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Changes in body attitude as a function of posthypnotic suggestions.

This study hypothesized that highly hypnotizable Ss who remained amnesic for posthypnotic suggestions to improve body attitude would show greater changes than Ss who were not amnesic. Ss given simulating instructions were used as a comparison group to assess experimental demands. 48 females were screened with the Harvard Group Scale of Hypnotic Susceptibility, Form A (Shor & E. Orne, 1962) and assigned to one of 4 conditions: (a) high hypnotizable with amnesia suggestions, (b) high hypnotizable without suggested amnesia, (c) low hypnotizable simulators with amnesia, and (d) low hypnotizable simulators without suggested amnesia. A fifth group was formed of those high hypnotizable Ss who remembered the suggestion despite instructions to the contrary. The Body Attitude Scale (Kurtz, 1966) was administered prior to and 3 days after the experimental suggestions. Results generally demonstrated that high hypnotizable amnesic Ss manifested the greatest attitudinal and phenomenological changes as a result of the posthypnotic suggestion, although conclusions were tempered by performance of simulating Ss. The implications for hypnosis research and clinical practice are discussed.

Adolescent↗

Direct versus indirect suggestions: a conceptual and methodological review.

The article reviews the literature on the effects of direct versus indirect hypnotic suggestions. A conceptual and methodological analysis of direct versus indirect suggestions is also provided. Three conclusions follow from the review: (a) Contrary to views of Ericksonian hypnotists, suggestion style has little effect on objective responding to hypnotic test items; (b) studies of clinical- and laboratory-induced pain and other measures of subjective experience have yielded contradictory results--however, the best controlled studies have not indicated that indirect suggestions are superior to direct suggestions; and (c) there is insufficient evidence to conclude that hypnotizability level and suggestion wording interact, such that low hypnotizable subjects are particularly responsive to indirect suggestions. Methodological and conceptual problems in defining and studying hypnotic communications, the lack of rigorous experimental controls, and research issues and directions are highlighted.

Arousal↗

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↗

Suggestion reduces the stroop effect.

We examined the effects of suggestion on Stroop interference in highly suggestible individuals. Participants completed the Stroop task with and without a suggestion to perceive Stroop words as meaningless symbols. Half the participants were given this suggestion in hypnosis, and half were given the suggestion without the induction of hypnosis. Suggestion produced a significant reduction in Stroop inhibition, accounting for about 45% of the variance in Stroop responding, regardless of whether hypnosis had been induced. These findings indicate that suggestion can at least partially overcome the automaticity associated with the Stroop effect.

Adult↗

Hypnosis, suggestions, and altered states of consciousness: experimental evaluation of the new cognitive-behavioral theory and the traditional trance-state theory of "hypnosis".

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.

Cognition↗

Outpatient video EEG recording in the diagnosis of non-epileptic seizures: a randomised controlled trial of simple suggestion techniques.

OBJECTIVE: To assess the yield of recorded habitual non-epileptic seizures during outpatient video EEG, using simple suggestion techniques based on hyperventilation and photic stimulation. DESIGN: Randomised controlled trial of "suggestion" v "no suggestion" during outpatient video EEG recording. SETTING: Regional epilepsy service (tertiary care; single centre). PARTICIPANTS: 30 patients (22 female, 8 male), aged over 16 years, with a probable clinical diagnosis of non-epileptic seizures; 15 were randomised to each group. MAIN OUTCOME MEASURES: Yield of habitual non-epileptic seizures recorded, and requirement for additional inpatient video EEG. RESULTS: 10/15 patients had habitual non-epileptic seizures with suggestion; 5/15 had non-epileptic seizures with no suggestion (p = 0.058; NS); 8/9 patients with a history of previous events in medical settings had non-epileptic seizures recorded during study. Logistic regression analysis with an interaction clause showed a significant effect of suggestion in patients with a history of previous events in medical settings (p = 0.003). An additional inpatient video-EEG was avoided in 14 of the 30 patients (47%). CONCLUSIONS: Habitual non-epileptic seizures can be recorded reliably during short outpatient video EEG in selected patients. Simple (non-invasive) suggestion techniques increase the yield at least in the subgroup with a history of previous events in medical settings. Inpatient video EEG can be avoided in some patients.

