The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Mark P Jensen - One of the best experts on this subject based on the ideXlab platform.
-
an experimental investigation of the effects and mechanisms of mindfulness meditation versus self hypnosis versus an attention control on cold pressor outcomes
Mindfulness, 2021Co-Authors: Michelle P Grover, Mark P Jensen, Dawn M Ehde, Melissa A Day, Alexandra Ferreiravalente, Charles L Ward, Jason B Mattingley, Beverly E ThornAbstract:This research examined whether brief sessions of mindfulness meditation (MM) or Self-Hypnosis (HYP) produce changes in cold pressor task (CPT) outcomes and whether outcome improvement, when it occurs, is mediated by attentional processes (i.e., pain focus, mindful observing) or pain appraisals (i.e., threat, challenge). Healthy adults (N = 201) were randomly assigned to 20-min sessions of MM, HYP, or an attention Control. Participants completed assessments of potential mediators before the first CPT and after experimental intervention, but before a second CPT. HYP and MM participants reported greater reductions in CPT pain intensity than Control participants, and CPT unpleasantness was reduced in HYP compared to Control. Neither MM nor HYP resulted in significant changes in pain focus or mindful observing, and these scales were not associated with CPT outcomes. However, threat appraisals were reduced in HYP versus Control, and threat appraisal reductions were associated with increased pain tolerance. Challenge appraisal increased in both HYP versus Control and HYP versus MM, and challenge increases were associated with reductions in CPT unpleasantness. Challenge changes were a significant mediator of unpleasantness changes when HYP was compared to MM (p = .042); this mediation effect was non-significant for HYP compared to Control (p = .059). The findings indicate single sessions of HYP and MM produce changes in CPT outcomes. HYP also influenced threat and challenge appraisals, which were associated with CPT outcome changes, and challenge appraisals emerged as a potential mechanism of HYP. Further research is needed to identify mediating mechanisms for these two pain management approaches.
-
copahs study protocol of a randomised experimental study comparing the effects of hypnosis mindfulness meditation and spiritual practices on experimental pain in healthy adults
BMJ Open, 2021Co-Authors: Alexandra Ferreiravalente, Melissa A Day, Filipa Pimenta, Rui Miguel Costa, Jose Luis Paisribeiro, Mark P JensenAbstract:Background There has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of Self-Hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation. Methods and analysis Recruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either Self-Hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes. Ethics and dissemination This study was approved by ISPA—University Institute’s internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences. Trial registration number ClinicalTrials.gov registry (NCT04491630). Stage: pre-results.
-
pain related beliefs cognitive processes and electroencephalography band power as predictors and mediators of the effects of psychological chronic pain interventions
Pain, 2021Co-Authors: Mark P Jensen, Dawn M Ehde, Melissa A Day, Shahin Hakimian, Mark W Pettet, Atsuo Yoshino, Marcia A CiolAbstract:ABSTRACT The current study used data from a clinical trial to identify variables that are associated with and/or mediate the beneficial effects of four psychological chronic pain treatments: one teaching patients Self-Hypnosis to reduce pain intensity (HYP), one teaching Self-Hypnosis to change thoughts about pain (hypnotic cognitive therapy, or HYP-CT), one teaching cognitive restructuring skills to change thoughts about pain (cognitive therapy, or CT), and one providing education about pain (ED; included as an active control condition). Of 17 possible mechanism variables examined, and with alpha not corrected for multiple comparisons, significant between-group differences were observed for three. Two of these (changes in beliefs about control over pain and number of days of skill practice) were supported as mediators of the beneficial effects of HYP, CT, or HYP-CT, relative to ED. Six mechanism variables evidenced significant pre- to post-treatment changes in the sample as a whole, without showing significant between-group differences. Pre- to post-treatment changes in all six were associated with improvements in pain interference, pain intensity, or both. In addition, participant ratings of therapeutic alliance at post-treatment were associated significantly with improvements in both pain intensity and pain interference in the sample as a whole. Thus, of the 17 possible mediators examined, there were relatively few that serve as mediators for the beneficial effects of specific treatments; a larger number of variables predicted treatment outcome overall. The extent to which these variables are treatment mediators (i.e., are responsible for, rather than merely associated with, treatment-related improvements) will require further research.
