Two experimental groups, hypnosis plus audiotapes and hypnosis without audiotapes, and the control group were investigated for weight loss immediately after treatment and again after a 6-mo follow-up. The primary hypothesis that hypnosis is an effective treatment for weight loss was confirmed, but the 7 concomitant variables and the use of audiotapes were not significant contributors to weight loss.

Colgan SM, Faragher EB, Whorwell PJ Controlled trial of hypnotherapy in relapse prevention of duodenal ulceration Lancet 1988;1(8598):1299-300 30 patients with rapidly relapsing duodenal ulceration were studied to assess the possible benefit of hypnotherapy in relapse prevention. After the ulcer had healed on treatment with ranitidine, the drug was continued for a further 10 weeks during which time patients received either hypnotherapy or no hypnotherapy. The two randomly selected groups were comparable in terms of age, sex, smoking habits, and alcohol consumption. Follow-up of both groups of patients was continued for 12 months after the cessation of ranitidine. After 1 year, 8(53%) of the hypnotherapy patients and 15(100%) of the control subjects had relapsed. The results of this study suggest that hypnotherapy may be a useful therapeutic adjunct for some patients with chronic recurrent duodenal ulceration.

Council JR. Kirsch I. Vickery AR. Carlson D. "Trance" versus "skill" hypnotic inductions: the effects of credibility, expectancy, and experimenter modeling. Journal of Consulting & Clinical Psychology 1983;51(3):432-40 A hypnotic induction procedure based on social learning principles (skill induction) was compared with a traditional eye-fixation/relaxation trance induction, a highly credible placebo induction, and a no induction base rate control. The trance induction surpassed the skill induction only on the Field Inventory, a measure of hypnotic depth that contains items corresponding to suggestions contained in the trance induction. Experimenter modeling was not found to enhance the effectiveness of the skill induction. Skill and trance inductions elicited slightly higher behavioral scores on the Stanford Hypnotic Susceptibility Scale: Form C than did the placebo induction. However, this difference was not obtained on other measures of hypnotic responsivity and depth. Significant correlations were found between expectancy, absorption, and responsiveness on all dependent measures. Multiple regression analyses indicated that the relationship between absorption and responsivity was mediated by expectancy. The results are interpreted as supporting the hypotheses that hypnotic responses are elicited by the expectancy for their occurrence and that induction procedures are a means of increasing subjects' expectancies for hypnotic responses.

Crawford HJ. Allen SN. Paired-associate learning and recall of high and low imagery words: moderating effects of hypnosis, hypnotic susceptibility level, and visualization abilities. American Journal of Psychology. 1996;109(3):353-72 Relationships between recall of low and high imagery paired-associate (P-A) words and hypnotic susceptibility, and the influence of hypnosis on recall as moderated by hypnotic level were examined. Subjects were assessed on 2 hypnotic susceptibility scales [Harvard Group Scale of Hypnotic Susceptibility; Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C)]. Forty-one low (0-4 SHSS:C) and 41 highly (9-12 SHSS:C) hypnotizable college students were assigned to 1 of 4 experimental groups: waking-hypnosis, hypnosis-waking, waking-waking, or hypnosis-hypnosis. Recall was significantly better for high than low imagery words. In the more sensitive within-subjects design, high hypnotizables recalled more P-A words during hypnosis than waking, and lows did not differ. In the between-subjects design, hypnotic level was not a moderator of performance during hypnosis. Low hypnotizables recalled more words in the within-subjects design. Visualization ability was a poor moderator of imagery-mediated learning. High imagery recall correlated significantly with Marks's (1973) Vividness of Visual Imagery Questionnaire (.25) and Paivio and Harshman's (1983) Individual Differences Questionnaire (IDQ) Verbal scale (.29 1973;), but not with the IDQ Imagery scale, the 

Mental Rotations Test (Vandenberg & Kuse

Crawford HJ. Harrison DW. Kapelis L. Visual field asymmetry in facial affect perception: moderating effects of hypnosis, hypnotic susceptibility level, absorption, and sustained attentional abilities. International Journal of Neuroscience. 1995;82(1-2):11-23 Effects of hypnotic level, affect valence and cerebral asymmetry on reaction time (RT) in the discrimination of Ekman and Friesen's (1978) stimuli of angry and happy faces were studied in counterbalanced conditions of waking and hypnosis. Assessed previously on two hypnotic susceptibility scales [Harvard Group Scale of Hypnotic Susceptibility; Stanford Hypnotic Susceptibility Scale, Form C (SHSSC)], non-depressed subjects were 16 low (0-4 SHSSC) and 17 highly (10-12 SHSSC) hypnotizable, right-handed college students. Subjects were required to identify affects of faces, presented tachistoscopically to left (LVF) or right (RVF) visual fields, by using a forced-choice RT paradigm. Highs were significantly faster than lows in angry and happy affect recognition. Hypnosis had no significant effects. For highs only, angry emotional valence was identified faster when presented to the right hemisphere (LVF), but there were no significant hemispheric effects for happy emotional valence. For lows there were no hemispheric differences. Gender was a nonsignificant factor. Significant correlations showed that faster reaction times to angry and happy stimuli, in both LVF and RVF in waking and hypnosis, were obtained by subjects who reported more deeply absorbed and extremely focused and sustained attention on the Tellegen (1982) Absorption Scale and a subscale of the Differential Attentional Processes Inventory (Grumbles & Crawford, 1981). Vividness of Visual Imagery Questionnaire (Marks, 1973) and Affect Intensity Measure (Larsen, 1985), in general, did not correlate with RTs. The potential role of the fronto-limbic attentional system in the recognition of external visual sensory affect is discussed.

Crawford HJ. Macdonald H. Hilgard ER. Hypnotic deafness: a psychophysical study of responses to tone intensity as modified by hypnosis. American Journal of Psychology 1979;92(2):193-214 Hypnotic deafness was suggested for 1000 Hz tones presented in random orders at seven intensities between 17 and 70 db. Subjects were 70 college students stratified into four levels of hypnotic susceptibility, ranging from low to high. Four conditions were presented within a single session. Two conditions tested normal hearing, one in waking and one in hypnosis; two tested reported loudness of the tones as reduced by hypnotic suggestion. The method of magnitude estimation was employed. Hearing reduction was found to correlate .59 with hypnotic susceptibility in the total sample. Few high hypnotizables reduced their hearing to zero; their mean residual hearing during the deafness conditions was 55% of normal. Power functions for the relationship between tone intensity and magnitude estimates for conditions of normal hearing and deafness were found to be relatively parallel and orderly, differing primarily in intercept value. Order effect anomalies are discussed. The "hidden observer" method showed that for 4 of the 70 subjects the covert hearing was found to be at least 20% greater than that reported overtly within hypnotic deafness and approached normal hearing. As in our previous hypnotic analgesia research, not all subjects who reduced their hearing significantly gave subsequent covert reports which differed from reported overt hearing. Discussion is given for evidence of two levels of information processing during hypnotically suggested perceptual distortions.

Crowther JH. Stress management training and relaxation imagery in the treatment of essential hypertension. Journal of Behavioral Medicine 1983;6(2):169-87 The present study compared the effectiveness of three procedures in the treatment of 34 individuals with essential hypertension: (1) stress management training plus relaxation imagery, which consisted of an adaptation of existing stress management techniques in conjunction with extensive relaxation training using relaxation imagery; (2) relaxation imagery alone; and (3) weekly blood pressure checks. The relaxation imagery technique involved visualization of a relaxing image along with concentration on suggestions of relaxation, heaviness, and warmth. Treatment was individualized and lasted 8 weeks. Results indicated stress management plus relaxation imagery and relaxation imagery alone were significantly more effective than blood pressure checks in reducing systolic and diastolic blood pressures during treatment and in maintaining diastolic blood pressure reductions during follow-up. However, no significant differences were found between the two treatment procedures. Clinical implications of these findings are discussed.

Cruise CJ. Chung F. Yogendran S. Little D. Music increases satisfaction in elderly outpatients undergoing cataract surgery. Canadian Journal of Anaesthesia 1997;44(1):43-8 PURPOSE: Music has long been known to reduce anxiety, minimize the need for sedatives, and make patients feel more at ease. The purpose of the study was to evaluate the effect of music in elderly outpatients undergoing elective cataract surgery with retrobulbar block and monitored anaesthetic care using fentanyl or alfentanil and midazolam. METHODS: One hundred and twenty one patients were prospectively and randomly assigned to hear: relaxing suggestions, white noise, operating room noise or relaxing music via audio-cassette headphones. Vital signs were documented before and after retrobulbar block and every 15 min thereafter. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before and after surgery. Visual analogue scales (VAS) were used to assess anxiety and patient satisfaction postoperatively with a standardized questionnaire. Between group comparisons were made using Chi-Square, or ANOVA, where appropriate. RESULTS: There were no differences between groups in STAI or anxiety VAS scores at any time. Differences were noted in systolic blood pressure, but not in other vital signs. Patients' ratings of the whole operative experience, satisfaction with the tape played, general level of relaxation and preference for the chosen tape for subsequent surgery were different (music > relaxing suggestions > white noise and OR noise, P < 0.05). CONCLUSIONS: Elderly patients undergoing cataract surgery under retrobulbar block were more satisfied with their experience if they heard relaxing music, rather than relaxing suggestions or white noise or OR noise. The type of auditory stimuli to which the patients were exposed did not influence the level of anxiety.