Adult↗

Response of asthmatics to methacholine and suggestion.

Effects of diluent, methacholine, and suggestion on pulmonary function were studied in 9 asthmatic subjects. On day 1, flavored diluent was given as a control preparation. On day 2, increasing concentrations of similarly flavored methacholine were administered. On day 3, the effect of flavored diluent plus suggestion was studied. Although all variables were affected, the dose-response relationships for methacholine were most pronounced for specific airway conductance and airway resistance, in contrast to maximal mid-expiratory flow, forced expiratory volume in 1 sec, and forced vital capacity. Suggestion toward bronchoconstriction significantly affected only the plethysmographic parameters, specific airway conductance, and airway resistance, and not the spirometric variables. Both airway resistance and 1-sec forced expiratory volume showed slight, but significant, changes as a result of bronchodilator suggestion, which was used to overcome the suggestion toward bronchoconstriction. Because suggestion had a greater effect on large airways than peripheral airways, a role for the vagus is implied. Thus, any protocol using body plethysmography must consider a possible effect of suggestion on results.

Adolescent↗

Autokinetic illusion as affected by suggestions of experimenter and observer.

Two experiments were done to examine whether an experimenter's suggestion and self-suggestion could affect the autokinetic illusion and to specify that effect. Exp. I compared the effect of a facilitative suggestion with a suppressive one, by measuring the moving latency, duration, frequency, and by analyzing the movement trace. Time and frequency did not detect any effects of marked individual differences. Trace analysis, on the other hand, showed that suggestions were effective in the expected direction for some subjects. Exp. II gave the suggestion for and against subjects' dominant direction of the movement and was designed to specify the effect. While effects indicated by time and frequency measures were not consistent, the movement trace showed the effect in suggested directions, which was more distinct for subjects whose nonsuggested illusion was not so markedly directed. These findings indicate that suggestion could affect the spatiotemporal aspect of the illusion, so the trace analysis may be useful for studies in this field.

Adult↗

[Use of positive suggestions in medical practice: experiences in the intensive care unit].

The stressful states (e.g. the state of illness, sickness, acute or chronic pain, comatose and perioperative states) can be considered as psychological states in which we are more susceptible to all suggestions, including the deliberate or involuntary, direct or implicit ones. Under these conditions whether conscious of unconscious, peoples' thinking processes change, become literal, direct and somewhat paranoid, overly sensitive for not only to the direct, but to the implicit, inner meanings of communicative messages, as well. Research evidence shows that even the comatose people may maintain contact with the environment, therefore the conversation around and other communicative effects may serve as a special suggestion. These messages can be (unconsciously) interpreted by the patients following different logic than it would have been processed in the waking state. Treating people who are in these special stressful states one should carefully analyze all of the meaning layers of his/her communication, to make the helpful, positive suggestions more effective, and avoid the negative, destructive ones. The possible negative suggestions are those words, labels, and actions, that may be proper from practical, economical or organisational point of view, but we do not take their implicit suggestive meanings into considerations. The paper gives a detailed overview about the role of suggestions used during the management of a patient in intensive care situations, and some guidelines are outlined to make our (possible) negative suggestions to be helpful and positive.

Critical Care↗

Providing a "good death": critical care nurses' suggestions for improving end-of-life care.

BACKGROUND: Providing appropriate end-of-life care has become a primary concern of nurses and the public. The highly technological critical care environment may not facilitate such care. OBJECTIVE: To collect suggestions from critical care nurses for improving end-of-life care in intensive care units. METHODS: A geographically dispersed, random sample of 1409 members of the American Association of Critical-Care Nurses was sent a 72-item survey on perceptions of end-of life care. The survey included a request for suggestions on ways to improve end-of life care. RESULTS: Of the 861 critical care nurses who responded to the survey, 485 offered 530 suggestions for improving end-of-life care. Providing a "good death" was the major theme; specific suggestions included ways to help ensure death with dignity and peace. Barriers to providing good deaths included nursing time constraints, staffing patterns, communication challenges, and treatment decisions that were based on physicians' rather than patients' needs. Suggestions for providing a good death included facilitating dying with dignity; not allowing patients to be alone while dying; managing patients' pain and discomfort; knowing, and then following, patients' wishes for end-of-life care; promoting earlier cessation of treatment or not initiating aggressive treatment at all; and communicating effectively as a health-care team. Educational initiatives for professionals and the public were also suggested. CONCLUSIONS: Implementation of specific suggestions provided by experienced critical care nurses might increase the quality of end-of-life care, facilitating a good death for intensive care patients.