-
clinical hypnosis for chronic pain in outpatient integrative medicine an implementation and training model
Journal of Alternative and Complementary Medicine, 2020Co-Authors: Lindsey C Mckernan, David R Patterson, Michael T M Finn, Rhonda M Williams, Mark P JensenAbstract:Introduction: Clinical hypnosis for pain management cultivates specific skills to enhance general self-regulation and address pain. Hypnosis is well suited to integrative medicine settings; however...
-
case study cognitive restructuring hypnosis for chronic pain in a quadriplegic patient
American Journal of Clinical Hypnosis, 2019Co-Authors: Rocio De La Vega, Joy F Chan, Elena M Mendoza, Mark P JensenAbstract:This case study reports on a 28-year-old male with spinal cord injury (SCI), quadriplegia, and chronic pain with neuropathic characteristics. The treatment had to be adapted to address the patient's needs, as he was on a respirator and paralyzed from the chin down. The intervention consisted of eight 90-minute sessions. The first four sessions were based on a standardized hypnotic cognitive therapy protocol developed for a randomized controlled trial (RCT). The sessions included training in cognitive restructuring skills and a hypnosis session with suggestions that was audiorecorded. Instructions to practice at home, both with the recording and by using Self-Hypnosis, were provided as well. Most of the outcome domains assessed (i.e., pain intensity, pain interference, sleep quality) showed clinically meaningful improvements that were maintained (or increased) at one-year follow-up. The patient reported that he was still using Self-Hypnosis at one-year follow-up. His subjective impression of change was positive and he did not report any negative side effects. Results show that the hypnotic cognitive therapy protocol used is a promising intervention that can benefit individuals with SCI presenting with complex symptomatology. Such therapy helps patients by teaching them effective coping strategies that they can use on their own to manage pain and its effects. In addition, it is important to note that this therapy provided benefits to someone who had not experienced any benefits from numerous medications he had tried before treatment. Therefore, the findings support continued efforts to make this treatment more accessible to patients who could benefit from this approach.
David Spiegel - One of the best experts on this subject based on the ideXlab platform.
-
brain activity and functional connectivity associated with hypnosis
Cerebral Cortex, 2016Co-Authors: Heidi Jiang, Matthew P White, Michael D Greicius, Lynn C Waelde, David SpiegelAbstract:Hypnosis has proven clinical utility, yet changes in brain activity underlying the hypnotic state have not yet been fully identified. Previous research suggests that hypnosis is associated with decreased default mode network (DMN) activity and that high hypnotizability is associated with greater functional connectivity between the executive control network (ECN) and the salience network (SN). We used functional magnetic resonance imaging to investigate activity and functional connectivity among these three networks in hypnosis. We selected 57 of 545 healthy subjects with very high or low hypnotizability using two hypnotizability scales. All subjects underwent four conditions in the scanner: rest, memory retrieval, and two different hypnosis experiences guided by standard pre-recorded instructions in counterbalanced order. Seeds for the ECN, SN, and DMN were left and right dorsolateral prefrontal cortex, dorsal anterior cingulate cortex (dACC), and posterior cingulate cortex (PCC), respectively. During hypnosis there was reduced activity in the dACC, increased functional connectivity between the dorsolateral prefrontal cortex (DLPFC;ECN) and the insula in the SN, and reduced connectivity between the ECN (DLPFC) and the DMN (PCC). These changes in neural activity underlie the focused attention, enhanced somatic and emotional control, and lack of self-consciousness that characterizes hypnosis.
-
beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment when being nice does not suffice
Journal of Vascular and Interventional Radiology, 2008Co-Authors: Elvira V Lang, Kevin S Berbaum, Salomao Faintuch, Eleanor Laser, Stephen G Pauker, Gloria Salazar, Susan K Lutgendorf, Henrietta L Logan, David SpiegelAbstract:Purpose To determine how hypnosis and empathic attention during percutaneous tumor treatments affect pain, anxiety, drug use, and adverse events. Materials and Methods For their tumor embolization or radiofrequency ablation, 201 patients were randomized to receive standard care, empathic attention with defined behaviors displayed by an additional provider, or self-hypnotic relaxation including the defined empathic attention behaviors. All had local anesthesia and access to intravenous medication. Main outcome measures were pain and anxiety assessed every 15 minutes by patient self-report, medication use (with 50 μg fentanyl or 1 mg midazolam counted as one unit), and adverse events, defined as occurrences requiring extra medical attention, including systolic blood pressure fluctuations (≥50 mm Hg change to >180 mm Hg or Results Patients treated with hypnosis experienced significantly less pain and anxiety than those in the standard care and empathy groups at several time intervals and received significantly fewer median drug units (mean, 2.0; interquartile range [IQR], 1–4) than patients in the standard (mean, 3.0; IQR, 1.5–5.0; P = .0147) and empathy groups (mean, 3.50; IQR, 2.0–5.9; P = .0026). Thirty-one of 65 patients (48%) in the empathy group had adverse events, which was significantly more than in the hypnosis group (eight of 66; 12%; P = .0001) and standard care group (18 of 70; 26%; P = .0118). Conclusions Procedural hypnosis including empathic attention reduces pain, anxiety, and medication use. Conversely, empathic approaches without hypnosis that provide an external focus of attention and do not enhance patients' self-coping can result in more adverse events. These findings should have major implications in the education of procedural personnel.