Dahlgren LA. Kurtz RM. Strube MJ. Malone MD. Differential effects of hypnotic suggestion on multiple dimensions of pain. Journal of Pain & Symptom Management. 1995;10(6):464-70 Within the framework of multidimensional pain assessment, this study extended an earlier finding that hypnotic analgesia and relaxation suggestions have differential effects on pain reduction by evaluating these strategies in subjects undergoing a cold pressor protocol. Thirty-two highly susceptible subjects were randomly assigned to an analgesia or a relaxation suggestion treatment group. Six pain reports were taken at 10-sec intervals for each experimental condition. The baseline measures served as covariates. A 2 x 2 x 2 x 6 repeated-measures analysis of covariance (ANCOVA) revealed a significant group (analgesia, relaxation) by pain dimension (intensity, unpleasantness), by condition (suggestion alone, hypnotic induction plus suggestion) interaction. Analysis of the simple-simple main effects, holding both group and condition constant, revealed that application of hypnotic analgesia reduced report of pain intensity significantly more than report of pain unpleasantness. Conversely, hypnotic relaxation reduced pain unpleasantness more than intensity. The clinical implications of the study are discussed.

De Pascalis V. Caddia F. Effect of suggestion on perception: replication of Gheorghiu and Reyher's study. Perceptual & Motor Skills 1985;61(1):123-30 Gheorghiu and Reyher in 1982 described a Scale of Sensory Suggestibility consisting of an indirect-direct method of assessing suggestibility. In this study a further sample of 81 women was tested on Gheorghiu and Reyher's scale. The scale has tactual, auditory, and visual items. Each item was administered to the left and right sides of the body in random sequence and the method of presentation was varied. The scale is indirect in that the announced stimuli are never presented to participants, contrary to their expectations; it is direct because the subjects are cautioned that a stimulus might not actually be presented. The scale showed acceptable internal consistency. There were no right-left side differences. 

The methods of presentation were not equally successful. Progressive Intensification and Progressive Decrease in Intensification of stimulation were the most successful, whereas Expectation of series without objective stimuli was the least successful, contrary to Georghiu and Reyher's results. Finally, item analysis showed that all the items had high reliability coefficients, except two auditory and one visual items. Implications for clinical practice were discussed.

DeBenedittis G. Cigada M. Bianchi A. Signorini MG. Cerutti S. Autonomic changes during hypnosis: a heart rate variability power spectrum analysis as a marker of sympatho-vagal balance. International Journal of Clinical & Experimental Hypnosis 1994;42(2):140-52 Spectral analysis of beat-to-beat variability in electrocardiography is a simple, noninvasive method to analyze sympatho-vagal interaction. The electrocardiogram is analyzed by means of an automatic, autoregressive modeling algorithm that provides a quantitative estimate of R-R interval variability by the computation of power spectral density. Two major peaks are recognizable in this specter: a low-frequency peak (LF, -0.1 Hz), related to the overall autonomic activity (ortho+parasympathetic) and a high-frequency peak (HF, -0.25 Hz), representative of the vagal activity. The LF/HF ratio is an index of the sympatho-vagal interaction. This technique was applied, using a computer-assisted electrocardiograph, to 10 healthy volunteers (6 high and 4 low hypnotizable subjects as determined by the Stanford Hypnotic Susceptibility Scale, Form C) in randomized awake and neutral hypnosis conditions. Preliminary results indicated that hypnosis affects heart rate variability, shifting the balance of the sympatho-vagal interaction toward an enhanced parasympathetic activity, concomitant with a reduction of the sympathetic tone. A positive correlation between hypnotic susceptibility and autonomic responsiveness during hypnosis was also found, with high hypnotizable subjects showing a trend toward a greater increase of vagal efferent activity than did low hypnotizables.

Dikel W. Olness K. Self-hypnosis, biofeedback, and voluntary peripheral temperature control in children. Pediatrics 1980;66(3):335-40 Forty-eight children, aged 5 to 15 years, were tested for their ability to raise and lower their index finger temperature with self-hypnosis and/or biofeedback. Group A (self-hypnosis only) and group B (self-hypnosis with biofeedback) were children who had previous successful experience with self-hypnosis (eg, for the treatment of enuresis, pain, asthma, or obesity). Group C (biofeedback only) were children with no experience with hypnosis. All three groups showed significant success with warming and cooling. The range of warming for the three groups was 0 to 3.7 F, and for cooling, 0 to 7.3 F or 0 to 8.8 F for attempts exceeding the ten-minute trial period. No significant difference in ability to warm or cool was noted when the children were compared by group, age, or sex. Some of the children in group A who had little or no success with hypnosis only were very successful with the addition of biofeedback monitoring, suggesting a synergistic effect between biofeedback and hypnosis. A significant temperature rise was also noted in groups A and B accompanying a neutral hypnotic induction relaxation-imagery exercise in which no mention of temperature change was made. This rise varied from 0 to 6 F, averaging 1.7 F. Possible therapeutic implications include the treatment of migraine headaches, Raynaud's syndrome, sickle cell anemia, and the use of temperature monitoring as a diagnostic and therapeutic adjunct to clinical hypnosis.

Disbrow EA. Bennett HL. Owings JT. Effect of preoperative suggestion on postoperative gastrointestinal motility Western Journal of Medicine. 1993;158(5):488-92 Autonomic behavior is subject to direct suggestion. We found that patients undergoing major operations benefit more from instruction than from information and reassurance. We compared the return of intestinal function after intra-abdominal operations in 2 groups of patients: the suggestion group received specific instructions for the early return of gastrointestinal motility, and the control group received an equal-length interview offering reassurance and nonspecific instructions. The suggestion group had a significantly shorter average time to the return of intestinal motility, 2.6 versus 4.1 days. Time to discharge was 6.5 versus 8.1 days. Covariates including duration of operation, amount of intraoperative bowel manipulation, and amount of postoperative narcotics were also examined using the statistical model analysis of covariance. An average savings of $1,200 per patient resulted from this simple 5-minute intervention. In summary, the use of specific physiologically active suggestions given preoperatively in a beleivable manner can reduce the morbidity associated with an intra-abdominal operation by reducing the duration of ileus.

Donk LJ. Vingoe FJ. Hall RA. Doty R. The comparison of three suggestion techniques for increasing reading efficiency utilizing a counterbalanced research paradigm. International Journal of Clinical & Experimental Hypnosis 1970;18(2):126-133. Reports an experiment in which both Barber-type and alert-trance procedures significantly increased reading speed while maintaining comprehension when compared to a control group; a traditional hypnotic procedure followed by the specific suggestions failed to obtain these results. 32 volunteer undergraduates were randomly assigned to 4 groups in terms of a counterbalanced design. 2 groups were administered trance inductions (traditional and alert) followed by specific suggestions, a 3rd simply the suggestions, while the 4th served as control. Reading suggestions were to eliminate specific problems, increase speed, and increase or maintain comprehension. (Spanish & German summaries)

Dubreuil DL. Spanos NP. Bertrand LD. Does hypnotic amnesia dissipate with time? Imagination, Cognition Personality 1982;832(2):103-113. Investigated, in 2 experiments, the hypothesis that hypnotic amnesia dissipates "spontaneously" over time. Subjects were 94 undergraduates (mean age 19 yrs) who obtained scores of 2 or above on the Objective dimension of a responsiveness to suggestion scale. Subjects were assigned at random to 4 groups. Subjects in the Remember More, Remember Less, and Retest control groups showed partial amnesia on the 1st of their 2 challenge trials. After the administration of a hypnotic amnesia suggestion for a previously learned word list, Retest Subjects in Exp I received 2 successive recall challenges before cancellation of the suggestion. Delay Subjects received only 1 challenge. It occurred at the same time that Retest Subjects received the 2nd challenge. No differences in amount of amnesia were found between the Delay trial and either of the Retest trials, thereby failing to provide support for the dissipation hypothesis. Exp II manipulated Subjects' expectations concerning the amount of amnesia typically shown on a 2nd challenge. Subjects in the Remember More or Remember Less conditions were led to believe that they would recall either more or less critical material on the 2nd amnesia challenge. Both Retest (no expectancy) and Remember More Subjects recalled significantly more words on the 2nd challenge than on the 1st one. However, a significantly greater proportion of Remember More Subjects than Retest Subjects showed recall increments on the 2nd challenge. Results do not support the dissipation hypothesis of hypnotic amnesia.

Eberhart LH. Doring HJ. Holzrichter P. Roscher R. Seeling W. Therapeutic suggestions given during neurolept-anaesthesia decrease post-operative nausea and vomiting. European Journal of Anaesthesiology 1998;15(4):446-52 A double-blind randomized study was performed in 100 patients undergoing thyroidectomy to evaluate the effect of positive therapeutic suggestions made during neurolept-anaesthesia. The classic droperidol-fentanyl-N2O technique was used as these drugs preserve the neurophysiological functions required to process the information in the therapeutic suggestions given during general anaesthesia. Patients in the suggestion group heard positive non-affirmative suggestions during the whole operation. An autoreverse tape player was used. The control group listened to an empty tape. Both groups were comparable with respect to demographic variables, anaesthetic technique, drug dosage, duration of anaesthesia and surgery. Patients in the suggestion group suffered significantly less from post-operative nausea or vomiting (suggestion: 47.2% vs. control: 85.7%) and required less anti-emetic treatment (suggestion: 30.6% vs. control: 68.6%). We conclude that therapeutic suggestions heard during neurolept-anaesthesia are processed and decrease post-operative nausea and vomiting in patients after thyroidectomy.

