The suggestion card as an alternative to the suggestion book.
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Books↗
The effects of hypnotic and nonhypnotic imaginative suggestion on pain.
BACKGROUND: Few studies have compared placebo and suggested pain reduction. PURPOSE: Hypnotic and nonhypnotic imaginative analgesia suggestions were compared against a placebo in reducing experimental pain. The mediator role of response expectancies and the moderator role of hypnotic and nonhypnotic imaginative suggestibility were evaluated. METHODS: Sixty participants previously assessed for hypnotic and nonhypnotic imaginative suggestibility were assigned to one of two experimental conditions or a no-treatment control condition. In the "placebo first" condition, participants received placebo, followed by imaginative and then hypnotic analgesia suggestions. In the "placebo last" condition, participants received imaginative and then hypnotic suggestions, followed by placebo. RESULTS: Imaginative and hypnotic suggestions did not differ significantly and were more effective than no treatment in reducing pain. The placebo was no different from the analgesia suggestions and was more effective than no treatment, but only when administered after the suggestions. Pain reduction was mediated by expectancy but was not significantly related to suggestibility or hypnotizability, the latter operationalized as hypnotic suggestibility with imaginative suggestibility statistically controlled. CONCLUSIONS: In the general population, nonhypnotic imaginative suggestions may be as effective as hypnotic suggestions in reducing pain. Response expectancies would seem to be an important mechanism of placebo and suggested pain reduction.
Humans↗
Imaginative suggestibility and hypnotizability: an empirical analysis.
Hypnotic and nonhypnotic suggestibility were investigated in 2 experiments. In Experiment 1, nonhypnotic suggestibility was suppressed when measured after hypnotic suggestibility, whereas hypnotic suggestibility was not affected by the order of assessment. Experiment 2 confirmed a small but significant effect of hypnosis on suggestibility when nonhypnotic suggestibility was measured first. Nonhypnotic suggestibility was correlated with absorption, fantasy proneness, motivation, and response expectancy, but only expectancy predicted suggestibility when the other variables were controlled. Behavioral response to hypnosis was predicted by nonhypnotic suggestibility, motivation, and expectancy in a model accounting for 53% of the variance. Experiential response to hypnotic suggestion was predicted only by nonhypnotic suggestibility. Unexpectedly, hypnosis was found to decrease suggestibility for a substantial minority of participants.
Adolescent↗
Hypnotic suggestion and the modulation of Stroop interference.
BACKGROUND: Hypnosis has been used clinically for hundreds of years and is primarily a phenomenon involving attentive receptive concentration. Cognitive science has not fully exploited hypnosis and hypnotic suggestion as experimental tools. This study was designed to determine whether a hypnotic suggestion to hinder lexical processing could modulate the Stroop effect. METHODS: Behavioral Stroop data were collected from 16 highly suggestible and 16 less suggestible subjects; both naturally vigilant and under posthypnotic suggestion. Subjects were urged to only attend to the ink color and to impede reading the stimuli under posthypnotic suggestion. RESULTS: Whereas posthypnotic suggestion eliminated Stroop interference for highly suggestible subjects, less suggestible control subjects showed no significant reduction in the interference effect. CONCLUSIONS: This outcome challenges the dominant view that word recognition is obligatory for proficient readers, and may provide insight into top-down influences of suggestion on cognition.
Adult↗
Differences in review quality and recommendations for publication between peer reviewers suggested by authors or by editors.
CONTEXT: Many journals give authors who submit papers the opportunity to suggest reviewers. Use of these reviewers varies by journal and little is known about the quality of the reviews they produce. OBJECTIVE: To compare author- and editor-suggested reviewers to investigate differences in review quality and recommendations for publication. DESIGN, SETTING, AND PARTICIPANTS: Observational study of original research papers sent for external review at 10 biomedical journals. Editors were instructed to make decisions about their choice of reviewers in their usual manner. Journal administrators then requested additional reviews from the author's list of suggestions according to a strict protocol. MAIN OUTCOME MEASURE: Review quality using the Review Quality Instrument and the proportion of reviewers recommending acceptance (including minor revision), revision, or rejection. RESULTS: There were 788 reviews for 329 manuscripts. Review quality (mean difference in Review Quality Instrument score, -0.05; P = .27) did not differ significantly between author- and editor-suggested reviewers. The author-suggested reviewers were more likely to recommend acceptance (odds ratio, 1.64; 95% confidence interval, 1.02-2.66) or revise (odds ratio, 2.66; 95% confidence interval, 1.43-4.97). This difference was larger in the open reviews of BMJ than among the blinded reviews of other journals for acceptance (P = .02). Where author- and editor-suggested reviewers differed in their recommendations, the final editorial decision to accept or reject a study was evenly balanced (50.9% of decisions consistent with the preferences of the author-suggested reviewers). CONCLUSIONS: Author- and editor-suggested reviewers did not differ in the quality of their reviews, but author-suggested reviewers tended to make more favorable recommendations for publication. Editors can be confident that reviewers suggested by authors will complete adequate reviews of manuscripts, but should be cautious about relying on their recommendations for publication.