-
loneliness within a nomological net an evolutionary perspective
Journal of Research in Personality, 2006Co-Authors: John T Cacioppo, Louise C Hawkley, John M Ernst, Mary H Burleson, Gary G Berntson, Bita Nouriani, David SpiegelAbstract:Loneliness is characterized by feelings of social pain and isolation and has both heritable and unshared environmental underpinnings. An evolutionary theory of loneliness is outlined, and four studies replicate and extend prior research on the characteristics of lonely individuals. Studies 1 and 2 indicate that loneliness and depressed aVect are related but separable constructs. Study 3 conWrms that lonely, relative to nonlonely, young adults are higher in anxiety, anger, negative mood, and fear of negative evaluation, and lower in optimism, social skills, social support, positive mood, surgency, emotional stability, conscientiousness, agreeableness, shyness, and sociability. The set of six personality factors associated with loneliness (surgency, emotional stability, agreeableness, conscientiousness, shyness, and sociability) do not explain the associations between loneliness and negative mood, anxiety, anger, optimism (pessimism), self-esteem, and social support, as each association remained statistically signiWcant even after statistically controlling for these personality factors. Study 4 used hypnosis to experimentally manipulate loneliness to determine whether there were associated
-
hypnosis reduces distress and duration of an invasive medical procedure for children
Pediatrics, 2005Co-Authors: Lisa D Butler, Barbara K Symons, Shelly L Henderson, Linda D Shortliffe, David SpiegelAbstract:Objective. Voiding cystourethrography (VCUG) is a commonly performed radiologic procedure in children that can be both painful and frightening. Given the distress that some children experience during the VCUG and the need for children to be alert and cooperative during the procedure, finding a psychological intervention that helps children to manage anxiety, distress, and pain is clearly desirable. This study was designed to examine whether relaxation and analgesia facilitated with hypnosis could reduce distress and procedure time for children who undergo this procedure. Methods. Forty-four children who were scheduled for an upcoming VCUG were randomized to receive hypnosis ( n = 21) or routine care ( n = 23) while undergoing the procedure. The sample consisted of 29 (66%) girls and 15 (34%) boys with a mean age of 7.6 years (SD: 2.5; range: 4–15 years). Ethnic/racial backgrounds were 72.7% white, 18.2% Asian, 4.5% Latino, 2.3% black, and 2.3% Filipino. The mean number of previous VCUGs was 2.95 (SD: 2.51; mode: 2; range: 1–15). Potential participants were identified through computerized hospital records of upcoming VCUGs. Parents were contacted by telephone and invited to participate if their child was eligible. To be eligible for the study, the child must have undergone at least 1 previous VCUG, been at least 4 years of age at that time, and experienced distress during that procedure, and both the child and the participating parent had to be English speaking. Each eligible child and parent met with the research assistant (RA) before the day of the scheduled procedure for an initial assessment. Children were queried regarding the degree of crying, fear, and pain that they had experienced during their most recent VCUG. Parents completed a series of parallel questions. Immediately after this assessment, those who were randomized to the hypnosis condition were given a 1-hour training session in self-hypnotic visual imagery by a trained therapist. Parents and children were instructed to practice using the imaginative Self-Hypnosis procedure several times a day in preparation for the upcoming procedure. The therapist was also present during the procedure to conduct similar exercises with the child. The majority (83%) of those who were randomized to the routine care control group chose to participate in a hospital-provided recreation therapy program (offered as part of routine care). The program includes demonstration of the procedure with dolls, relaxation and breath work training, and assistance during the procedure. On the day of the VCUG, the RA met the family at the clinic before the procedure, and both the child and the parent rated the child9s present level of fearfulness. During the procedure, the RA recorded observational ratings of the child9s emotional tone and behavior and timed the overall procedure and its phases. Immediately after the VCUG, the child was asked how much crying, fear, and pain he or she had experienced during the procedure; the parent rated the child9s experience on the same dimensions and also how traumatic the procedure had been (both generally and compared with their previous one), and the medical staff rated the degree of procedural difficulty. Outcomes included child reports of distress during the procedure, parent reports of how traumatic the present VCUG was compared with the previous one, observer ratings