Biomedical subjects

R Zachariae

Publications and source records attributed to R Zachariae.

12 recordsLinked to original sources

PubMed1996

Effects of psychologic intervention on psoriasis: a preliminary report.

BACKGROUND: Case reports have indicated that psychologic treatments may have a beneficial effect on psoriasis activity. OBJECTIVE: Our purpose was to further investigate the hypothesis that psychologic intervention has a beneficial effect on psoriasis activity in a blinded, controlled manner. METHODS: Fifty-one patients with psoriasis vulgaris were randomly assigned to a treatment or a control group. Patients in the treatment group participated in seven individual psychotherapy sessions in 12 weeks. Intervention techniques included stress management, guided imagery, and relaxation. The Psoriasis Area Severity Index (PASI), Total Sign Score (TSS), and Laser Doppler Skin Blood Flow (LDBF) of a selected reference plaque was measured in a blinded fashion at baseline (week 0), week 4, week 8, and after treatment (week 12). RESULTS: Slight, but significant, changes in TSS and LDBF were found in the treatment group but not in the control group. When analyses were performed for both groups separately, the treatment group displayed significant reductions for all three psoriasis activity measures, whereas no changes were seen in the control group. CONCLUSION: Our preliminary results suggest that psychologic intervention may have a moderate beneficial effect on psoriasis activity.

Adult↗

PubMed1996

Danish norms for the Harvard group scale of hypnotic susceptibility, form A.

Norms for a Danish adaptation of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) are presented. Four samples tested from 1988 to 1991 (n = 166, n = 54, n = 95, and n = 61) were pooled, resulting in an aggregate sample of 376 participants. The normative data were generally congruent with earlier normative studies with regard to score distribution, item difficulty levels, and reliability. Studies using the Danish adaptation of the HGSHS:A as a screening instrument have shown the predictive value of the instrument in a Danish context. Data for a comparable American sample of volunteers (n = 170) tested by the same hypnotist were included in the analysis. A comparison revealed a marked difference for the posthypnotic suggestion item, hinting that cultural differences between the Danish and American samples with regard to expectancies and attitudes toward hypnosis may play a role. Further studies comparing attitudes toward hypnosis across different cultural contexts are needed to clarify this issue.

Adult↗

PubMed1994

Effect of hypnotic suggestion on the delayed-type hypersensitivity response.

OBJECTIVE: To determine whether individuals selected for good general health, high hypnotizability, and the ability to alter skin temperature under hypnotic suggestion can influence the delayed-type hypersensitivity (DTH) response to varicella-zoster (VZ) antigen under hypnotic suggestion. DESIGN: A blinded clinical trial using a repeated measures design with subjects serving as their own controls. Subjects were randomly assigned to undergo a predetermined sequence of four different experimental conditions, occurring at weekly intervals, with each condition including VZ skin testing: (1) hypnosis with suggestions to enhance the DTH response to VZ antigen; (2) hypnosis with suggestions to suppress the DTH response; (3) hypnosis with suggestions for relaxation only; and (4) skin testing without hypnosis. SETTING: A National Institutes of Health-supported clinical research center in a teaching hospital. SUBJECTS: A stratified sample of 24 ambulatory, healthy, highly hypnotizable, volunteer college students selected for their above-average ability to alter skin temperature after hypnotic suggestions and their positive baseline responses to VZ antigen. There were 11 males and 13 females with a mean +/- SD age of 22 +/- 6 years. The mean +/- SD hypnotizability score (Harvard Group Scale of Hypnotic Susceptibility) was 11 +/- 1. INTERVENTIONS: Intradermal skin testing with VZ antigen (Mantoux method) and hypnotic suggestion. MAIN OUTCOME MEASURES: Areas of induration of the DTH response measured at 24 and 48 hours after injection of antigen. RESULTS: The area of the DTH response was not affected by the experimental interventions. The area of erythema was likewise unaffected. CONCLUSIONS: Our subjects were unable to alter their DTH responses using hypnotic suggestion.