Adult↗

The effects of suggestion on the total respiratory resistance of nonasthmatic female subjects.

Bronchodilation suggestion, bronchoconstriction suggestion, or neutral suggestion was given to thirty nonasthmatic female subjects; the effect of the suggestion on the total respiratory resistance (Rt) of the subjects was examined. Subjects were told either (a) that they would inhale a substance which would make their breathing better, (b) that they would inhale a substance which would make their breathing worse, or (c) that they would inhale a substance which would have no effect on their breathing. In actuality, no subject inhaled any substance. Those subjects who were told that their breathing would worsen exhibited a reliable increase in R1, whereas those subjects who were told that their breathing would become better or that their breathing would not be affected exhibited no reliable change in Rt. This study confirmed earlier work, showing that bronchoconstriction suggestion increases Rt in healthy individuals. Furthermore, this study showed that bronchodilation suggestion alone is not sufficient to produce a decrease in Rt.

Adult↗

Negative affectivity and the influence of suggestion on asthma symptoms.

OBJECTIVE: To investigate the effect of suggestion on subjective and objective asthma symptoms as a function of negative affectivity of the patients. METHODS: Asthmatics (n=32) took puffs from three separate placebo inhalers, being described as an inert (practice) substance, a bronchoconstrictor, and a bronchodilator. Negative affectivity, social desirability, probability of medication-intake, intensity of asthma symptoms and total respiratory resistance were measured at onset. The latter three measures were repeated after each trial. Heart rate, end tidal PCO(2), and breathing behaviour were measured during each trial. RESULTS: Asthmatics with high negative affectivity had overall more intense asthma symptoms. They also reported more airway obstruction after suggested bronchoconstriction and less after suggested bronchodilation, whereas persons with low negative affectivity did not show such variation. These effects were unrelated to social desirability. Respiratory symptoms correlated with the odds of medication intake. Neither negative affectivity nor suggestion influenced lung function and only breathing parameters under voluntary control changed as a function of suggestion. CONCLUSION: Self-reported symptoms of asthmatics with high negative affectivity are more influenced by suggestion than those of patients with low negative affectivity.

Adult↗

The contribution of suggestibility and expectation to placebo analgesia phenomenon in an experimental setting.

This study reports how placebo analgesia was produced by conditioning whereby the intensity of electric stimulation was surreptitiously reduced in order to examine the contribution of psychological factors of suggestibility and expectancy on placebo analgesia. This strategy was used in order to manipulate expectancy for pain reduction. The magnitudes of the placebo effects were estimated after a manipulation procedure and during experimental trials in which stimulus intensities were reset to original baseline levels. Individual differences in suggestibility, verbal expectancy for drug efficacy and manipulation procedure for pain reduction were tested as possible mediators of placebo analgesia. The following dependent variables were measured: (a) subjective expectancy for drug efficacy in pain relief, (b) expected pain intensity and unpleasantness, (c) concurrent pain intensity and unpleasantness and (d) remembered pain intensity and unpleasantness. Statistically significant placebo effects on sensory and affective measures of pain were obtained independently of the extent of the surreptitious lowering of stimulus strength during manipulation trials. The pairing of placebo administration with painful stimulation was sufficient to produce a generalized placebo analgesic effect. However, verbal expectancy for drug efficacy and individual differences in suggestibility were found to contribute significantly to the magnitude of placebo analgesia. The highest placebo effect was shown by the most pronounced reductions in pain ratings in highly suggestible subjects who received suggestions presumed to elicit high expectancy for drug efficacy. The results also demonstrated that placebo effects established on remembered pain were at least twice as great as those obtained on concurrent placebo effects. This was mainly because baseline pain was remembered as being much more intense than it really was. Moreover, remembered placebo effects, like the concurrent placebo effects, were highly correlated with expected pain scores obtained just after manipulation trials. These results indicate that multiple factors contribute to the placebo effect, including suggestibility, expectancy and conditioning, and that the judgement of placebo analgesia is critically determined by whether pain relief is assessed concurrently or after treatment.