of distress during the procedure, medical staff reports of the difficulty of the procedure overall, and total procedural time. Results. Results indicate significant benefits for the hypnosis group compared with the routine care group in the following 4 areas: (1) parents of children in the hypnosis group compared with those in the routine care group reported that the procedure was significantly less traumatic for their children compared with their previous VCUG procedure; (2) observational ratings of typical distress levels during the procedure were significantly lower for children in the hypnosis condition compared with those in the routine care condition; (3) medical staff reported a significant difference between groups in the overall difficulty of conducting the procedure, with less difficulty reported for the hypnosis group; and (4) total procedural time was significantly shorter—by almost 14 minutes—for the hypnosis group compared with the routine care group. Moderate to large effect sizes were obtained on each of these 4 outcomes. Conclusions. Hypnotic relaxation may provide a systematic method for improving the overall medical care of children with urinary tract abnormalities and may be beneficial for children who undergo other invasive medical procedures. Because the VCUG is an essential part of the evaluation of urinary tract infections and vesicoureteral reflux in children, lower distress during the procedure may improve patient and family compliance with initial as well as follow-up evaluations. These findings augment the accumulating literature demonstrating the benefits of using hypnosis to reduce distress in the pediatric setting. The present findings are noteworthy in that this study was a controlled, randomized trial conducted in a naturalistic medical setting. In this context, we achieved a convergence of subjective and objective outcomes with moderate to large effect sizes, including those that may have an impact on patient care and procedure cost, that were consistently supportive of the beneficial effects of hypnosis—a noninvasive intervention with minimal risk. The findings, therefore, have immediate implications for pediatric care. Limitations of this study include the lack of participant and staff blindness to the child9s condition assignment, which could have introduced bias into reports. However, the objective procedural time differences between groups were consistent with the other, more subjective outcome findings. The sample was also small and primarily white in ethnic/racial makeup, which may have restricted our ability to detect some differences and may limit the generalizability of findings to more representative samples. In addition, the sample comprised children who had already undergone at least 1 VCUG during which they had had difficulty. Consequently, additional research is needed to determine whether hypnosis would be helpful to those who are undergoing their first VCUG. Additional limitations, clinical observations, and directions for future research are also discussed.
-
adjunctive non pharmacological analgesia for invasive medical procedures a randomised trial
The Lancet, 2000Co-Authors: Elvira V Lang, Kevin S Berbaum, Michael L Berbaum, Susan K Lutgendorf, Henrietta L Logan, Eric G Benotsch, Lauri J Fick, David SpiegelAbstract:Summary Background Non-pharmacological behavioural adjuncts have been suggested as efficient safe means in reducing discomfort and adverse effects during medical procedures. We tested this assumption for patients undergoing percutaneous vascular and renal procedures in a prospective, randomised, singlecentre study. Methods 241 patients were randomised to receive intraoperatively standard care (n=79), structured attention (n=80), or self-hypnotic relaxation (n=82). All had access to patient-controlled intravenous analgesia with fentanyl and midazolam. Patients rated their pain and anxiety on 0–10 scales before, every 15 min during and after the procedures. Findings Pain increased linearly with procedure time in the standard group (slope 0·09 in pain score/15 min, p<0·0001), and the attention group (slope 0·04/15 min; p=0·0425), but remained flat in the hypnosis group. Anxiety decreased over time in all three groups with slopes of 0·04 (standard), 0·07 (attention), and 0·11 (hypnosis). Drug use in the standard group (1·9 units) was significantly higher than in the attention and hypnosis groups (0·8 and 0·9 units, respectively). One hypnosis patient became haemodynamically unstable compared with ten attention patients (p=0·0041), and 12 standard patients (p=0·0009). Procedure times were significantly shorter in the hypnosis group (61 min) than in the standard group (78 min, p=0·0016) with procedure duration of the attention group in between (67 min). Interpretation Structured attention and self-hypnotic relaxation proved beneficial during invasive medical procedures. Hypnosis had more pronounced effects on pain and anxiety reduction, and is superior, in that it also improves haemodynamic stability.