Echterling LG. Whalen J. Stage hypnosis and public lecture effects on attitudes and beliefs regarding hypnosis. American Journal of Clinical Hypnosis. 1995;38(1):13-21 Stage hypnosis shows, designed to entertain and amaze, and public lectures, designed to explain and educate, provide dramatically different introductions to hypnosis. This study examined how audience members' attitudes and beliefs regarding hypnosis are affected by these two different experiences. Two hundred and five college students completed pretest measures before either watching a stage hypnosis show, or attending a lecture on hypnosis, or participating in a control group. Subjects completed posttest measures between one to three weeks later. Both the stage hypnosis show and the lecture increased attendees' motivation to use hypnosis in treatment and decreased their belief that hypnotizability reflects lower intelligence. Moreover, the lecture also increased beliefs that hypnotizability reflects creativity and inner strength. Finally, while the lecture reduced the belief that a hypnotized person is robotlike and automatically acts on all suggestions, the stage hypnosis show increased this attitude among its audience members.

Enqvist B. Bjorklund C. Engman M. Jakobsson J. Preoperative hypnosis reduces postoperative vomiting after surgery of the breasts. A prospective, randomized and blinded study. Acta Anaesthesiologica Scandinavica 1997;41(8):1028-32 BACKGROUND: Postoperative nausea and vomiting (PONV) after general anesthesia and surgery may have an incidence as high as 70% irrespective of antiemetic drug therapy. The use of preoperative hypnosis and mental preparation by means of an audio tape was investigated in the prophylaxis of nausea and vomiting before elective breast reduction surgery. Similar interventions have not been found in the literature. METHODS: Fifty women were randomized to a control group or a hypnosis group; the latter listened to an audio tape daily 4-6 days prior to surgery. A hypnotic induction was followed by suggestions as to how to relax and experience states incompatible with nausea and vomiting postoperatively (e.g. thirst and hunger). There was a training part on the tape where the patients were asked to rehearse their own model for stress reduction. Premedication and anesthetic procedures were standardized. RESULTS: Patients in the hypnosis group had significantly less vomiting, 39% compared to 68% in the control group, less nausea and less need of analgesics postoperatively. CONCLUSIONS: Preoperative relaxation and/or hypnotic techniques in breast surgery contribute to a reduction of both PONV and postoperative analgesic requirements.

Enqvist B. Fischer K. Preoperative hypnotic techniques reduce consumption of analgesics after surgical removal of third mandibular molars: a brief communication. International Journal of Clinical & Experimental Hypnosis 1997;45(2):102-8 The effects of hypnosis in connection with surgery have been described in many clinical publications, but few controlled studies have been published. The aim of the present study was to evaluate the effects of preoperative hypnotic techniques used by patients planned for surgical removal of third mandibular molars. The patients were randomly assigned to an experimental (hypnotic techniques) or a control (no hypnotic techniques) group. During the week before the surgery, the experimental group listened to an audiotape containing a hypnotic relaxation induction. Posthypnotic suggestions of healing and recovery were given on the tape together with advice regarding ways to achieve control over stress and pain. The control group received no hypnotic intervention. Only one surgeon who was not aware of patient group assignments performed all the operations. Thirty-six patients in the control group were compared to 33 patients in the experimental group. Anxiety before the operation increased significantly in the control group but remained at baseline level in the experimental group. Postoperative consumption of analgesics was significantly reduced in the experimental group compared to the control group.

Enqvist B. von Konow L. Bystedt H. Pre- and perioperative suggestion in maxillofacial surgery: effects on blood loss and recovery. International Journal of Clinical & Experimental Hypnosis 1995;43(3):284-94 The basic assumption underlying the present study was that emotional factors may influence not only recovery but also blood loss and blood pressure in maxillofacial surgery patients, where the surgery was performed under general anesthesia. Eighteen patients were administered a hypnosis tape containing preoperative therapeutic suggestions, 18 patients were administered hypnosis tapes containing pre- and perioperative suggestions, and 24 patients were administered a hypnosis tape containing perioperative suggestions only. The patients who received taped suggestions were compared to a group of matched control patients. The patients who received preoperative suggestions exhibited a 30% reduction in blood loss. A 26% reduction in blood loss was shown in the group of patients receiving pre- and perioperative suggestions, and the group of patients receiving perioperative suggestions only showed a 9% reduction in blood loss. Lower blood pressure was found in the groups that received pre- and perioperative and perioperative suggestions only. Rehabilitation was facilitated in the group of patients receiving perioperative suggestions only.

Ernst E. Rand JI. Stevinson C. Complementary therapies for depression: an overview. Archives of General Psychiatry 1998;55(11):1026-32 Depression is one of the most common reasons for using complementary and alternative therapies. The aim of this article is to provide an overview of the evidence available on the treatment of depression with complementary therapies. Systematic literature searches were performed using several databases, reference list searching, and inquiry to colleagues. Data extraction followed a predefined protocol. The amount of rigorous scientific data to support the efficacy of complementary therapies in the treatment of depression is extremely limited. The areas with the most evidence for beneficial effects are exercise, herbal therapy (Hypericum perforatum), and, to a lesser extent, acupuncture and relaxation therapies. There is a need for further research involving randomized controlled trials into the efficacy of complementary and alternative therapies in the treatment of depression. [References: 95]

Evans C, Richardson PH Therapeutic suggestions during general anesthesia Advances 1988;5(4):6-11 Tested the hypothesis that the quality and duration of recovery from surgery would be improved by therapeutic suggestions made while patients were under general anesthesia, in a double-blind randomized controlled study of 39 adult hospital patients who were admitted for an abdominal hysterectomy. Results support the hypothesis.

Evans C. Richardson PH. Improved recovery and reduced postoperative stay after therapeutic suggestions during general anaesthesia. Lancet. 1988 Aug 27;2(8609):491-3. The clinical value of therapeutic suggestions during general anaesthesia was assessed in a double-blind randomised placebo-controlled study. 39 unselected patients were allocated to suggestion (n = 19) or control (n = 20) groups who were played either recorded therapeutic suggestions or a blank tape, respectively, during hysterectomy. The patients in the suggestion group spent significantly less time in hospital after surgery, suffered from a significantly shorter period of pyrexia, and were generally rated by nurses as having made a better than expected recovery. Patients in the suggestion group, unlike those in the control group, guessed accurately that they had been played an instruction tape.

Everett JJ. Patterson DR. Burns GL. Montgomery B. Heimbach D. Adjunctive interventions for burn pain control: comparison of hypnosis and ativan: the 1993 Clinical Research Award. Journal of Burn Care & Rehabilitation. 1993;14(6):676-83 Thirty-two patients hospitalized for the care of major burns were randomly assigned to groups that received hypnosis, lorazepam, hypnosis with lorazepam, or placebo controls as adjuncts to opioids for the control of pain during dressing changes. Analysis of scores on the Visual Analogue Scale indicated that although pain during dressing changes decreased over consecutive days, assignment to the various treatment groups did not have a differential effect. This finding was in contrast to those of earlier studies and is likely attributable to the low baseline pain scores of subjects who participated. A larger number of subjects with low baseline pain ratings will likely be necessary to replicate earlier findings. The results are argued to support the analgesic advantages of early, aggressive opioid use via PCA or through careful staff monitoring and titration of pain drugs.

Ewer TC, Stewart DE Improvement in bronchial hyper-responsiveness in patients with moderate asthma after treatment with a hypnotic technique: a randomised controlled trial BMJ Clinical Research Edition. 1986;293(6555):1129-32 A prospective, randomised, single blind, and controlled trial of a hypnotic technique was undertaken in 39 adults with mild to moderate asthma graded for low and high susceptibility to hypnosis. After a six week course of hypnotherapy 12 patients with a high susceptibility score showed a 74.9% improvement (p less than 0.01) in the degree of bronchial hyper-responsiveness to a standardised methacholine challenge test. Daily home recordings of symptoms improved by 41% (p less than 0.01), peak expiratory flow rates improved by 5.5% ( p less than 0.01), and use of bronchodilators decreased by 26.2% (p less than 0.05). The improvement in bronchial hyper-reactivity occurred without a change in subjective appreciation of the degree of bronchoconstriction. A control group of 17 patients and 10 patients undergoing treatment with low susceptibility to hypnosis had no change in either bronchial hyper-responsiveness or any of the symptoms recorded at home. This study shows the efficacy of a hypnotic technique in adult asthmatics who are moderately to highly susceptible to hypnosis.

Faymonville ME. Mambourg PH. Joris J. Vrijens B. Fissette J. Albert A. Lamy M. Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study. Pain 1997;73(3):361-7 Stress reducing strategies are useful in patients undergoing surgery. Hypnosis is also known to alleviate acute and chronic pain. We therefore compared the effectiveness of these two psychological approaches for reducing perioperative discomfort during conscious sedation for plastic surgery. Sixty patients scheduled for elective plastic surgery under local anesthesia and intravenous sedation (midazolam and alfentanil upon request) were included in the study after providing informed consent. They were randomly allocated to either stress reducing strategies (control: CONT) or hypnosis (HYP) during the entire surgical procedure. Both techniques were performed by the same anesthesiologist (MEF). Patient behavior was noted during surgery by a psychologist, the patient noted anxiety, pain, perceived control before, during and after surgery, and postoperative nausea and vomiting (PONV). Patient satisfaction and surgical conditions were also recorded. Peri- and postoperative anxiety and pain were significantly lower in the HYP group. This reduction in anxiety and pain were achieved despite a significant reduction in intraoperative requirements for midazolam and alfentanil in the HYP group (alfentanil: 8.7 +/- 0.9 microg kg(-1)/h(-1) vs. 19.4 +/- 2 microg kg(-1)/h(-1), P < 0.001; midazolam: 0.04 +/- 0.003 mg kg(-1)/h(-1) vs. 0.09 +/- 0.01 mg kg(-1)/h(-1), P < 0.001). Patients in the HYP group reported an impression of more intraoperative control than those in the CONT group (P < 0.01). PONV were significantly reduced in the HYP group (6.5% vs. 30.8%, P < 0.001). Surgical conditions were better in the HYP group. Less signs of patient discomfort and pain were observed by the psychologist in the HYP group (P < 0.001). Vital signs were significantly more stable in the HYP group. Patient satisfaction score was significantly higher in the HYP group (P < 0.004). This study suggests that hypnosis provides better perioperative pain and anxiety relief, allows for significant reductions in alfentanil and midazolam requirements, and improves patient satisfaction and surgical conditions as compared with conventional stress reducing strategies support in patients receiving conscious sedation for plastic surgery.