Adult↗

Source misattributions and the suggestibility of eyewitness memory.

Although the suggestibility of eyewitness memory is well documented, previous studies have not clearly established the extent to which misled Ss might come to believe they actually remember seeing the suggested details they report. To assess whether Ss confuse misleading suggestions for their "real memories" of a witnessed event, Ss were asked specific questions about their memory for the source of suggested items. The results of 5 experiments showed that misled Ss do sometimes come to believe they remember seeing items that were merely suggested to them, a phenomenon we refer to as the source misattribution effect. Nevertheless, the results also showed that the magnitude of this effect varies and that source misattributions are not an inevitable consequence of exposure to suggestions.

Humans↗

Mediation and moderation of psychological pain treatments: response expectancies and hypnotic suggestibility.

The mediator role of response expectancies and the moderator role of hypnotic suggestibility were evaluated in the analogue treatment of pain. Approximately 1,000 participants were assessed for hypnotic suggestibility. Later, as part of a seemingly unrelated experiment, 188 of these individuals were randomly assigned to distraction, cognitive-behavioral package, hypnotic cognitive-behavioral package, hypnotic analgesia suggestion, placebo control, or no-treatment control conditions. Response expectancies partially mediated the effects of treatment on pain. Hypnotic suggestibility moderated treatment and was associated with the relief produced only by the hypnotic interventions. The results suggest that response expectancies are an important mechanism of hypnotic and cognitive-behavioral pain treatments and that hypnotic suggestibility is a trait variable that predicts hypnotic responding across situations, including hypnosis-based pain interventions.

Adolescent↗

Effects of posthypnotic suggestion on perceived egocentric distance.

The effects of posthypnotic suggestion on the perception of egocentric distance were evaluated by two methods, one direct and the other indirect. The direct method was the verbal report of the perceived distance of the stimulus. The indirect method used a measure based on apparent concomitant motion of the stimulus with a lateral movement of the head. The indirect method, unlike the direct method, has been shown to be insensitive to cognitive biases. Two highly trained hypnotic observers received posthypnotic suggestions to see a point of light at approximately 2, 4, or 6 ft (61, 122, or 183 cm) from themselves. For each suggested distance the light was physically at 2, 4, or 6 ft. As a control, trails were completed using these same physical distances without the posthypnotic suggestions. Nine experimental trails, one for each combination of suggested distance and physical distance, constituted a trial set. One observer completed three sets, and the other completed two sets. It was found that the posthypnotic suggestions affected the direct but not the indirect measures of the perceived distances of the light.

Adolescent↗

Suggestibility or hypnosis: what do our scales really measure?

Conceptually, hypnotizability has always been defined as the increase in suggestibility produced by hypnosis. In practice, hypnotizability is measured as suggestibility following a hypnotic induction. The data indicate that these are different constructs. Although the induction of hypnosis increases suggestibility to a substantial degree, the correlation between hypnotic and nonhypnotic suggestibility approximates the reliability coefficients of so-called hypnotizability scales. This indicates that hypnotic susceptibility scales are better measures of waking suggestibility than they are of hypnotizability. The discordance between conceptual and operational definitions of hypnotizability can be resolved either by changing the conceptual definitions of hypnosis and hypnotizability or by reinterpreting hypnotizability scores as indexes of nonhypnotic, imaginative suggestibility.

Humans↗

Suicidality and interrogative suggestibility.

All people are subject to memory suggestibility, but suicidal individuals may be especially so. The link between suicidality and suggestibility is unclear given mixed findings and methodological weaknesses of past research. To test the link between suicidality and interrogative suggestibility, 149 undergraduates answered questions about suicidal thoughts and reasons for living, and participated in a direct suggestibility procedure. As expected, suggestibility correlated with suicidality but accounted for little overall variance (4%). Mental health professionals might be able to take advantage of client suggestibility by directly telling suicidal persons to refrain from suicidal thoughts or actions.

Adolescent↗