John Gruzelier - One of the best experts on this subject based on the ideXlab platform.
-
a randomised controlled single blind trial of the effects of reiki and positive imagery on well being and salivary cortisol
Brain Research Bulletin, 2010Co-Authors: Deborah Bowden, Lorna Goddard, John GruzelierAbstract:The study investigated whether participants who received Reiki would show greater health and well-being benefits than a group who received no Reiki. A method of blinding participants to Reiki was also tested, where non-contact Reiki or No-Reiki with random assignment was given to 35 healthy psychology undergraduates whose attention was absorbed in one of three tasks involving Self-Hypnosis/relaxation. Participants experienced ten 20-min intervention sessions over a period of two and a half to 12 weeks. Reiki was directed by the experimenter who sat behind the participants as they were absorbed in the tasks. Self-report measures of illness symptoms, mood and sleep were assessed pre–post-intervention as was salivary cortisol. While the Reiki group had a tendency towards a reduction in illness symptoms, a substantive increase was seen in the No-Reiki. The Reiki group also had a near-significant comparative reduction in stress, although they also had significantly higher baseline illness symptoms and stress scores. The Reiki blinding was successful – the groups did not differ statistically in their beliefs regarding group membership. The results are suggestive that the Reiki buffered the substantive decline in health in the course of the academic year seen in the No-Reiki group.
-
relaxation strategies and enhancement of hypnotic susceptibility eeg neurofeedback progressive muscle relaxation and self hypnosis
Brain Research Bulletin, 2006Co-Authors: Martin J Batty, Samantha Bonnington, Bokim Tang, Malcolm B Hawken, John GruzelierAbstract:Hypnosis has been shown to be efficacious in a range of clinical conditions, including the management of chronic pain. However, not all individuals are able to enter a hypnotic state, thereby limiting the clinical utility of this technique. We sought to determine whether hypnotic susceptibility could be increased using three methods thought to facilitate relaxation, with particular interest in an EEG neurofeedback protocol which elevated the theta to alpha ratio. This was compared with progressive muscle relaxation and Self-Hypnosis. Ten subjects with moderate levels of susceptibility (2–7/12) were randomly assigned to each condition and assessed for hypnotic susceptibility prior to and upon completion of 10 sessions of training. Hypnotic susceptibility increased post-training in all groups, providing further evidence that operant control over the theta/alpha ratio is possible, but contrary to our predictions, elevation of the theta/alpha ratio proved no more successful than the other interventions. Nonetheless, all three techniques successfully enhanced hypnotic susceptibility in over half of the participants (17/30), a similar incidence to that reported using other methods. As previously reported, the majority who were not susceptible to modification were at the lower levels of susceptibility, and the greater increases tended to occur in the more susceptible subjects. However, here enhancement was disclosed in some at low levels, and capability was found of reaching high levels, both features not typically reported. Further research is warranted.
-
self hypnosis and osteopathic soft tissue manipulation with a ballet dancer
Contemporary Hypnosis, 2003Co-Authors: Christophermarc Gordon, John GruzelierAbstract:This single case study of a ballet dancer incorporates essentially osteopathy, Self-Hypnosis and neurolinguistic programming (NLP) in the management of exhaustion, stress, anxiety and pain symptoms of the right thigh, calf and ankle combined with confidence strengthening techniques. Physical and mental burnout symptoms had reached the point of constant pain and overstrain of the muscles of the right leg and hip, spine and neck. In parallel with these were symptoms of exhaustion, unhappiness and a tendency to over-focus on other dancers at the expense of self-focus and motivation. The osteo/physical therapy entailed the rebalancing of overused, strained and hyper-tense muscular tissues using myofascial-release techniques, together with the deactivation of trigger points and postural integration. The mental attitude was supported through reframing techniques during Self-Hypnosis directed at general feelings of being blocked, imprisoned, cramped, exhausted and weakened in the right leg. Psychophysiological assessment post therapy was compatible with self-regulation training.