Adult↗

PubMed1994

Laser-induced pain-related brain potentials and sensory pain ratings in high and low hypnotizable subjects during hypnotic suggestions of relaxation, dissociated imagery, focused analgesia, and placebo.

Pain reports and amplitudes of painful argon laser-induced brain potentials were obtained for 10 high and 10 low hypnotizable volunteers following placebo and a randomized sequence of four hypnotically induced conditions of (a) neutral hypnosis, (b) deep relaxation, (c) pleasant dissociated "out of body" imagery, and (d) focused analgesia of the hand. Both high and low hypnotizable subjects exhibited significant reductions of reported pain during conditions of neutral hypnosis, relaxation, dissociated imagery, and focused analgesia. High hypnotizable subjects displayed significantly greater reductions than low hypnotizables in all conditions except placebo. Both high and low hypnotizables exhibited significant reductions of reported pain in all five conditions as well as in the posthypnotic condition, when amplitudes of evoked potentials were compared to the prehypnotic baseline. Only the high hypnotizable group showed significant reductions in amplitudes when the data were recalculated to reflect relative changes compared to the average amplitude of the pre- and postconditions to compensate for a possible habituation effect indicated by the significantly lowered amplitudes in the posthypnotic condition. The results are discussed in light of a number of hypotheses concerning mechanisms of hypnotic analgesia.

Adult↗

PubMed1994

Changes in cellular immune function after immune specific guided imagery and relaxation in high and low hypnotizable healthy subjects.

This article presents the results of two investigations, each measuring cellular immune function on 3 investigation days 1 week apart in 15 high and 15 low hypnotizable healthy subjects randomly selected for three groups: (1) a guided imagery group receiving instructions to enhance cellular immune function: (2) a relaxation group which did not receive instructions regarding the immune system, and (3) a control group. Study 1 investigated changes in monocyte chemotaxis (MC) and lymphocyte proliferative response (LPR) to three mitogens, while natural killer cell activity (NKCA) was measured in study 2. The results show similar patterns of brief decreases in LPR and NKCA immediately after intervention on all investigation days in both the imagery and relaxation groups. Increases in MC were found in both intervention groups on day 1. On a follow-up investigation day in study 2, a brief stress task yielded a slight increase in NKCA. In study 2, the control group showed decreases in NKCA similar to those observed in the two intervention groups. In general there were no significant changes in preintervention immune function throughout the investigation period. When comparing the effects in high and low hypnotizable subjects, we found that high hypnotizables showed greater decreases in LPR and NKCA than low hypnotizables. There are several inconsistencies between the results of the limited number of investigations studying the effects of guided imagery and relaxation on immune function. These differences may in part be explained by differences in methodology, time intervals between blood sampling, and subject characteristics such as age, health status and hypnotizability. The inconsistent results make it premature to make inferences about possible benefits of the application of these techniques in the treatment of immune related diseases, and further investigations are needed.

Adolescent↗

PubMed1994

Effects of hypnotic suggestions on ultraviolet B radiation-induced erythema and skin blood flow.

Results from both animal and human studies have indicated that inflammatory skin reactions such as the flare response to histamine prick test involve a neurogenic regulatory component. It is still unknown to which degree inflammation induced by ultraviolet (UV) radiation may be mediated by the central nervous system. To investigate this, the effect of hypnotic suggestions to increase and decrease the response to UVB radiation on erythema and cutaneous blood flow was investigated in 10 highly hypnotizable subjects. The results showed a significant effect of hypnotic suggestions on cutaneous blood flow compared with the responses of a control group. For erythema no conclusive evidence was found. The results indicate the possibility of separate regulatory mechanisms behind central nervous system influence on UVB-induced erythema and skin blood flow respectively, and further investigations are needed.

Adult↗

PubMed1993

Increase and decrease of delayed cutaneous reactions obtained by hypnotic suggestions during sensitization. Studies on dinitrochlorobenzene and diphenylcyclopropenone.

