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PubMed1996

The impact of a confusion technique on hypnotic responsivity in low-susceptible subjects.

The present study investigated the hypothesis that a confusion technique would produce greater hypnotic responsiveness for subjects who responded minimally to a standard hypnotic induction. Ten subjects who scored in the low range of hypnotic susceptibility on the HGSHS:A (scores of 0-4) participated in a confusion induction session. Hypnotic responsiveness was measured by several scales: the Harvard Group Scale of Hypnotic Susceptibility (HGSHS:A), a Depth Estimate (DE), and the Inventory Scale of Hypnotic Depth (ISHD). Qualitative data was collected via a follow-up interview. Collectively, the results did not support the hypothesis that a confusion technique is more effective than a standard induction for low-susceptible subjects. Implications for future research will be discussed.

Adolescent↗
PubMed1989

Effects of hypnotic analgesia and hypnotizability on experimental ischemic pain.

Mechanisms of hypnotic analgesia are still poorly understood and conflicting data are reported regarding the underlying neurochemical correlates. The present study was designed to investigate the effects of hypnotically induced analgesia and hypnotizability on experimental ischemic pain, taking into account pain and distress tolerance as well as the neurochemical correlates. 11 high hypnotizable Ss and 10 low hypnotizable Ss, as determined by scores on the Stanford Hypnotic Susceptibility Scale, Form C (Weitzenhoffer & E. R. Hilgard, 1962), were administered an ischemic pain test in both waking and hypnotic conditions. The following variables were measured: (a) pain and distress tolerance, (b) anxiety levels, and (c) plasma concentrations of beta-endorphin and adrenocorticotropic hormone (ACTH). Results confirmed significant increases of pain and distress tolerance during hypnosis as compared to the waking state, with positive correlations between pain and distress relief and hypnotizability. Moreover, a hypnotically induced dissociation between the sensory-discriminative and the affective-motivational dimensions of pain experience was found, but only in high hypnotizable Ss. Hypnotic analgesia was unrelated to anxiety reduction and was not mediated either by endorphins or by ACTH.

Adult↗
PubMed1989

The relation of self-reports of hypnotic depth in self-hypnosis to hypnotizability and imagery production.

The relationship of self-reports of hypnotic depth obtained during self-hypnosis to hypnotizability and to the kinds of imagery produced during self-hypnosis is investigated. The sample consisted of 22 highly hypnotizable Ss who practiced self-hypnosis in 1-hour daily sessions for 4 weeks and kept daily journals in which they detailed the contents of their self-hypnosis experiences. The journals were coded for imagery production by scoring for both reality-oriented and primary process imagery. Ss had been taught to monitor their hypnotic depth using a slightly revised version of the Extended North Carolina Scale (ENCS) of Tart (1979). Previously, ENCS has been used only with heterohypnotic Ss. The self-reports of depth using ENCS correlated highly with hypnotizability as measured by the Revised Stanford Profile Scale of Hypnotic Susceptibility. Form I of Weitzenhoffer and Hilgard (1967) and with imagery production. Results demonstrate that ENCS scores are also a valid indicator of self-hypnotic depth among highly hypnotizable Ss. Furthermore, they indicate that both hetero-hypnotizability and imagery production are related to self-hypnotic depth, but that the association between imagery and hypnotizability is due to their individual relationships to self-hypnotic depth.

Adolescent↗
PubMed1991

The role of expectancy in hypnotic hypermnesia: a brief communication.

Previous research has yielded equivocal evidence of hypnotic memory enhancement. The present experiment assessed the effects of expectancy and hypnotizability on recall for videotaped material under waking and hypnotic conditions. Ss (N = 138) were informed of hypnotic induction either before (expectancy condition) or after (no expectancy condition) watching a videotaped enactment of a crime and completing an initial waking recall test (RI). Both groups then underwent hypnotic induction, and completed the test again (R2). Ss' raw recall scores were significantly greater under hypnotic than waking conditions, but this hypermnesia was not evident when scores were corrected for mere increase in rate of responding. Ss expecting later hypnosis scored significantly higher than Ss with no such expectations, but again, this difference was not evident in corrected scores. Hypnotizability of Ss was, however, related to corrected recall, with high hypnotizable Ss displaying the greatest increase in rate of responding from R1 to R2. No evidence for the hypothesized "suppression effect" underlying hypnotic hypermnesia was found.

Adult↗
PubMed1993

The effects of direct versus indirect hypnotic suggestion on pain in a cold pressor task.