-
individual differences in personality immunology and mood in patients undergoing self hypnosis training for the successful treatment of a chronic viral illness hsv 2
Contemporary Hypnosis, 2002Co-Authors: John Gruzelier, Andy Champion, Paul Fox, Matthew S H Rollin, Sheena Mccormack, Pepe Catalan, S E Barton, Don HendersonAbstract:Individual differences in personality, in particular cognitive activation, withdrawal and hypnotic susceptibility were examined in a study of Self-Hypnosis training in patients with chronic and severe herpes simplex virus (HSV-2), genital herpes, along with depression, anxiety and activation ratings. Immune parameters were assayed before and after the six-week training. Self-Hypnosis almost halved recurrence rate, benefiting 65% of the patients. Furthermore clinical responders demonstrated an increase in natural killer cell (NKC) cytotoxicity of herpes infected cells as well as up-regulation of nonspecific immune parameters. In replication of a student exam stress study (Gruzelier, Smith, Nagy and Henderson, 2001a) cognitive activation was positively associated with immune function; with improvement in herpes recurrence, improvements in specific NKC cytotoxicity, baseline functional NKC activity and energy ratings, and was unrelated to frequency of practice. No other measure of personality or affect was associated with immune system up-regulation and improvements in health. Depression and, to a lesser extent, anxiety improved independently of herpes outcome. Depression and/or anxiety at baseline were positively associated with withdrawal, particularly the affective aspects, and neuroticism, which were associated with immune down-regulation seen in NKC counts and NKC functional activity at baseline. Hypnotizability was associated positively with aspects of immune system up-regulation and negatively with clinical depression. Immune system up-regulation in clinical responders correlated positively with frequency of Self-Hypnosis practice. This is possibly the first evidence for the efficacy of Self-Hypnosis training for a chronic medical illness. Evidence (1) of the benefits to health and (2) of the viral specificity of the immune changes, here in the form of increased cytotoxicity of NKC for cells infected with the herpes virus, gives credence to the value of a psychological intervention for immunity; evidence for which is scarce in the field of psychoneuroimmunology. The predictive ability of cognitive activation for response to hypnotherapy is in keeping with the preferential effects on both immune parameters and health of hypnosis instructions which require the generation of dynamic imagery in contrast to instructions of passive relaxation imagery (Gruzelier, Levy, Williams and Henderson, 2001b).
Melissa A Day - One of the best experts on this subject based on the ideXlab platform.
-
an experimental investigation of the effects and mechanisms of mindfulness meditation versus self hypnosis versus an attention control on cold pressor outcomes
Mindfulness, 2021Co-Authors: Michelle P Grover, Mark P Jensen, Dawn M Ehde, Melissa A Day, Alexandra Ferreiravalente, Charles L Ward, Jason B Mattingley, Beverly E ThornAbstract:This research examined whether brief sessions of mindfulness meditation (MM) or Self-Hypnosis (HYP) produce changes in cold pressor task (CPT) outcomes and whether outcome improvement, when it occurs, is mediated by attentional processes (i.e., pain focus, mindful observing) or pain appraisals (i.e., threat, challenge). Healthy adults (N = 201) were randomly assigned to 20-min sessions of MM, HYP, or an attention Control. Participants completed assessments of potential mediators before the first CPT and after experimental intervention, but before a second CPT. HYP and MM participants reported greater reductions in CPT pain intensity than Control participants, and CPT unpleasantness was reduced in HYP compared to Control. Neither MM nor HYP resulted in significant changes in pain focus or mindful observing, and these scales were not associated with CPT outcomes. However, threat appraisals were reduced in HYP versus Control, and threat appraisal reductions were associated with increased pain tolerance. Challenge appraisal increased in both HYP versus Control and HYP versus MM, and challenge increases were associated with reductions in CPT unpleasantness. Challenge changes were a significant mediator of unpleasantness changes when HYP was compared to MM (p = .042); this mediation effect was non-significant for HYP compared to Control (p = .059). The findings indicate single sessions of HYP and MM produce changes in CPT outcomes. HYP also influenced threat and challenge appraisals, which were associated with CPT outcome changes, and challenge appraisals emerged as a potential mechanism of HYP. Further research is needed to identify mediating mechanisms for these two pain management approaches.
-
copahs study protocol of a randomised experimental study comparing the effects of hypnosis mindfulness meditation and spiritual practices on experimental pain in healthy adults
BMJ Open, 2021Co-Authors: Alexandra Ferreiravalente, Melissa A Day, Filipa Pimenta, Rui Miguel Costa, Jose Luis Paisribeiro, Mark P JensenAbstract:Background There has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of Self-Hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation. Methods and analysis Recruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either Self-Hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes. Ethics and dissemination This study was approved by ISPA—University Institute’s internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences. Trial registration number ClinicalTrials.gov registry (NCT04491630). Stage: pre-results.