Fellows BJ. Creamer M. An investigation of the role of 'hypnosis', hypnotic susceptibility and hypnotic induction in the production of age regression. British Journal of Social & Clinical Psychology 1978;17(2):165-71 In response to criticisms of the methodology of Barber's(1969)experiments, a 2x2 factorial design, varying hypnotic susceptibility and hypnotic treatment, was used to study the role of 'hypnosis' in the production of age regression by suggestion. Twenty subjects of high hypnotic susceptibility and 20 subjects of low hypnotic susceptibility were randomly allocated to one of two treatment conditions:hypnotic induction procedure or motivational instructions. Both treatments were followed by suggestions to regress to the age of seven years. Two measures of age regression were taken:the Draw-A-Man-Test and a subjective rating of the reality of the experience. The results showed significant effects of both variables, with high suceptibility and induction treatment producing better regression on both measures than low susceptibility and motivation treatment. Hypnotic susceptibility was the stronger of the two variables. The ranking of the four conditions corresponded with predictions of hypnotic depth from the state theory of hypnosis, but the findings were not inconsistent with the non-state theory. The drawings of all regressed groups were more mature than the norms for the age of seven and the drawings of a group of seven year old children.

Freeman RM. Macaulay AJ. Eve L. Chamberlain GV. Bhat AV. Randomised trial of self hypnosis for analgesia in labour. BMJ Clinical Research Edition. 1986;292(6521):657-8 We undertook a randomised trial to evaluate the effect of selfhypnosis on pain relief, satisfaction, and analgesic requirements for women in their first labour.

Fry L, Mason AA, Pearson RS Effect of hypnosis on allergic skin responses in asthma and hayfever BMJ 1964; i: 1145-8

Gearan P. Kirsch I. Response expectancy as a mediator of hypnotizability modification: a brief communication. International Journal of Clinical & Experimental Hypnosis. 1993;41(2):84-91 The role of response expectancy in bringing about increases in hypnotic susceptibility by use of the Carleton Skill Training Program (CSTP) was assessed with 27 subjects selected for their low hypnotizability scores. Subjects were randomly assigned to one of two conditions: 13 received the CSTP to increase their hypnotic susceptibility, and 14 received no training. In addition to assessing hypnotizability, hypnotic response expectancies were assessed before and after training. With pretreatment hypnotizability controlled, subjects in the training group scored significantly higher than control subjects on all self-report measures of hypnotizability but not on a measure of observed behavioral response. Changes in response expectancy were found to be highly correlated with changes in hypnotizability. With changes in expectancy controlled, no significant differences between the trained and control groups were found.

Gearan P. Schoenberger NE. Kirsch I. Modifying hypnotizability: a new component analysis. International Journal of Clinical & Experimental Hypnosis 1995;43(1):70-89 The effects of the Carleton Skills Training Program (CSTP) on hypnotizability were compared to those of a modified training program in which instructions for physical enactment of the response were omitted. After training, subjects in the original CSTP reported an increase in the extent to which they intentionally enacted suggested behaviors. In contrast, subjects in the modified training program reported increased fantasy without voluntary physical enactment. Nevertheless, both training programs increased behavioral and subjective responsiveness to suggestion, and there were no significant differences in response enhancement between the two programs. Across conditions, increases in behavioral and subjective responses to suggestion were correlated with increased use of fantasy. In contrast, increases in enactment were correlated only with compliance. The modified training program is recommended as a means of enhancing suggestibility with less likelihood than the original CSTP of engendering compliance.

Godeby J. Erdt G. Canavan T. Revenstorf D. Experimental hypermnesia: Effects of hypnosis on learning and memory processes Experimentelle und 

Klinische Hypnose 1993;9(2):71-95. Studied the effects of hypnosis on learning and memory to test the hypothesis that hypnotic trance facilitates learning and memory processes by changing the form and depth of verbal processing. Subjects included 36 normal male and female German adults (aged 21-45 yrs) (university students). Subjects were randomly assigned to 1 of 4 experimental groups. Group 1 learned a list of 48 neutral words in a waking state and had to recall it later under hypnosis. Group 2 learned the list under hypnosis and was tested during a waking state. Group 3 learned and recalled the list under hypnosis, and Group 4 learned and recalled the list in a waking state. Intergroup differences in recall performances were analyzed. (English abstract)

Goldmann L. Ogg TW. Levey AB. Hypnosis and daycase anaesthesia. A study to reduce pre-operative anxiety and intra-operative anaesthetic requirements. Anaesthesia 1988;43(6):466-9 Fifty-two female patients who underwent gynaecological operations as day cases received either a short pre-operative hypnotic induction or a brief discussion of equal duration. Hypnotized patients who underwent vaginal termination of pregnancy required significantly less methohexitone for induction of anaesthesia. They were also significantly more relaxed as judged by their visual analogue scores for anxiety. Less than half of the patients were satisfied with their knowledge about the operative procedure even after discussions with the surgeon and anaesthetist. A significant correlation was found between anxiety and perceived knowledge of procedures. The results suggest that pre-operative hypnosis can provide a quick and effective way to reduce pre-operative patient anxiety and anaesthetic requirements for gynaecological daycase surgery.

Greenberg RP. Land JM. Influence of some hypnotist and subject variables on hypnotic susceptibility. Journal of Consulting & Clinical Psychology 1971;37(1):111-5 Randomly assigned 48 21-56 yr. Old females to 1 of 4 groups given different information with regard to a hypnotist's warmth and experience. The 6 male graduate student hypnotists had previously been judged on their objective warmth and competent appearance. Following structuring, all ss underwent individual hypnotic induction. As predicted, ss run by the objectively warmer, more competent appearing es obtained significantly higher susceptibility scores. Structured warmth produced significant differences only in ss run by the objectively less warm es. Both structured warmth and experience affected ss' subjective impressions of whether they thought they had been hypnotized. The complex relationship between antecedent variables and the various objective and subjective dependent indicators of hypnotic phenomena are discussed.

Greenleaf M. Fisher S. Miaskowski C. DuHamel K. Hypnotizability and recovery from cardiac surgery. American Journal of Clinical Hypnosis 1992;35(2):119-28 We studied 32 coronary bypass patients to examine the effect of hypnosis on recovery from surgery. The patients were assessed for hypnotizability with the Hypnotic Induction Profile (HIP) and assigned to experimental groups with a random stratification procedure to equate for differences in hypnotizability, age, and severity of illness. We taught patients in groups one and two formal hypnosis with different treatment strategies; patients in group three were not taught formal hypnosis or a treatment strategy. Scores on the HIP were significant predictors of recovery, independent of experimental treatment with formal hypnosis. Patients who scored "Midrange" stabilized more quickly in the intensive care unit (ICU) than those who scored "High" or "Low" (p = < .05). Patients who scored "High" had more labile blood pressure in the ICU compared to the "Midrange" and "Lows" (p = < .05). Measured hypnotizability was associated with the recovery sequence from surgery.

Gregory J. Diamond MJ. Increasing hypnotic susceptibility by means of positive expectancies and written instructions. Journal of Abnormal Psychology 1973;82(2):363-7 Investigated the extent to which hypnotic susceptibility could be modified by means of induced positive expectancies and written instructions that were designed to correct misconceptions concerning hypnosis as well as to provide concrete methods for experiencing hypnosis. 40 undergraduates were given a baseline test of hypnotic susceptibility and then randomly assigned to 1 of 4 conditions. Subjects receiving the positive expectancy were given false personality test feedback that they were good hypnotic Subjects prior to a criterion hypnotic scale. Subjects receiving the written instructions were given 10 min to read the information prior to the hypnotic test. Other Subjects browsed through magazines prior to testing in hypnosis. Both positive expectancies and written instructions were significantly effective in increasing susceptibility in comparison with practice only. Theoretical explanations are advanced and the implications of these findings are considered.

Griffiths RA, Channon-Little L The hypnotizability of patients with bulimia nervosa and partial syndromes participating in a controlled treatment outcome study Contemporary Hypnosis 1993;10(2):81-7 This is a report of the hypnotizability of a large sample of bulimia nervosa and partial syndromes (n = 113) who participated in a controlled treatment outcome study. Data from the HGSHS:A (Harvard Group Scale of Hypnotic Susceptibility, Fom A) confirmed previous findings of high hypnotizability in these patients compared with normal populations. Furthermore, there was evidence that the responses of bulimia nervosa and partial syndrome patients differed significantly to the responses of the normal population on seven of the 12 items of the HGSHS:A.