Cutaneous reactivity to challenge with dinitrochlorobenzene (DNCB) and diphenylcyclopropenone (DCP) was studied in 16 volunteers following hypnotic suggestions to increase and decrease response during sensitization. The immunoreactivity to DNCB and DCP was modulated by direct suggestions and guided imagery under hypnosis. The volunteers were highly susceptible subjects selected by means of the Harvard Group Scale of Hypnotic Susceptibility, Form A. Measurement of skin reactions to the challenge 1 month after sensitization was performed double blindly. Results showed a significant (P < 0.01) difference in visually scored reactions to DCP and DNCB between the group instructed to increase reaction to DCP and decrease reaction to DNCB and the group given the opposite instructions. A non-significant difference (P = 0.055) in skin thickness measured by ultrasound was found between the two groups. The study supports previous reports of experimental modulation of immunoreactivity and indicates that the specific immunological processes involved in the development of allergic reactions may be susceptible to psychological factors.

Adult↗

PubMed1991

The effect of hypnotically induced emotional states on brain potentials evoked by painful argon laser stimulation.

The relationship between pain perception and emotional states is well known. However, the nature of this relationship and how different emotional states affect sensory and cognitive dimensions of pain remains uncertain. Results from experimental investigations are often contradictory, which may be due to methodological difficulties in inducing pain and monitoring physiological responses. In addition, most studies have focused on a single emotion, and data on the relative effects of different emotional states are lacking. In the present study we attempted to eliminate some of these methodological problems. Laser evoked potentials were used as a quantitative correlate to pain perception and were measured in 12 highly hypnotically susceptible subjects during seven conditions: (a) a prehypnotic baseline condition; (b) a neutral hypnotic control condition; (c-e) hypnotically recalled anger, fear, and depression in randomized order; (f) a hypnotically recalled happy condition, and (g) a posthypnotic awake control condition. The pain evoked potentials were significantly decreased in the angry condition and significantly increased in the depressed condition compared with baseline. No differences could be detected for either the happy or the fear-related condition compared with the baseline or neutral hypnotic condition. A significant positive correlation between the subjective intensity of depression and the increase in evoked potentials was found, but none for the other three emotions. The results support earlier findings that clinical depression is related to increased pain perception, and findings that the expression of anger can inhibit the experience of pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Monocyte chemotactic activity in sera after hypnotically induced emotional states.

In a number of studies it has been shown that psychological factors in general and specifically emotional factors can be correlated to changes in immunological function and defence mechanisms. Although the mediating pathways between the central nervous system and the immune system still remain unclear, it is known that some of the 'classical stress hormones' such as cortisol and catecholamines have modulatory effects on different immunological parameters. In this investigation we wished to study the effect of brief hypnotically induced emotional states on monocyte chemotaxis and endocrinological parameters. Eleven highly hypnotically susceptible volunteers were, while in a deep trance, given suggestions to re-experience earlier life experiences involving intense anger and depression in random order. Before concluding hypnosis subjects were given suggestions to re-experience a feeling of happiness and well-being. Monocyte chemotactic activity in sera and serum levels of cortisol, as well as venous plasma levels of the catecholamines epinephrine, norepinephrine, DOPA and DOPAC, were measured before hypnosis, after each emotional state and immediately after hypnosis. The results showed a significant differences (P less than 0.02) in chemotactic activity between the angry and the depressed emotional states, the depressed state exhibiting a decreased chemotactic index compared with the angry state. Chemotactic index after the happy relaxed emotional state also showed a significant (P less than 0.01) increase compared with both chemotactic index before hypnosis and chemotactic activity after the angry and depressed state. Though there were significant differences between emotions and between emotions and the before-hypnosis-condition, no clear-cut significant differences between the emotional states of anger and depression could be detected for serum cortisol levels and catecholamine plasma levels. Significant positive correlations (P less than 0.01) for differences in chemotactic activity and differences in plasma DOPA levels between emotional states was found. When investigated in vitro, DOPA did not in itself exhibit monocyte chemotactic properties. No other significant correlations between differences in chemotactic activity and other endocrinological parameters could be detected. Soluble interleukin-2 receptors in serum were also measured. No significant differences were found.