-
pain related beliefs cognitive processes and electroencephalography band power as predictors and mediators of the effects of psychological chronic pain interventions
Pain, 2021Co-Authors: Mark P Jensen, Dawn M Ehde, Melissa A Day, Shahin Hakimian, Mark W Pettet, Atsuo Yoshino, Marcia A CiolAbstract:ABSTRACT The current study used data from a clinical trial to identify variables that are associated with and/or mediate the beneficial effects of four psychological chronic pain treatments: one teaching patients Self-Hypnosis to reduce pain intensity (HYP), one teaching Self-Hypnosis to change thoughts about pain (hypnotic cognitive therapy, or HYP-CT), one teaching cognitive restructuring skills to change thoughts about pain (cognitive therapy, or CT), and one providing education about pain (ED; included as an active control condition). Of 17 possible mechanism variables examined, and with alpha not corrected for multiple comparisons, significant between-group differences were observed for three. Two of these (changes in beliefs about control over pain and number of days of skill practice) were supported as mediators of the beneficial effects of HYP, CT, or HYP-CT, relative to ED. Six mechanism variables evidenced significant pre- to post-treatment changes in the sample as a whole, without showing significant between-group differences. Pre- to post-treatment changes in all six were associated with improvements in pain interference, pain intensity, or both. In addition, participant ratings of therapeutic alliance at post-treatment were associated significantly with improvements in both pain intensity and pain interference in the sample as a whole. Thus, of the 17 possible mediators examined, there were relatively few that serve as mediators for the beneficial effects of specific treatments; a larger number of variables predicted treatment outcome overall. The extent to which these variables are treatment mediators (i.e., are responsible for, rather than merely associated with, treatment-related improvements) will require further research.
-
use of neurofeedback and mindfulness to enhance response to hypnosis treatment in individuals with multiple sclerosis results from a pilot randomized clinical trial
International Journal of Clinical and Experimental Hypnosis, 2018Co-Authors: Mark P Jensen, Leslie Sherlin, Samuel L Battalio, Joy F Chan, Karlyn A Edwards, Melissa A Day, Dawn M EhdeAbstract:AbstractThis pilot study evaluated the possibility that 2 interventions hypothesized to increase slower brain oscillations (e.g., theta) may enhance the efficacy of hypnosis treatment, given evidence that hypnotic responding is associated with slower brain oscillations. Thirty-two individuals with multiple sclerosis and chronic pain, fatigue, or both, were randomly assigned to 1 of 2 interventions thought to increase slow wave activity (mindfulness meditation or neurofeedback training) or no enhancing intervention, and then given 5 sessions of Self-Hypnosis training targeting their presenting symptoms. The findings supported the potential for both neurofeedback and mindfulness to enhance response to hypnosis treatment. Research using larger sample sizes to determine the generalizability of these findings is warranted.
Elvira V Lang - One of the best experts on this subject based on the ideXlab platform.
-
beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment when being nice does not suffice
Journal of Vascular and Interventional Radiology, 2008Co-Authors: Elvira V Lang, Kevin S Berbaum, Salomao Faintuch, Eleanor Laser, Stephen G Pauker, Gloria Salazar, Susan K Lutgendorf, Henrietta L Logan, David SpiegelAbstract:Purpose To determine how hypnosis and empathic attention during percutaneous tumor treatments affect pain, anxiety, drug use, and adverse events. Materials and Methods For their tumor embolization or radiofrequency ablation, 201 patients were randomized to receive standard care, empathic attention with defined behaviors displayed by an additional provider, or self-hypnotic relaxation including the defined empathic attention behaviors. All had local anesthesia and access to intravenous medication. Main outcome measures were pain and anxiety assessed every 15 minutes by patient self-report, medication use (with 50 μg fentanyl or 1 mg midazolam counted as one unit), and adverse events, defined as occurrences requiring extra medical attention, including systolic blood pressure fluctuations (≥50 mm Hg change to >180 mm Hg or Results Patients treated with hypnosis experienced significantly less pain and anxiety than those in the standard care and empathy groups at several time intervals and received significantly fewer median drug units (mean, 2.0; interquartile range [IQR], 1–4) than patients in the standard (mean, 3.0; IQR, 1.5–5.0; P = .0147) and empathy groups (mean, 3.50; IQR, 2.0–5.9; P = .0026). Thirty-one of 65 patients (48%) in the empathy group had adverse events, which was significantly more than in the hypnosis group (eight of 66; 12%; P = .0001) and standard care group (18 of 70; 26%; P = .0118). Conclusions Procedural hypnosis including empathic attention reduces pain, anxiety, and medication use. Conversely, empathic approaches without hypnosis that provide an external focus of attention and do not enhance patients' self-coping can result in more adverse events. These findings should have major implications in the education of procedural personnel.