Authorship↗
False attribution of suggestibility to explain recovered memory of childhood sexual abuse following extended amnesia.
Suggestibility is central to arguments proffered by critics of recovered memory of childhood sexual abuse who believe that memories involving amnesia are false creations of treatment. The present study represents the first direct investigation of suggestibility among patients who report recovered memory. Suggestibility was measured in 44 patients who recovered memories and in a 31 patient comparison group without a history of sexual trauma using the Gudjonsson Suggestibility Scale. Results indicated that patients who recover memories were remarkably less suggestible than the clinical field has been led to believe by advocates of false memory. As a group, they scored low on suggestibility. Recovered Memory patients yielded to suggested prompts an average of 6.7 times per case. This compares to an average of 10.6 in the Psychiatric comparison group. Paradoxically, patients without a history of sex abuse were more at risk for altering memory to suggestive prompts. These findings appreciably challenge advocated theories of suggested memory.
Adult↗
The suggestibility of children's memory for being touched: planting, erasing, and changing memories.
Investigates recent claims that it is relatively easy to suggestively plant false memories in children, by comparing the relative vulnerability to suggestibility of changed, planted, and erased memories. 80 4-year-olds and 80 10-year-olds either were touched in a specific way or were not touched at all, and it was later suggested that a different touch, a completely new touch, or no touch at all had occurred. The suggestibility effect occurred only in the changed memory condition; the difference between the experimental changed condition and the corresponding control condition was significant. In the planted and erased memory conditions no suggestibility effect occurred; there was no significant reduction in the experimental groups relative to the corresponding control conditions. Thus, although it is relatively easy to suggest to a child a change in an event that was experienced, it is less likely that an event can be planted in or erased from memory. It is thus inappropriate to provide courtroom testimony regarding the probability of suggestively planting false memories based on the classic suggestibility research, which has largely been restricted to the study of suggestively changing memories.
Child↗
Suggestibility and negative priming: two replication studies.
Research suggests that inhibiting the effect of irrelevant stimuli on subsequent thought and action (cognitive inhibition) may be an important component of suggestibility. Two small correlation studies were conducted to address the relationship between different aspects of suggestibility and individual differences in cognitive inhibition, operationalized as the degree of negative priming generated by to-be-ignored stimuli in a semantic categorization task. The first study found significant positive correlations between negative priming, hypnotic suggestibility, and creative imagination; a significant negative correlation was obtained between negative priming and interrogative suggestibility, demonstrating the discriminant validity of the study results. The second study replicated the correlation between negative priming and hypnotic suggestibility, using a different suggestibility measurement procedure that assessed subjective experience and hypnotic involuntariness as well as objective responses to suggestions. These studies support the notion that the ability to engage in cognitive inhibition may be an important component of hypnotic responsivity and maybe of other forms of suggestibility.
Adult↗
Hypnosis, suggestion type, and subjective experience--the order-effects hypothesis revisited: a brief communication.
In a replication and extension of Field, Evans, and Orne's (1965) research, no support was found for the hypothesis that suggestion order is related to hypnotic responding. Confirming earlier findings, Ss were no more responsive to suggestions ordered from easy-to-difficult than they were to suggestions ordered from difficult-to-easy. Measures of subjective involvement in suggestions, involuntariness, and archaic involvement with the hypnotist were no more sensitive to order effects than was the measure of objective responding. Nor were order effects more apparent with Ss who received direct versus indirect suggestions. Direct suggestions facilitated suggestion-related involuntariness and response to the hypnotic amnesia item after cancellation, whereas indirect suggestions enhanced fears of negative appraisal by the hypnotist. Finally, female Ss were more involved in suggestions than were the males, particularly in response to more difficult test items.
Adolescent↗
Pre- and perioperative suggestion in maxillofacial surgery: effects on blood loss and recovery.
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.
Adult↗
Brief modification of suggestibility and hypnotic analgesia: too good to be true?
A 10-minute training procedure, based on the Carleton Skill Training Program, has previously been reported to produce substantial increments in responsiveness to hypnotic suggestion. The authors attempted to replicate this effect and also assessed the impact of the training procedure on hypnotically suggested analgesia. Ninety-eight students who had been preselected for high, medium, and low levels of initial suggestibility were randomly assigned to experimental and control groups. Training failed to increase overall suggestibility scores or to enhance the effects of a suggestion for pain reduction. Suggested pain reduction was more highly correlated with posttreatment suggestibility scores than with pretreatment suggestibility and, in a regression analysis, only posttreatment suggestibility predicted pain reduction uniquely.
Female↗
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↗
"Indirect" suggestion in hypnosis: theoretical and experimental issues.
"Indirect" suggestion is conceptualized in two distinct ways in the literature. From an Ericksonian perspective "indirect" suggestions are theoretically approached as suggestions which can circumvent the censorship of consciousness to reach the "unconscious" where they can activate dormant potentials. In contrast, from a research perspective "indirect" suggestion is operationally defined as a technique. Based on Ericksonian theory, it was claimed that "indirect" suggestion was more effective than traditional, "direct" suggestion. However, this claim could not be empirically substantiated. In this paper it is shown that the theoretical claim is based on questionable assumptions about the existence of the "unconscious" as a reified entity and about the direct and lineal influence of certain suggestions on this entity. Also, it is argued that traditional research strategies which emphasize strict controls are unable to verify or unambiguously refute the Ericksonian claim because these strategies are biased toward "direct" suggestion. Finally, the paper provides a different, contextual perspective on "indirect" suggestion, thereby placing the theoretical and experimental issues in a different context of meaning.
