Mindful Self-Hypnosis Combined with Resistance Training to Reduce Perceived Stress and Improve Other Psychological Factors in Female College Students.

Perceived stress is a significant problem among female college students that can impact psychological distress, sleep, and overall well-being. Mindful self-hypnosis (MSH) and resistance training (RT) have both been shown to reduce perceived stress. The rationale for the present study was to investigate whether MSH combined with RT could be more effective at reducing perceived stress as measured by the Perceived Stress Scale than RT alone due to synergistic effects achieved by combining the interventions. Forty-four female college students were randomized to one of the three groups: MSH+RT, RT only, or a wait-list control (WLC). Results indicated that, compared to RT only, the addition of MSH led to pronounced improvements in perceived stress which was significantly greater than WLC. Also, MSH+RT resulted in significant increases in mindfulness, sleep, strength, and well-being in comparison to WLC. MSH+RT was shown to be feasible with highly satisfactory participant ratings. Future research should examine the MSH+RT intervention with a larger population and with older women who are more at risk for stress and declining strength.

Treating Hot Flashes with Hypnosis: Does Hypnotizability Modulate Reductions?

Hypnosis is an effective treatment option for a variety of concerns. Past research has suggested that those who score in the high range of hypnotizability initially show greater improvement than those in the low range. A post hoc analysis was conducted to examine the extent to which hypnotizability modulates the reduction of hot flash frequency. Average number of hot flashes reported during hypnosis treatment and a 12-week follow-up were grouped according to participants' level of hypnotizability. Using baseline data, the reduction percentage of hot flash frequency was plotted and visually examined to determine when a clinically significant reduction (50%) in hot flashes was reached. Our results suggested that, regardless of hypnotizability, participants ultimately obtained a 50% reduction in hot flash frequency. Interestingly, participants who were rated as either moderately or highly hypnotizable achieved a 50% reduction by Week 3 while those of low hypnotizability did not cross the 50% reduction threshold until the 12-week follow-up. Implications from these findings include the importance of assessing hypnotizability in clinical settings to better tailor treatment dose and expectations.

Exploring Variables Associated with the Effects of a Self-Administered Hypnosis Intervention for Improving Sleep Quality.

About two-thirds of college students rate their sleep as suboptimal which is associated with a variety of additional issues. Poor sleep is shown to follow certain pre-sleep cognitive activity that inhibits sleep onset and reduces sleep quality. Preliminary evidence suggests that a self-administered hypnosis intervention is feasible in improving sleep within a college student population, and the current study explores potential correlating variables to inform future mechanistic research. Twenty-two college students who self-reported poor sleep quality utilized a three-week self-administered hypnosis intervention while completing baseline and endpoint measures of sleep quality, insomnia symptoms, and psychological factors. Results indicated that participants experienced significant improvement with large effects in sleep quality (d = -1.21) and significant decreases in insomnia symptoms (d = 1.05) from pre- to post-intervention. Significant improvements were also observed on measures of pre-sleep arousal and worry. The results suggest that a self-administered hypnosis intervention may modulate pre-sleep cognitive activity associated with poor sleep quality.

Integrating mindful self-hypnosis with resistance training to reduce stress: a case study.

This case study explores the effects of a combined intervention involving Mindful Self-Hypnosis (MSH) and Resistance Training (RT) on perceived stress levels and well-being in a university student. The participant, Ms. P, engaged in a 12-week program comprised of two weekly RT sessions accompanied by MSH inductions. Perceived stress levels were evaluated using the Perceived Stress Scale (PSS), and well-being was assessed using the WHO-5 Well-Being Index. Intervention sessions were designed to enhance focus and calmness, along with imagery of performing the workout. Results from the case study reveal a notable reduction in Ms. P's perceived stress levels over the intervention period as indicated by a 30.8% decrease in PSS scores. Additionally, Ms. P demonstrated an improved strength in leg press 1-repetition maximum by an increased weight of 153.9%. This case study suggests that integrating MSH and RT may offer a beneficial strategy for stress reduction and enhancing well-being in university students. The findings underscore the potential applicability of this intervention to address stress-related challenges in this population. Future research with a larger sample size is needed to determine general efficacy of an MSH + RT intervention for stress reduction.