Griffiths RA, Hadzi Pavlovic D, Channon Little L A controlled evaluation of hypnobehavioural treatment for bulimia nervosa: Immediate pre post treatment effects Eur Eating Disord Rev. 1994;2(4):202-220 The study reports the pre post findings from a controlled comparative evaluation of treatments for bulimia nervosa. These pre post results allow comparison of the hypnobehevioural and cognitive behavioural treatments with a waiting list control group and a comparison of the immediate effects of the two modalities. One hundred and thirty subjects were screened to enter the study. Seventy eight subjects entered the investigation after being randomly allocated to either a waiting list control group, or to hypnobehavioural or cognitive behavioural groups. The treatments were delivered individually and matched in duration (8 weeks) and the number of sessions. Pre to posttreatment outcome indicated significant differences between the control group and the two treatments in reductions in bulimic behaviours and related eating pathology. The immediate effects of both treatments were equal. There were no differences at posttreatment between the treatments in abstinence from either bingeing or purging. The treatment effects were also similar to the immediate effects obtained by longer therapeutic approaches.

Grond M. Pawlik G. Walter H. Lesch OM. Heiss WD. Hypnotic catalepsy-induced changes of regional cerebral glucose metabolism. Psychiatry Research. 1995;61(3):173-9 In an attempt to elucidate the physiological basis of hypnosis, we investigated the changes of whole-brain and regional cerebral glucose metabolism, from a state of resting wakefulness to a hypnotized state with whole-body catalepsy, using positron emission tomography and the 2[18F]fluorodeoxyglucose method in 15 highly hypnotizable adults. Neither the random order of study conditions nor any of the other experimental factors had a measurable effect, and there was no statistically significant global activation or metabolic depression. However, repeated measures analysis of variance revealed a statistically significant heterogeneity of symmetric regional responses: Mainly the occipital areas, including visual and paravisual cortex, became relatively deactivated, while some metabolic recruitment was found in structures involved in sensorimotor functions. The observed pattern of changes of regional cerebral activity corresponds with the shift of attention away from normal sensory input that hypnosis is known to produce.

Groth-Marnat G. Mitchell K. Responsiveness to direct versus indirect hypnotic procedures: the role of resistance as a predictor variable. International Journal of Clinical & Experimental Hypnosis 1998;46(4):324-33 Empirical research attempting to demonstrate that indirectly phrased hypnotic suggestions result in greater responsiveness than do direct approaches generally has not shown any differences on formal hypnotizability scales. However, empirical research in related areas along with clinical observation suggests that client resistance might be a crucial moderating variable. Specifically, participants with greater resistance would be expected to be more responsive to indirect approaches, whereas those with low levels of resistance would be more responsive to direct hypnotic procedures. To test this hypothesis, participants were given either a standardized test of hypnotic responsiveness that used direct suggestions (Harvard Group Scale of Hypnotizability) or a comparable indirect scale (Alman Wexler Indirect Hypnotic Susceptibility Scale) followed by administration of a measure of resistance (Therapeutic Reactance Scale). The hypothesis was not confirmed, in that those with higher (or lower) reactance/resistance did not score differently than those on either the indirect or direct hypnotizability measures.

Grunberger J. Linzmayer L. Walter H. Hofer C. Gutierrez-Lobos K.Stohr H. Assessment of experimentally-induced pain effects and their elimination by hypnosis using pupillometry studies. Wiener Medizinische Wochenschrift 1995;145(23):646-50 Hypnotherapeutical technique were often used for control of pain. However, an objective examination of this phenomenon was seldom carried out. The aim of the study was the psychophysiological objectivation of the effect of experimental induced pain and the elimination of pain by means of hypnosis. 22 healthy volunteers (11 female and 11 male) aged between 22 and 35 years participated in the study. In the 1st phase of the experiment static pupillometry was carried out before randomized presentation of a light stimulus (143 lux, 0.3 sec) and of a pain stimulus (coldness-spray, -50 degrees C, 0.5 sec) respectively. Afterwards the dynamic pupillary measurement was done. Additionally the Fourier analyses of pupillary oscillations reflecting central nervous activation during the static measurement (25,6 sec) was calculated. In the 2nd phase the subjects were investigated by means of the same techniques during hypnosis with specific suggestions for elimination of pain. Under light condition as well as after induction of pain an autonomic deactivation could be observed during hypnosis. Furthermore under pain condition a central deactivation could also be found, reflecting the depth of the hypnosis and the reduced perception of pain.

Haanen HC. Hoenderdos HT. van Romunde LK. Hop WC. Mallee C. Terwiel JP. Hekster GB. Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia. Journal of Rheumatology 1991;18(1):72-5 In a controlled study, 40 patients with refractory fibromyalgia were randomly allocated to treatment with either hypnotherapy or physical therapy for 12 weeks with followup at 24 weeks. Compared with the patients in the physical therapy group, the patients in the hypnotherapy group showed a significantly better outcome with respect to their pain experience, fatigue on awakening, sleep pattern and global assessment at 12 and 24 weeks, but this was not reflected in an improvement of the total myalgic score measured by a dolorimeter. At baseline most patients in both groups had strong feelings of somatic and psychic discomfort as measured by the Hopkins Symptom Checklist. These feelings showed a significant decrease in patients treated by hypnotherapy compared with physical therapy, but they remained abnormally strong in many cases. We conclude hypnotherapy may be useful in relieving symptoms in patients with refractory fibromyalgia.

Haddock CK. Rowan AB. Andrasik F. Wilson PG. Talcott GW. Stein RJ. Home-based behavioral treatments for chronic benign headache: a meta-analysis of controlled trials. Cephalalgia 1997;17(2):113-8 Controlled clinical trials have consistently demonstrated that behavioral treatments for chronic benign headache produce clinically beneficial outcomes both post-treatment and at follow-up. Given these results there is interest in cost-reduction and redesign of these treatments to improve their accessibility. One promising approach in this regard is home-based headache treatment. These treatments seek to provide the same amount of treatment as clinic-based treatments; however, some of the material typically presented to the patient by a clinician is presented through home-study materials (e.g., manuals, audiotapes). To date, the published literature contains 20 controlled clinical trials which have examined the outcomes produced by home-based treatments. This article presents the first comprehensive meta-analysis of these clinical outcome studies. Results of the quantitative analyses suggest that home-based treatments produce comparable, or with certain outcome measures, superior results to clinic-based treatments. Moreover, costeffectiveness scores of home-based treatments were found to be more than five times larger than those of clinic-based therapies. Methodological analyses are also presented along with suggestions for future research.

Hammarstrand G. Berggren U. Hakeberg M. Psychophysiological therapy vs. hypnotherapy in the treatment of patients with dental phobia. European Journal of Oral Sciences 1995;103(6):399-404 The aim of this study was to compare two different modes of behaviorally-oriented therapies for dental fear. The subjects were chosen consecutively from the waiting-list of a Dental Fears Research and Treatment Clinic. In addition, a control group was selected from patients treated under general anesthesia to compare levels of dental and general fear with the experimental groups. Twenty-two women, with a mean age of 31.8 yr, were included and randomly assigned to two groups. The median time of avoidance of dental care was 9.5 yr. One group received hypnotherapy (HT) and one group a behavioral treatment based on psychophysiological principles (PP). Both therapies included eight sessions followed by standardized conventional dental test treatments. Pre- and posttreatment measures were dental fear, general fear, mood, and patient behavior. Nine patients were not able to conclude the treatment sessions (6 HT and 3 PP); these patients did not differ significantly from the remaining patients before treatment. The PP group reported a statistically significant decrease in dental fear as well as a rise in mood during dental situations, as opposed to the HT group. General fear levels decreased but not significantly. Eleven patients completed conventional dental treatment according to a dentist's behavioral rating scale, indicating that they were relaxed, and no problems occurred during the treatments. These patients were referred to general practitioners within the community dental service. In conclusion, this small size study showed that a majority of the patients, who accomplished the behavioral therapy and the dental test treatments, became less fearful of dental care and were able to manage conventional dental care, including changing dentist.

Hammond DC. Haskins-Bartsch C. Grant CW= Jr. McGhee M. Comparison of self-directed and tape-assisted self-hypnosis. American Journal of Clinical Hypnosis 1988;31(2):129-37 48 inexperienced adult volunteers were hypnotized and taught self-hypnosis by posthypnotic suggestion and immediate practice in the office. Subjects were randomly assigned to 1 of 2 experimental orders to practice self-directed and tape-assisted self-hypnosis. No differences were found between heterohypnosis or either type of self-hypnosis in response to behavioral suggestions. Experiential ratings, however, consistently favored heterohypnosis over either type of self-hypnosis. Tape-assisted self-hypnosis was consistently evaluated as superior to self-directed practice by newly trained Subjects.

Harmon TM. Hynan MT. Tyre TE. Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. Journal of Consulting & Clinical Psychology 1990;58(5):525-30 The benefits of hypnotic analgesia as an adjunct to childbirth education were studied in 60 nulliparous women. Subjects were divided into high and low hypnotic susceptibility groups before receiving 6 sessions of childbirth education and skill mastery using an ischemic pain task. Half of the Ss in each group received a hypnotic induction at the beginning of each session; the remaining control Ss received relaxation and breathing exercises typically used in childbirth education. Both hypnotic Ss and highly susceptible Ss reported reduced pain. Hypnotically prepared births had shorter Stage 1 labors, less medication, higher Apgar scores, and more frequent spontaneous deliveries than control Ss' births. Highly susceptible, hypnotically treated women had lower depression scores after birth than women in the other 3 groups. We propose that repeated skill mastery facilitated the effectiveness of hypnosis in our study.