Past studies have investigated the usefulness of hypnosis in pain reduction. Although hypnotic analgesia has been found to be effective, it is generally only those subjects who are highly susceptible to hypnosis who benefit. Some experimenters have found that even low-susceptible subjects can use hypnotic analgesia, if the hypnotic induction uses indirect rather than direct hypnotic suggestions. In the present study, high- and low-susceptible subjects were tested for analgesia using either direct or indirect hypnotic suggestion on pain in a cold pressor task. Findings suggest that high susceptibles experience greater pain reduction than do low susceptibles. However, no significant differences were found between the pain reduction in the direct versus the indirect hypnotic suggestion groups. Possible explanations for this lack of differences are discussed.

Adult↗
PubMed1994

Event-related potentials during hypnotic hallucination.

Event-related potentials were elicited by visual stimulation and recorded at frontal, central, and posterior scalp sites so as to study the psychophysiological process associated with hypnotic hallucination. Subjects were screened using two measures of hypnotic susceptibility (Harvard Group Scale of Hypnotic Susceptibility, Form A and the Stanford Hypnotic Susceptibility Scale, Form C). Seven high and 9 low hypnotizable right-handed females participated in the experiment. Eight intermediate hypnotizable right-handed females served as controls. Peak amplitudes and latencies of P1, N1, P2, N2, and P3 components were compared in two hypnotic conditions (obtained by means of hypnotic suggestions): stimulus enhancement and stimulus elimination. High hypnotizable subjects displayed a significant attenuation of the P1 and N1 amplitudes of the evoked response while experiencing stimulus elimination. The effect for the P1 component was greatest at the posterior sites compared to that found at the anterior and central sites. A similar trend across condition was also observed for P3 peak amplitude, even though the Group x Condition interaction was only marginally significant (p < .07). During negative hallucination, P3 peak latency for high hypnotizables was shorter than that obtained during stimulus enhancement. This effect was more pronounced across the right hemisphere. These results are discussed in light of previous findings.

Adult↗
PubMed1995

Hypnotic analgesia, expectancy effects, and choice of design: a reexamination.

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-subjects designs were considered in explaining the superiority of hypnotic analgesia over waking analgesia typically found in within-subjects models.

Adult↗
PubMed1992

Potentiated hypnotic action with a combination of fentanyl, a calcium channel blocker and an alpha 2-agonist in rats.

An investigation was made of the hypnotic-anaesthetic effects in rats of subcutaneous coadministration of fentanyl (25-100 micrograms.kg-1), clonidine (100-300 micrograms.kg-1) and verapamil (1-5 mg.kg-1). Hypnotic-anaesthetic efficacy was assessed via loss of the righting reflex. In the doses used, none of the three drugs alone was associated with appreciable hypnotic-anaesthetic effects. Coadministration of fentanyl and clonidine resulted in a dose-related enhancement of the anaesthetic potency, without change in the duration of hypnotic action. Verapamil coadministration failed to increase the anaesthetic efficacy of binary combinations of fentanyl and clonidine, but a marked prolongation of the duration of hypnotic action was observed (P less than 0.001). These results suggest the existence of unreported interactions between these three drugs in the production of hypnotic-anaesthetic action in rats.

Adrenergic alpha-Agonists↗
PubMed1999

Cerebral mechanisms of hypnotic induction and suggestion.

The neural mechanisms underlying hypnotic states and responses to hypnotic suggestions remain largely unknown and, to date, have been studied only with indirect methods. Here, the effects of hypnosis and suggestions to alter pain perception were investigated in hypnotizable subjects by using positron emission tomography (PET) measures of regional cerebral blood flow (rCBF) and electroencephalographic (EEG) measures of brain electrical activity. The experimental conditions included a restful state (Baseline) followed by hypnotic relaxation alone (Hypnosis) and by hypnotic relaxation with suggestions for altered pain unpleasantness (Hypnosis-with-Suggestion). During each scan, the left hand was immersed in neutral (35 degree C) or painfully hot (47 degrees C) water in the first two conditions and in painfully hot water in the last condition. Hypnosis was accompanied by significant increases in both occipital rCBF and delta EEG activity, which were highly correlated with each other (r = 0.70, p < 0.0001). Peak increases in rCBF were also observed in the caudal part of the right anterior cingulate sulcus and bilaterally in the inferior frontal gyri. Hypnosis-related decreases in rCBF were found in the right inferior parietal lobule, the left precuneus, and the posterior cingulate gyrus. Hypnosis-with-suggestions produced additional widespread increases in rCBF in the frontal cortices predominantly on the left side. Moreover, the medial and lateral posterior parietal cortices showed suggestion-related increases overlapping partly with regions of hypnosis-related decreases. Results support a state theory of hypnosis in which occipital increases in rCBF and delta activity reflect the alteration of consciousness associated with decreased arousal and possible facilitation of visual imagery. Frontal increases in rCBF associated with suggestions for altered perception might reflect the verbal mediation of the suggestions, working memory, and top-down processes involved in the reinterpretation of the perceptual experience. These results provide a new description of the neurobiological basis of hypnosis, demonstrating specific patterns of cerebral activation associated with the hypnotic state and with the processing of hypnotic suggestions.