Anger↗

PubMed1990

The effect of hypnotically induced analgesia on flare reaction of the cutaneous histamine prick test.

The effect of psychological pain reduction on the cutaneous inflammatory process was investigated by studying the effect of hypnotically induced analgesia on the flare reaction of cutaneous histamine prick tests. Ten highly hypnotically susceptible volunteers had their cutaneous reactivity against histamine prick tests on both arms measured before hypnosis. Their pain-related brain potentials were measured on the basis of eight argon laser stimulations. These measurements were repeated in the hypnotic condition, where subjects were given repeated suggestions of analgesia in one arm. Final measurements were performed in the post-hypnotic condition. Subjectively felt pain was measured on a visual analogue scale. Results showed a mean reduction in subjectively felt pain of 71.7% compared to the baseline condition. A significant (P less than 0.01) mean reduction of the evoked potentials was found in the hypnotic analgesic condition compared to both the pre-hypnotic (49.9%) and the post-hypnotic condition (36.9%). A significant difference was measured in the histamine flare area between the pre-hypnotic and the hypnotic analgesic condition (P = 0.01-0.02) and between the hypnotic analgesic and the post-hypnotic condition when compared with the control arm. The mean ratio of flare area between the analgesic arm and the control arm was 1.04 (SD, 0.16) in the pre-hypnotic condition, 0.78 (SD, 0.22) in the hypnotic analgesic condition, and 1.37 (SD, 0.49) in the post-hypnotic condition. The results support the hypothesis that higher cortical processes can be involved in the interaction of inflammatory and pain processes.

Adult↗

PubMed1990

Effect of psychological intervention in the form of relaxation and guided imagery on cellular immune function in normal healthy subjects. An overview.

The present study measured the effects of relaxation and guided imagery on cellular immune function. During a period of 10 days 10 healthy subjects were given one 1-hour relaxation procedure and one combined relaxation and guided imagery procedure, instructing the subjects to imagine their immune system becoming very effective. Even though no major changes in the composition of the major mononuclear leukocyte subsets could be demonstrated a significant increase in natural killer function was demonstrated. These data suggest that relaxation and guided imagery might have a beneficial effect on the immune defense and could form the basis of further studies on psychological intervention and immunological status.

Adult↗

PubMed1989

Modulation of type I immediate and type IV delayed immunoreactivity using direct suggestion and guided imagery during hypnosis.

Cutaneous reactivity against histamine skin prick test (Type I) and purified tuberculin protein derivative (Mantoux reaction, Type IV) was studied in eight volunteers under hypnosis. Types I and IV immunoreactivity were modulated by direct suggestion (Type I) and guided imagery (Type IV). The volunteers were highly susceptible subjects, selected by means of the Harvard Group Scale of Hypnotic Susceptibility, Form A. When the volunteers underwent hypnotic suggestion to decrease the cutaneous reaction to histamine prick test, a significant (P less than 0.02) reduction of the flare reaction (area of erythema) was observed compared with control histamine skin prick tests. The wheal reaction did not respond to hypnotic suggestion. Neither wheal nor flare reaction could be increased in size by hypnotic suggestion compared with control histamine skin prick tests. A hypnotic suggestion of increasing the Type IV reaction on one arm and decreasing the reaction on the other revealed a significant difference in both erythema size (P less than 0.02) and palpable induration (P less than 0.01). In two cases the reactions were monitored by laser doppler blood flowmetry and skin thickness measurement by ultrasound. The difference between the suggested increased and decreased reaction was 19% for the laser doppler bloodflow (in favor of the augmented side), and 44% for the dermal infiltrate thickness. This study objectively supports the numerous uncontrolled case reports of modulation of immunoreactivity in allergic diseases involving both Type I and Type IV skin reactions following hypnotic suggestions.

Adult↗