Hartman BJ. Hypnotizability as Affected by Attitudinal and Motivational Variables. International Journal of Clinical & Experimental Hypnosis 1967;15(2):86-91 Attempted to discover whether task-motivated subjects would be more hypnotizable than those not given task-motivation instructions, and whether the attitude of the E would affect subjects' hypnotizability. The Barber suggestibility scale was employed for measuring susceptibility to hypnosis. Subjects were divided randomly into 6 groups of 10: task-motivated, E neutral; non-task-motivated, E neutral; task-motivated, E friendly; task-motivated, E harsh; non-task-motivated, E friendly; and non-task-motivated, E harsh. Analyses of variance, both for objective and subjective scores, did not yield significant results for the task-motivation variable but did yield significant results (p = .01) for the variable dealing with E attitude.

Harvey RF. Hinton RA. Gunary RM. Barry RE. Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome. Lancet 1989;1(8635):424-5 33 patients with refractory irritable bowel syndrome were treated with four 40-minute sessions of hypnotherapy over 7 weeks. 20 improved, 11 of whom lost almost all their symptoms. Short-term improvement was maintained for 3 months without further formal treatment. Hypnotherapy in groups of up to 8 patients was as effective as individual therapy.

Hendler CS, Redd WH Fear of hypnosis: The role of labeling in patients' acceptance of behavioral interventions Behav Ther. 1986;17(1):2-13 One hundred and five outpatient cancer chemotherapy patients were interviewed to assess their attitudes toward hypnosis and relaxation as well as to determine their beliefs in and willingness to try a behavioral procedure. Patients were randomly assigned to groups receiving identical descriptions labeled 'hypnosis', 'relaxation', or 'passive relaxation with guided imagery'. The description stressed the behavioral components of hypnosis and relaxation rather than the nonbehavioral techniques often associated with hypnosis such as age regression and posthypnotic suggestion. Patients believed hypnosis to be a powerful process that involved loss of control and altered states of consciousness. When compared with a group of college students, patients held significantly more fearful, conservative views about hypnosis. Patients who received a description of an intervention labeled 'hypnosis' were significantly less likely to believe the procedure would effectively control their nausea and vomiting and were significantly less likely to state they would try the procedure than patients in the other two label conditions. This reaction to the label occurred independently of patients' degree of nausea, vomiting, and pain due to their chemotherapy treatments.

Hockenberry-Eaton MJ. Cotanch PH. Evaluation of a child's perceived self-competence during treatment for cancer. Journal of Pediatric Oncology Nursing 1989;6(3):55-62 The purpose of this study was to evaluate the effect of self-hypnosis on the perceived self-competence of children undergoing treatment for cancer and to determine longitudinal differences in perception of self-competence over time. Twenty-two children were randomized into an experimental group (taught self-hypnosis) and a control group (given standard care). Data were collected using the Harter Perceived Self-Competence Profile (HPSCP) during four courses of chemotherapy. A decrease in mean scores for the control group was found compared with the hypnosis group, which showed an increase in mean scores in five of six domains. Both groups showed a statistically significant increase in the scholastic cognitive domain and social acceptance domain from the time of diagnosis compared with the second test period. Ten children had a visible physical disability. 

These children were found to have significant decreases in the domains of athletic competence, social acceptance, and global self-worth. Decreases remained significant throughout all test periods in the athletic competence domain for the children with a visible physical disability. This study is unique in that the researchers evaluated children's perception of self-competence over time. These findings support previous studies and identify the need for nurses to become actively involved in helping children develop effective coping skills during chemotherapy for cancer.

Houle M. McGrath PA. Moran G. Garrett OJ. The efficacy of hypnosis- and relaxation-induced analgesia on two dimensions of pain for cold pressor and electrical tooth pulp stimulation. Pain 1988;33(2):241-51 This study evaluated the efficacy of hypnosis- and relaxation-induced suggestions for analgesia for reducing the strength and unpleasantness dimensions of pain evoked by noxious tooth pulp stimulation and by cold pressor stimulation. The Tellegen Absorption Questionnaire was used to assess hypnotic susceptibility for 28 subjects in order to match treatment groups according to sex and susceptibility scores. Tooth pulp stimulation consisted of a 1 sec train of 1 msec pulses at a frequency of 100 Hz, applied at 20 sec intervals to the central incisor. Six stimuli, selected between subject's pain and tolerance thresholds, were presented 3 times each in random order. Cold pressor stimulation consisted of forearm immersion in a circulating water bath maintained at 0-1 degrees C. Subjects made threshold determinations of pain and tolerance and used Visual Analogue Scales to rate the strength and the unpleasantness of both noxious stimuli before and after receiving either hypnosis- or relaxation-induced analgesia. There were no significant differences in pain reductions between hypnosis- and relaxation-induced interventions. 

However, the percent reduction in both strength and unpleasantness varied significantly as a function of the type of pain. Both hypnosis and relaxation significantly reduced the strength and the unpleasantness of tooth pulp stimulation, but only the unpleasantness dimension of cold pressor pain. The pain reductions were not correlated with subjects' hypnotic susceptibility levels. The results indicate that the extent and the quality of the analgesia produced by these cognitive-based therapies vary not only according to subjects' characteristics and the efficacy of the intervention, but also according to the nature of the noxious stimuli. Tooth pulp and cold pressor stimulation represent qualitatively different stimuli with respect to both the type of nerves activated and the mode of stimulus application. Discrete, randomly presented levels of noxious electrical stimulation to the teeth activate predominantly small fibers and produce brief pain sensations that vary unpredictably in intensity. In contrast, continuous cold stimulation to the forearm activates a variety of nociceptive and non-nociceptive fibers and produces progressive cold and pain sensations with a predictable increase in intensity from cold sensations to paresthesia and severe pain.

Howard WL. Reardon JP. Changes in the self concept and athletic performance of weight lifters through a cognitive-hypnotic approach: an empirical study. American Journal of Clinical Hypnosis 1986;28(4):248-57 Examined the effects of a cognitive-hypnotic-imagery approach (CHI), cognitive restructuring, and hypnosis only treatments on neuromuscular performance, muscular growth, reduction of anxiety, and enhancement of self-concept in 32 male weightlifters (mean age 22.5 yrs). Subjects were randomly assigned to 4 treatment conditions conducted over a 4-wk period. The CHI group showed significant treatment effects over the other groups on 6 dependent variables from pretest to posttest 1. From posttest 1 to posttest 2, a 1-mo period in which no treatment was conducted, self-concept and muscular growth measures for CHI Subjects showed significance. The CHI group was superior to the other conditions. Neuromuscular performance and muscular growth were positively modified by CHI. Data suggest that combining hypnotic relaxation and imagery with cognitive restructuring enhances both the immediate and long-range effects of treatment.

Hughes JA. Sanders LD. Dunne JA. Tarpey J. Vickers MD. Reducing smoking. The effect of suggestion during general anaesthesia on postoperative smoking habits. Anaesthesia. 1994;49(2):126-8 In a double-blind randomised trial, 122 female smokers undergoing elective surgery were allocated to receive one of two prerecorded messages while fully anaesthetised. The active message was designed to encourage them to give up smoking whilst the control message was the same voice counting numbers. No patient could recall hearing the tape. Patients were asked about their postoperative smoking behaviour one month later. Significantly more of those who had received the active tape had stopped or reduced their smoking (p < 0.01). This would suggest a level of preconscious processing of information.

Hurley AE. The effects of self-esteem and source credibility on self-denying prophecies. Journal of Psychology 1997;131(6):581-94 Self-fulfilling prophecies are a well-studied phenomenon. The study of self-denying prophecies, however, is rare. Self-denying prophecies shift people's behavior in the direction opposite to the prophecy. The existence of self-denying prophecies was investigated in 222 students. The effects of self-esteem and the source of the prophecy were also investigated. The results suggest that self-denying prophecies exist and that self-esteem is an important moderator of self-denying prophecies. If managers and industrial/organizational psychologists had an understanding of self-denying prophecies, they might be better able to structure negative performance reviews in a way that could lead to improved employee performance.

Hurley JD. Differential effects of hypnosis, biofeedback training, and trophotropic responses on anxiety, ego strength, and locus of control. Journal of Clinical Psychology 1980;36(2):503-7 Pretested 60 college students on three scales: The IPAT Anxiety Scale, the Barron Ego-strength scale, and the Rotter I-E scale. The Ss then were assigned randomly to one of four treatment groups designated: Hypnotic treatment, biofeedback treatment, trophotropic treatment, and control. Three of these groups met separetely for 60 minutes once a week for 8 weeks. The control group did not meet during this time. During the sessions, each group was trained in a different technique for self-regulation. At the end of the 8-week period the scales were readministered to all groups. A series of covariance analyses indicated that hypnosis was a more effective self-regulatory technique for lowering anxiety levels when compared to biofeedback or trophotropic response procedures. With regard to increasing ego strength, both the hypnotic training group and the biofeedback training group proved to be significant. No significant difference was found between the experimental and control gorups on the I-E scores.

Hyman GJ. Stanley RO. Burrows GD. Horne DJ. Treatment effectiveness of hypnosis and behaviour therapy in smoking cessation: a methodological refinement. Addictive Behaviors 1986;11(4):355-65 Studies in smoking cessation have generally failed to adequately control for active treatment effects and have assumed that measures of smoking behaviour (i.e., estimated smoking rate, self-monitoring and chemical analysis) are equally reliable measures. Sixty smokers were randomly assigned to one of four different smoking cessation treatment groups: hypnosis, focussed smoking, attention placebo and a waiting list control. Subjects were asked to estimate and monitor their own smoking behaviour. Blood samples were also taken for thiocyanate analysis before treatment. Smoking rates were similarly measured directly, at 3 months and 6 months after treatment. The results indicate that the three measures of smoking behaviour were all highly correlated. No significant differences were found between treatments, directly after treatment or at the 3- and 6-month follow-ups. These results suggest that active treatment effects may not be responsible for behavioural change in a smoking cessation program. The implications of these findings are discussed.