Adult↗
PubMed1997

P300 event-related-potential amplitudes and evoked cardiac responses during hypnotic alteration of somatosensory perception.

Ten highly hypnotizable women and 10 women with low hypnotizability were tested in a somatosensory target detection task to evaluate the effects of hypnotic alterations of somatosensory perception on P3 peak amplitude and evoked cardiac response. Stimulus detection task consisted of standard and target electric stimuli delivered with a fixed foreperiod. The P3 peak amplitude of ERPs recorded from frontal, central and temporo-parieto-occipital (posterior) scalp sites and phasic heart rate deceleration response were compared in four conditions: (1) normal attention in waking state, (2) hypnotic obstructive hallucination, (3) hypnotic attention, (4) hypnotic passive attention. High hypnotizable subjects demonstrated significant suppression of P3 peak amplitude to target stimuli in the left frontal and posterior scalp sites during hypnotic obstructive hallucination as compared to a normal attention condition. In this condition P3 suppression was paralleled by a smaller anticipatory heart rate deceleration response to probe stimulus onset. The P3 peak to standard stimuli was found significantly greater in low hypnotizable subjects than for those with high hypnotizability regardless of condition. These findings demonstrate that hypnotically induced obstructive hallucination to somatosensory stimuli involve alterations in neural and autonomic responses and are consistent with a trait conception of hypnotizability.

Adult↗
PubMed1992

Pharmacology of benzodiazepine hypnotics.

The "revolution" in pharmacologic treatment of insomnia began in 1970 with the availability of flurazepam, the first of the benzodiazepine hypnotics. Flurazepam largely replaced all other hypnotics during the decade of the 1970s. The second revolution began in the early 1980s as shorter half-life hypnotics, triazolam and temazepam, became available and began to replace flurazepam. The decade of the 1990s will probably see a more balanced pattern of benzodiazepine hypnotic use, as well as use of newer nonbenzodiazepine hypnotics. Among available benzodiazepines, all have the capacity to produce dose- and concentration-dependent sedation, drowsiness, performance impairment, and amnesia. Benzodiazepine-induced amnestic effects are characterized by either impairment of information acquisition, impairment of consolidation and storage, or both. In general, apparent clinical differences among benzodiazepine hypnotics are explained by differences in pharmacokinetic properties of absorption, distribution, elimination, and clearance.

Benzodiazepines↗
PubMed1992

Individual differences in afterimage persistence: relationships to hypnotic susceptibility and visuospatial skills.

To investigate the moderating role of individual differences in hypnotic susceptibility and visuospatial skills on afterimage persistence, we presented a codable (cross) flash of light to 40 men and 46 women who had been dark adapted for 20 min. In an unrelated classroom setting, subjects had previously been given two standardized scales of hypnotic susceptibility (Harvard Group Scale of Hypnotic Susceptibility, Shor & Orne, 1962; Group Stanford Hypnotic Susceptibility Scale, Form C, Crawford & Allen, 1982) and the Mental Rotations Test (Vandenberg & Kuse, 1978). The first afterimage interval and the afterimage duration correlated significantly with hypnotic responsiveness, supporting Wallace (1979), but did not show the anticipated relationships with mental rotation visuospatial skills. Individuals in the high hypnotizable group had (a) significantly longer afterimage intervals between its first appearance and first disappearance than did those in medium or low groups, as well as (b) significantly longer afterimages between the first appearance and the final disappearance than did those in low groups, but those in medium groups did not differ significantly from the other groups. Discriminant analysis using the afterimage persistence measures classified correctly 65.2% of high hypnotizables, 37.5% of medium hypnotizables, and 54.8% of low hypnotizables. Hypothesized cognitive skills that assist in the maintenance of afterimages and underlie hypnotic susceptibility include abilities to maintain focused attention and resist distractions over time and to maintain vivid visual images.

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↗
PubMed1996

Paired-associate learning and recall of high and low imagery words: moderating effects of hypnosis, hypnotic susceptibility level, and visualization abilities.

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), but not with the IDQ Imagery scale, the Mental Rotations Test (Vandenberg & Kuse, 1973), or the revised Minnesota Paper Form Board Test (Likert & Quasha, 1941).