-
adjunctive self hypnotic relaxation for outpatient medical procedures a prospective randomized trial with women undergoing large core breast biopsy
Pain, 2006Co-Authors: Elvira V Lang, Kevin S Berbaum, Salomao Faintuch, Olga Hatsiopoulou, Noami Halsey, Michael L Berbaum, Eleanor Laser, Janet K BaumAbstract:Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures. Patients' self-ratings at 1 min-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women's anxiety increased significantly in the standard group (logit slope=0.18, p<0.001), did not change in the empathy group (slope=-0.04, p=0.45), and decreased significantly in the hypnosis group (slope=-0.27, p<0.001). Pain increased significantly in all three groups (logit slopes: standard care=0.53, empathy=0.37, hypnosis=0.34; all p<0.001) though less steeply with hypnosis and empathy than standard care (p=0.024 and p=0.018, respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 min/161 dollars for standard care, 43 min/163 dollars for empathy, and 39 min/152 dollars for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.
-
cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures
Radiology, 2002Co-Authors: Elvira V Lang, Max P RosenAbstract:PURPOSE: To compare the cost of standard intravenous conscious sedation with that of sedation with adjunct self-hypnotic relaxation during outpatient interventional radiologic procedures. MATERIALS AND METHODS: Data were reviewed from a prospective randomized study in which patients undergoing vascular and renal interventional procedures underwent either standard sedation (n = 79) or sedation with adjunct hypnosis (n = 82). These data were used to construct a decision analysis model to compare the cost of standard sedation with the cost of sedation with adjunct hypnosis. Multiple sensitivity analyses were performed to assess the applicability of these results to other institutions with different cost structures with respect to the following variables: cost of the hypnosis provider, cost of room time for interventional radiologic procedure, hours of observation after the procedure, and frequency and cost of complications associated with over- or undersedation. RESULTS: According to data from this experienc...
-
adjunctive non pharmacological analgesia for invasive medical procedures a randomised trial
The Lancet, 2000Co-Authors: Elvira V Lang, Kevin S Berbaum, Michael L Berbaum, Susan K Lutgendorf, Henrietta L Logan, Eric G Benotsch, Lauri J Fick, David SpiegelAbstract:Summary Background Non-pharmacological behavioural adjuncts have been suggested as efficient safe means in reducing discomfort and adverse effects during medical procedures. We tested this assumption for patients undergoing percutaneous vascular and renal procedures in a prospective, randomised, singlecentre study. Methods 241 patients were randomised to receive intraoperatively standard care (n=79), structured attention (n=80), or self-hypnotic relaxation (n=82). All had access to patient-controlled intravenous analgesia with fentanyl and midazolam. Patients rated their pain and anxiety on 0–10 scales before, every 15 min during and after the procedures. Findings Pain increased linearly with procedure time in the standard group (slope 0·09 in pain score/15 min, p<0·0001), and the attention group (slope 0·04/15 min; p=0·0425), but remained flat in the hypnosis group. Anxiety decreased over time in all three groups with slopes of 0·04 (standard), 0·07 (attention), and 0·11 (hypnosis). Drug use in the standard group (1·9 units) was significantly higher than in the attention and hypnosis groups (0·8 and 0·9 units, respectively). One hypnosis patient became haemodynamically unstable compared with ten attention patients (p=0·0041), and 12 standard patients (p=0·0009). Procedure times were significantly shorter in the hypnosis group (61 min) than in the standard group (78 min, p=0·0016) with procedure duration of the attention group in between (67 min). Interpretation Structured attention and self-hypnotic relaxation proved beneficial during invasive medical procedures. Hypnosis had more pronounced effects on pain and anxiety reduction, and is superior, in that it also improves haemodynamic stability.