Jacknow DS. Tschann JM. Link MP. Boyce WT. Hypnosis in the prevention of chemotherapy-related nausea and vomiting in children: a prospective study. Journal of Developmental & Behavioral Pediatrics 1994;15(4):258-64 To study the effectiveness of hypnosis for decreasing antiemetic medication usage and treatment of chemotherapy-related nausea and vomiting in children with cancer, we conducted a prospective, randomized, and controlled single-blind trial in 20 patients receiving chemotherapy for treatment of cancer. Patients were randomized to either hypnosis or standard treatment. The hypnosis group used hypnosis as primary treatment for nausea and vomiting, using antiemetic medication on a supplemental (p.r.n.) basis only, whereas the control group received a standardized antiemetic medication regimen. Nausea, vomiting, and p.r.n. antiemetic medication usage were measured during the first two courses of chemotherapy. Anticipatory nausea and vomiting were assessed at 1 to 2 and 4 to 6 months postdiagnosis. Patients in the hypnosis group used less p.r.n antiemetic medication than control subjects during both the first (p < .04) and second course of chemotherapy (p < .02). The two groups did not differ in severity of nausea and vomiting. The hypnosis group experienced less anticipatory nausea than the control group at 1 to 2 months postdiagnosis (p < .02). Results suggest self-hypnosis is effective for decreasing antiemetic medication usage and for reducing anticipatory nausea during chemotherapy.

Jacobs AL, Kurtz RM, Strube MJ Hypnotic analgesia, expectancy effects, and choice of design: a reexamination. Int J Clin Exp Hypn 1995 Jan;43(1):55-69 Previous research by Stam and Spanos suggests that if waking analgesia is followed by hypnotic analgesia, subjects refrain from maximally responding during the waking trial so they report less pain under hypnosis (i.e., a holdback effect). This hypothesis was re-examined using more stringent controls. Thirty-six highly susceptible subjects chosen by a combination of the Harvard Group Scale of Hypnotic Susceptibility, Form A and the Stanford Hypnotic Susceptibility Scale, Form C were randomly assigned to one of three treatment groups (waking analgesia followed by hypnotic analgesia, waking analgesia followed by waking analgesia, or hypnotic analgesia followed by waking analgesia). Each group received three 60-second immersions of cold pressor pain stimulation (baseline, Immersion 1, Immersion 2) and rated pain using a magnitude estimation and a category rating scale. The obtained results failed to support the hypotheses of a holdback effect or a reverse-order holdback effect. Properties of within-subjects and between-subjectsdesigns were considered in explaining the superiority of hypnotic analgesia over waking analgesia typically found in within-subjects models.

Jansen CK. Bonke B. Klein J. van Dasselaar N. Hop WC. Failure to demonstrate unconscious perception during balanced anaesthesia by postoperative motor response. Acta Anaesthesiologica Scandinavica 1991;35(5):407-10 Eighty patients undergoing a standardized balanced anaesthesia were randomly assigned to either a suggestion group (N = 38) or a control group (N = 42), in a double-blind design. Anaesthesia was maintained with nitrous oxide, enflurane and fentanyl. Patients in the suggestion group were played seaside sounds, interrupted by statements of the importance of touching the ear during a postoperative visit, by means of a prerecorded audiotape and headphones. Tapes containing these suggestions were played from 30 min after the first incision, for a duration of 15 min. Patients in the control group were only played seaside sounds. There were no significant differences between the groups in either the number of patients touching their ears postoperatively or the number and duration of ear touches.

Jasiukaitis P. Nouriani B. Spiegel D. Left hemisphere superiority for event-related potential effects of hypnotic obstruction. Neuropsychologia. 1996;34(7):661-8 Twenty-two highly hypnotizable subjects were run in a visual target detection task which compared hypnotic obstruction of the left and right visual fields over separate blocks. The visual event-related potentials (ERPs) to non-target stimuli revealed that hypnotic obstruction reduced the P200 component to stimuli in the right hemifield, but did not affect P200 for stimulation in the left hemifield. The earlier P100 and N100 were also reduced to hypnotic obstruction but not as preferentially for either hemifield, while the P300 was not significantly changed. Right visual field left hemisphere P200 reduction predicted suppression of behavioral response (button press) to hypnotically obstructed targets in both hemifields. The results are discussed in terms of Farah's model of a left hemisphere mechanism for image generation, and how highly hypnotizable subjects might use this mechanism to comply successfully with the suggestion of a hallucinated visually opaque barrier.

Javel AF. One-session hypnotherapy for smoking: a controlled study. Psychological Reports 1980;46(3 Pt 1):895-9 Not randomised

Jeffrey LK. Jeffrey TB. Exclusion therapy in smoking cessation: a brief communication. International Journal of Clinical & Experimental Hypnosis 1988;36(2):70-4 Investigated the effect of exclusion therapy on the outcome of a 5-session treatment protocol for smoking cessation. 120 adult Subjects were randomly assigned to a group hypnotic and behavioral program that required 48 hrs of pretreatment abstinence from use of tobacco products, or to an identical treatment that encouraged, but did not include, this pretreatment stipulation. Results indicate no significant differences between groups in dropout rates or number of Subjects abstinent from smoking. For all Subjects, including dropouts, the abstinence rate was 59.2% upon completion of treatment. It was 45.5% and 36.7% at 1- and 3-mo follow-up, respectively.

Johnson LS. Johnson DL. Olson MR. Newman JP. The uses of hypnotherapy with learning disabled children. J Clinical Psychology. 1981; 37(2):291-9 Three hypnotic training sessions and instructions for 6 weeks of daily self-hypnotic practice that contained suggestions for imagery related to improvement in these areas were given to 15 children (12 males and 3 females, ages from 7 to 13), their reading teacher, and both their parents, and their responses were compared to a similar but untreated control group of 18. No overall differences were observed between groups. A multiple regression analysis revealed important predictors of self-esteem improvement for the experimental group. The child's hypnotic susceptibility score and self-hypnotic practice by children and parents were the most relevant. These LD children were at least as hypnotically susceptible as a normative sample. Hypnotherapy is seen as feasible in group administration by persons only moderately trained in hypnosis and of potential benefit to self-esteem improvement in LD children, depending on individual difference factors.

Johnson PR. Thorn BE. Cognitive behavioral treatment of chronic headache: group versus individual treatment format. Headache 1989;29(6):358-65 Two hypotheses were tested in this study: (1) that a short course of cognitive behavioral therapy (CBT) is effective in the treatment of chronic headache; and (2) that group CT is as effective as individually administered CBT. Twenty-two chronic headache sufferers were randomly assigned to one of three treatment conditions: group administered CBT, individually administered CBT, or no treatment (wait list) control. Wait list subjects ultimately received treatment identical to that offered to subjects in the group treatment condition. Treatment outcome measures included the Brief Symptom Inventory, the McGill Pain Questionnaire, and several measures calculated from self-monitoring data. Tentative support was found for the hypothesis that CBT as provided in this study is effective in the treatment of chronic headache. There was no evidence that group versus individually treated subjects differed significantly on any of the measures used, although the small N and large variance among subjects limit us to preliminary conclusions for our findings. Clinical implications and suggestions for future research are discussed.

Johnson RL. Johnson HC. Effects of anxiety-reducing hypnotic training on learning and reading-comprehension tasks. Journal of the National Medical Association 1984;76(3):233-235. 15 college students who reported having test-taking anxiety were randomly assigned to an experimental or a control group. The experimental group received hypnotic training to reduce anxiety prior to taking a learning and reading-comprehension test. No significant difference was found between the experimental and the control group on the simple-recall task. However, on the reading-comprehension test the experimental group scored significantly higher than the control group. Further examination of the total score revealed that the experimental group difference was due to superior performance on the inference items. There was no difference between groups on items that required the recall of information from the passage. Findings support the notion that hypnotic training may be useful to reduce anxiety and improve test performance.

Johnson VC, Walker LG, Heys SD, Whiting PH, Eremin O Can relaxation training and hypnotherapy modify the immune response to stress, and is hypnotizability relevant? Contemporary Hypnosis 1996;13(2):100-8 A study was carried out with the following aims: (1) to evaluate the psychological and immunological effects of 3 weeks' relaxation practice; (2) to investigate the effects of relaxation training and hypnosis on the modulation of the immune response to an experimental stressor, and (3) to relate changes to hypnotic susceptibility. Twenty-four healthy volunteers were assigned, according to a stratified, permuted blocks, random allocation procedure, to relaxation training with hypnosis or to a control condition. Subjects attended of three occasions: day 1, day 21 and day 22 or 23. Various psychological tests were carried out on each of the occasions and, in addition, samples of urine and blood were collected for immunological and biochemical analysis. Two samples of blood were taken at the second visit, one before exposure to an experimental stressor on day 21 and one immediately thereafter. Relaxation had several effects including improvement on a number of measures of mental state and a reduction in lymphocyte responsiveness and IL-1 secretion. However, on exposure to the stressor, previous relaxation training and pre-exposure hypnotic suggestion led to increased lymphocyte responsiveness and IL-1 secretion. The extent to which IgA increased as a result of relaxation therapy for 3 weeks was positively correlated with Creative Imagination Scale (CIS) scores (changes in the control group during the same period were not correlated with CIS scores). Moreover, immediate changes in IL-1 following exposure to the stressor were positively correlated with CIS scores in the experimental groups and negatively in the control group. Hypnotizability, as assessed by the CIS, may be an important moderator of the psychneuroimmunological response to relaxation training and exposure to acute stress.