Humans↗
Skin temperature regulation: the effects of suggestion and feedback.
This study focuses on the effects of visual digital feedback and verbal suggestions on an individual's ability to increase hand skin temperature. In this 2 x 2 factorial design, thirty-eight college students were assigned to conditions receiving feedback or no feedback and suggestions or no suggestions. Subjects receiving suggestions heard a tape recorded imagery phrase related to increasing hand temperature; subjects in the no-suggestion condition received neutral phrases of electronic definitions. All subjects participated in three training sessions. Analysis of the third session indicated an interaction effect; post hoc analysis indicated a significant difference between subjects receiving feedback with suggestion and subjects receiving feedback and no suggestion. The results suggest that the ability to increase skin temperature may require the concomitant use of feedback and suggestion.
Biofeedback, Psychology↗
Effects of suggestion on increasing or decreasing skin temperature control.
In a 2 x 3 factorial design, 44 college students were assigned the task of either increasing or decreasing their hand skin temperature, receiving either suggestions, pseudo-suggestions, or no suggestions (response-specific instructions only). Subjects receiving suggestions heard imagery phrases related to increasing or decreasing hand skin temperature; subjects in the pseudo-suggestion condition heard phrases related to electronics; subjects in the response-specific condition were told only to increase or decrease their skin temperature prior to training. All subjects participated in three training sessions. Analyses of the third session indicated a significant main effect for temperature direction and a significant interaction effect. A marginally significant main effect for suggestion was obtained. The results suggest that the ability of a subject to regulate hand skin temperature is influenced by the combination of required direction of change and type of suggestion. The data support the notion that pseudo-suggestions may act as a distractor which disrupts the ability of a subject to control hand skin temperature in both the increase and decrease directions.
Biofeedback, Psychology↗
Effect of hypnotic suggestion on fibromyalgic pain: comparison between hypnosis and relaxation.
The main aims of this experimental study are: (1) to compare the relative effects of analgesia suggestions and relaxation suggestions on clinical pain, and (2) to compare the relative effect of relaxation suggestions when they are presented as "hypnosis" and as "relaxation training". Forty-five patients with fibromyalgia were randomly assigned to one of the following experimental conditions: (a) hypnosis with relaxation suggestions; (b) hypnosis with analgesia suggestions; (c) relaxation. Before and after the experimental session, the pain intensity was measured using a visual analogue scale (VAS) and the sensory and affective dimensions were measured with the McGill Pain Questionnaire. The results showed: (1) that hypnosis followed by analgesia suggestions has a greater effect on the intensity of pain and on the sensory dimension of pain than hypnosis followed by relaxation suggestions; (2) that the effect of hypnosis followed by relaxation suggestions is not greater than relaxation. We discuss the implications of the study on our understanding of the importance of suggestions used in hypnosis and of the differences and similarities between hypnotic relaxation and relaxation training.
Adult↗
Failure of computerized treatment suggestions to improve health outcomes of outpatients with uncomplicated hypertension: results of a randomized controlled trial.
STUDY OBJECTIVE: To assess the effects of evidence-based treatment suggestions for hypertension made to physicians and pharmacists using a comprehensive electronic medical record system. DESIGN: Randomized controlled trial with a 2 x 2 factorial design of physician and pharmacist interventions, which resulted in four groups of patients: physician intervention only, pharmacist intervention only, intervention by physician and pharmacist, and intervention by neither physician nor pharmacist (control). SETTING: Academic primary care internal medicine practice. SUBJECTS: Seven hundred twelve patients with uncomplicated hypertension. MEASUREMENTS AND MAIN RESULTS: Suggestions were displayed to physicians on computer workstations used to write outpatient orders and to pharmacists when filling prescriptions. The primary end point was generic health-related quality of life. Secondary end points were symptom profile and side effects from antihypertensive drugs, number of emergency department visits and hospitalizations, blood pressure measurements, patient satisfaction with physicians and pharmacists, drug therapy compliance, and health care charges. In the control group, implementation of care changes in accordance with treatment suggestions was observed in 26% of patients. In the intervention groups, compliance with suggestions was poor, with treatment suggestions implemented in 25% of patients for whom suggestions were displayed only to pharmacists, 29% of those for whom suggestions were displayed only to physicians, and 35% of the group for whom both physicians and pharmacists received suggestions (p=0.13). Intergroup differences were neither statistically significant nor clinically relevant for generic health-related quality of life, symptom and side-effect profiles, number of emergency department visits and hospitalizations, blood pressure measurements, charges, or drug therapy compliance. CONCLUSION: Computer-based intervention using a sophisticated electronic physician order-entry system failed to improve compliance with treatment suggestions or outcomes of patients with uncomplicated hypertension.
Antihypertensive Agents↗