Adult↗
PubMed1990

Placing obsolete hypnotics on prescription and the admission rate for acute poisoning with these drugs.

Since January 1 1988, certain older hypnotics have no longer been available over the counter in Belgium, but can still be dispensed on prescription. The influence of this measure on admission to our Emergency Department for acute poisoning with these hypnotics has been examined. From 1983 to 1987, a mean of 93 patients (range 87 to 99) per year were admitted as compared to 15 and 5 in 1988 and 1989, respectively. For older hypnotics that were on prescription before and after 1st January 1988, there was no decrease in 1988, and a reduction was observed in 1989. There was no change in the number of patients with benzodiazepine poisoning. The data indicate that moving these older hypnotics onto the prescription-only list resulted in a decrease in acute poisoning with them. The reduction observed in 1989 for the older hypnotics that were on prescription before as well as after 1988 may have been due to an influence of the measure on the prescribing habits of physicians.

Acute Disease↗
PubMed1999

[Dependency of non-benzodiazepine hypnotics. Two case reports].

With the introduction of the non-benzodiazepine hypnotics zopiclone and zolpidem it was expected to have hypnotics without side effects and risks characteristically seen with benzodiazepines. We report two cases with high-dose usage and dependency of non-benzodiazepine hypnotics. Both patients were prescribed the drugs to treat sleep disturbances occurring during a depressive episode. While one patient had a polysubstance abuse there was no evidence for an abuse history in the other patient. To reduce withdrawal symptoms long-acting benzodiazepines were given to both patients. Thus, it seems that not only patients with a history of substance abuse but also patients with a psychiatric disorder are at risk for abuse of non-benzodiazepine hypnotics. Considering the increasing number of case reports with abuse and dependence of zopiclone and zolpidem it seems necessary to reevaluate the dependency risk of the currently available non-benzodiazepine hypnotics.

Adult↗
PubMed1992

Benzodiazepine receptor binding of benzodiazepine hypnotics: receptor and ligand specificity.

Benzodiazepine (BDZ) hypnotics bind at a specific receptor located on postsynaptic neurons. Some data support specificity of binding for several hypnotics to receptor subtypes. We evaluated BDZ receptor binding in cerebral cortical membranes using agonist, antagonist, and subtype-specific ligands for commonly used hypnotics and their metabolites. All hypnotics competed similarly at BDZ1 and BDZ2 receptor subtypes except quazepam and its metabolite 2-oxo-quazepam and to a lesser extent hydroxyethyl flurazepam (EtOH) flurazepam. These compounds had relative specificity for the BDZ1 site. Triazolam, estazolam, and flurazepam bound equally to sites labeled by agonists and antagonists but desalkylflurazepam, EtOH flurazepam, temazepam, quazepam, and 2-oxo-quazepam did not; in addition, these four compounds did not bind to the "peripheral" BDZ site labeled by Ro 5-4864. BDZ hypnotics differ in their receptor subtype and ligand binding characteristics.

Animals↗
PubMed1992

Pertussis toxin-mediated ribosylation of G proteins blocks the hypnotic response to an alpha 2-agonist in the locus coeruleus of the rat.

Biologic responses mediated by adrenoceptors are transduced by a receptor-effector mechanism that involves a guanine nucleotide binding protein (G protein). Recently, we determined that the transduction mechanism for the hypnotic response to dexmedetomidine, a highly selective alpha 2-agonist, is located in the locus coeruleus (LC) of the rat. In this study, we examined the role of pertussis toxin-sensitive (PTX) G proteins in the LC for the hypnotic response to dexmedetomidine. The LC of rats were stereotactically cannulated and treated with PTX, 0.34 micrograms, or vehicle. Five days later, the hypnotic response to dexmedetomidine, 7 micrograms into the LC or 50 micrograms.kg-1 IP, was tested. On the following day, the LC was harvested and assayed to determine whether the G proteins had been ribosylated by pretreatment with PTX in vivo. Quantitative immunoblotting of G0 alpha, Gi alpha 1,2, and Gi alpha 3, the alpha-subunit of three PTX-sensitive proteins, was also performed. In vivo treatment with PTX into the LC blocked the hypnotic response to LC-administered dexmedetomidine and, to a lesser extent, IP-administered dexmedetomidine. The in vivo PTX treatment effectively ribosylated the G proteins. No alteration in the amount of the different species of PTX-sensitive alpha-subunit was produced by in vivo PTX treatment. These data suggest a pivotal role for PTX-sensitive G proteins in the LC in the hypnotic response to alpha 2-agonists in the rat.

Adenosine Diphosphate↗