Johnston M, Vogele C Benefits of psychological preparation for surgery: A meta analysis Ann Behav Med. 1993;15(4):245-256 There is now substantial agreement that psychological preparation for surgery is beneficial to patients. It is important, however, to establish which benefits can be achieved by psychological preparation and if all forms of preparation are equally effective. The results of randomized controlled trials of psychological methods of preparing adult patients for surgery were analyzed in terms of eight outputs (negative affect, pain, pain medication, length of stay, behavioral and clinical indices of recovery, physiological indices, and satisfaction). In order to reduce publication bias, published as well as unpublished studies were included in the meta analysis. It was concluded that significant benefits can be obtained on all of the major outcome variables that have been explored. Procedural information and behavioral instructions show the most ubiquitous effects in improving measures of post-operative recovery. The results have implications for the improvement of patient care in surgical units.

Kaplan GM, Barabasz AF Enhancing hypnotizability: differential effects of flotation restricted environmental stimulation technique and progressive muscle relaxation Australian Journal of Clinical & Experimental Hypnosis 1988 May;16(1):39-51 Investigated the effectiveness of flotation restricted environmental stimulation technique (REST) for enhancing hypnotizability. 30 Subjects were randomly assigned to flotation REST, progressive muscle relaxation (PMR), or no-treatment control conditions. Subjects were tested with the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C), and readministered the SHSS:C after treatment and at follow-up. Results show that PMR enhanced hypnotizability more than no-treatment control. Flotation REST was not found to enhance hypnotizability more than PMR. Both REST and PMR Subjects significantly increased hypnotizability over time while control Subjects did not. The role of relaxation in hypnosis is discussed.

Katcher A. Segal H. Beck A. Comparison of contemplation and hypnosis for the reduction of anxiety and discomfort during dental surgery. American Journal of Clinical Hypnosis 1984;27(1):14-21 Used complex moving visual stimuli to induce states of relaxation, hypnosis, and revery in 42 dental patients (aged 21-60 yrs). To test the efficacy of using aquarium contemplation to induce relaxation, Subjects were randomly assigned to 1 of 5 treatments prior to elective oral surgery: contemplation of an aquarium, contemplation of a poster, poster contemplation with hypnotic induction, aquarium contemplation with hypnosis, and a nonintervention control. Subjects were administered 5 tests of susceptibility adapted from the Stanford Hypnotic Susceptibility Scale; blood pressure, heart rate, and subjective and objective measures of anxiety were also taken. It was found that pretreatment with aquarium contemplation and hypnosis, either alone or in combination, produced significantly greater degrees of relaxation during surgery than poster contemplation or the control procedure. Two-way ANOVA demonstrated that a formal hypnotic induction did not augment the relaxation produced by aquarium contemplation. Findings suggest that aquarium contemplation can alter patients' subjective experiences and overt behavior during oral surgery. Other clinical applications of the contemplation procedure are discussed.

Katz ER. Kellerman J. Ellenberg L. Hypnosis in the reduction of acute pain and distress in children with cancer. Journal of Pediatric Psychology 1987;12(3):379-94 12 female and 24 male 6-11 yr olds with acute lymphoblastic leukemia who were undergoing repeated bone marrow aspirations (BMAs) were randomized to hypnosis or play comparison groups. Subjects were selected on their behavioral performance on baseline procedures and received interventions prior to their next 3 BMA procedures. Major results indicate an improvement in self-reported distress with both interventions. Girls exhibited more distress behavior than boys on 3 of 4 dependent measures. Suggestions of an interaction effect between sex and treatment groups were noted. The role of rapport between patient and therapist in therapeutic outcome is discussed.

Katz NW. Hypnotic inductions as training in cognitive self-control. Cognitive Therapy Research 1978;2(4):365-369. Compared the efficacy of the traditional trance induction, the author's cognitive training induction, and a combination of cognitive training and active-alert instructions. In the context of a guest lecture on hypnosis, volunteer undergraduates were randomly assigned to 1 of 3 groups. The Harvard Group Scale of Hypnotic Susceptibility and a measure of attitudes toward hypnosis and conceptions of the hypnotic process were used. Results show the following: (a) The 2 inductions containing training procedures were significantly more effective than the trance induction in enhancing suggestibility but did not differ from each other. (b) Subjects exposed to the combined training and fantasy inductions saw themselves as more hypnotizable in the future than Subjects exposed to training alone.

Kaufert JM. Rabkin SW. Syrotuik J. Boyko E. Shane F. Health beliefs as predictors of success of alternate modalities of smoking cessation: results of a controlled trial. Journal of Behavioral Medicine 1986;9(5):475-89 The primary objective of this study was to determine whether health beliefs influenced the outcome of the three alternate modalities of reducing cigarette consumption. The study randomized volunteers either to a control group or to one of three cessation programs, using behavior modification, health education, or hypnosis. A questionnaire was used to document health beliefs, demographic characteristics, and smoking history. Blood samples were taken before and after the completion of intervention programs to measure changes in serum thiocyanate. A follow-up questionnaire was used to assess smoking behavior after 6 months. Statistically significant decreases in serum thiocyanate levels followed participation in each of the three programs. Factor analysis and reliability tests were used to identify four scales reflecting major variable dimensions in the health belief model. Significant correlations between change in serum thiocyanate and two of the scales (general health concern and perceived vulnerability) were found only for the group randomly assigned to the health education intervention program.

Kirsch I. Hypnotic enhancement of cognitive-behavioral weight loss treatments--another meta-reanalysis Journal of Consulting & Clinical Psychology 1996;64(3):517-9 In a 3rd meta-analysis of the effect of adding hypnosis to cognitive-behavioral treatments for weight reduction, additional data were obtained from authors of 2 studies, and computational inaccuracies in both previous meta-analyses were corrected. Averaged across posttreatment and follow-up assessment periods, the mean weight loss was 6.00 lbs. (2.72 kg) without hypnosis and 11.83 lbs. (5.37 kg) with hypnosis. The mean effect size of this difference was 0.66 SD. At the last assessment period, the mean weight loss was 6.03 lbs. (2.74 kg) without hypnosis and 14.88 lbs. (6.75 kg) with hypnosis. The effect size for this difference was 0.98 SD. Correlational analyses indicated that the benefits of hypnosis increased substantially over time (r = .74).

Kirsch I. Montgomery G. Sapirstein G. Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis. Journal of Consulting & Clinical Psychology 1995;63(2):214-20 A meta-analysis was performed on 18 studies in which a cognitive-behavioral therapy was compared with the same therapy supplemented by hypnosis. The results indicated that the addition of hypnosis substantially enhanced treatment outcome, so that the average client receiving cognitive-behavioral hypnotherapy showed greater improvement than at least 70% of clients receiving nonhypnotic treatment. Effects seemed particularly pronounced for treatments of obesity, especially at long-term follow-up, indicating that unlike those in nonhypnotic treatment, clients to whom hypnotic inductions had been administered continued to lose weight after treatment ended. These results were particularly striking because of the few procedural differences between the hypnotic and nonhypnotic treatments.

Klein KB. Spiegel D. Modulation of gastric acid secretion by hypnosis. Gastroenterology 1989;96(6):1383-7 The ability of hypnosis to both stimulate and inhibit gastric acid secretion in highly hypnotizable healthy volunteers was examined in two studies. In the first, after basal acid secretion was measured, subjects were hypnotized and instructed to imagine all aspects of eating a series of delicious meals. Acid output rose from a basal mean of 3.60 +/- 0.48 to a mean of 6.80 +/- 0.02 mmol H+/h with hypnosis, an increase of 89% (p = 0.0007). In a second study, subjects underwent two sessions of gastric analysis in random order, once with no hypnosis and once under a hypnotic instruction to experience deep relaxation and remove their thoughts from hunger. When compared to the no-hypnosis session, with hypnosis there was a 39% reduction in basal acid output (4.29 +/- 0.93 vs. 2.60 +/- 0.44 mmol H+/h, p less than 0.05) and an 11% reduction in pentagastrin-stimulated peak acid output (28.69 +/- 2.34 vs. 25.43 +/- 2.98 mmol H+/h, p less than 0.05). We have shown that different cognitive states induced by hypnosis can promote or inhibit gastric acid production, processes clearly controlled by the central nervous system. Hypnosis offers promise as a safe and simple method for studying the mechanisms of such central control.

Kohen DP Relaxation-mental imagery (self-hypnosis) for childhood asthma: behavioral outcomes in a prospective, controlled study Hypnos 1995 Sep;22(3):132-44 Twenty-eight (28) 7-12 yr old children entered a controlled study of the effects of self-hypnosis on asthma. Asthma belief and behavioural inventories were collected before, and at one and two yrs after intervention. Asthma diaries were kept daily and mailed monthly. Subjects were randomly assigned to (1) Experimental (self-hypnosis), (2) Waking suggestion (no Hypnosis), (3) attention placebo (no hypnosis or asthma discussion), or (4) traditional control groups. Twenty four (24) completed 1 month follow-up, 16 completed 6 months, and 13 completed 2 yrs. Results included fewer Emergency Room visits in the experimental group (p greater than 0.05); (2) less school missed in the experimental group compared to the traditional controlled group (p greater than 0.001) and to the waking suggestion group (p greater than 0.005); (3) no differences in psychological evaluations between groups, and (4) surprising findings regarding hypnotic and hypnotic-like experiences among subjects.