Feasibility of a Self-Administered Hypnosis Intervention for Improving Sleep in College Students.

Approximately two out of three college students report experiencing suboptimal sleep quality. The aim of this study was to examine the feasibility of a self-administered hypnosis intervention to improve sleep in college students. Twenty-two college students who self-reported poor sleep quality were enrolled in a 4-week study comprising 1 baseline week and a 3-week self-administered hypnosis intervention. Sleep onset latency and sleep efficiency as measured by wrist actigraphy were significantly improved. The mean average nightly sleep duration during the baseline week was 398.88 minutes (SD = 56.44), which increased to a mean of 413.88 minutes (SD = 57.80) during the 3rd week of intervention. However, the results show that there was no statistically significant difference between weeks on objective nightly sleep duration, 95% CI [-11.13, 41.13], t(15) = 1.224, p = .240. Also, results showed that there was no significant difference between weeks on self-reported nightly sleep duration, F(3, 57) = 2.155, p = .103. Twenty participants (91%) completed the study intervention and adherence to daily self-hypnosis practice with an audio recording was high. Zero study-related adverse events were reported, and participants perceived the intervention as easy to use and helpful for improving sleep. These results provide evidence for the feasibility and safety of a self-administered hypnosis intervention to improve sleep in college students. A larger randomized clinical trial is warranted to determine efficacy.

Magnitude of placebo response in clinical trials of paroxetine for vasomotor symptoms: a meta-analysis.

Introduction: Vasomotor symptoms, or hot flashes, are among the most common complaints for menopausal and postmenopausal women. As an alternative to hormone replacement therapy, paroxetine mesylate became the only non-hormonal treatment approved by the U.S. Food and Drug Administration (FDA), despite limited evidence for its efficacy. More specifically, there is uncertainty around paroxetine's unique benefit and the magnitude of the placebo response in clinical trials of paroxetine. Methods: Relevant databases were searched to identify randomized clinical trials examining the efficacy of paroxetine to treat hot flashes. The primary outcomes of interest were hot flash frequency and hot flash severity scores. Data was extracted from the published results, and risk of bias assessments were conducted. Results: Six randomized clinical trials that included a total of 1,486 women were coded and analyzed. The results demonstrated that 79% of the mean treatment response for hot flash frequency is accounted for by a placebo response, resulting in a mean true drug effect of 21% at most. Additionally, 68% of the mean treatment response for hot flash severity is accounted for by a placebo response, resulting in a maximum true drug effect of 32%. Discussion: The results herein call into question the actual efficacy of the only FDA approved, non-hormonal treatment for hot flashes by demonstrating that a placebo response accounts for the majority of treatment responses for reductions in both hot flash frequency and severity. The findings provide evidence to reevaluate the use of paroxetine to treat postmenopausal hot flashes and emphasize the importance of considering effective, alternative treatments for vasomotor symptoms.

Adaptive Experiential Theory of Hypnosis.

State and nonstate theories of hypnosis have dominated the field for decades and helped advance hypnosis clinically and scientifically. However, they fall short in various ways including insufficient consideration of unconscious/experiential processes. The authors' new theory is predicated on Epstein's cognitive-experiential self-theory, a dual-process model that provides a comprehensive understanding of the rational system and the experiential system and highlights that, although they interact synergistically, their features and modes of operation differ greatly. The rational system, influenced by logic and reason, is demanding of cognitive resources and operates effortfully with minimal affect. In contrast, the experiential system is emotionally driven, associative, and encodes reality in images and feelings without conscious effort. Our theory, the adaptive experiential theory, posits that complex hypnotic responding is attributable to an individual's ability to adapt and deliberately shift from processing primarily within the rational system to the experiential system. Greater association with the experiential system yields alterations in processing reality, which allows hypnotic suggestions to be internalized and enacted without excessive interference from the rational system.

Posttraumatic growth-oriented peer-based training among U.S. veterans: evaluation of post-intervention and long-term follow-up outcomes.

Introduction: Exposure to trauma among U.S. military veterans occurs at a high rate, often resulting in continued difficulty with emotional adjustment and a diagnosis of posttraumatic stress disorder (PTSD). The present study provides data from 184 U.S. military veterans who completed a manualized posttraumatic-growth oriented training program during an integrative seven-day retreat. Methods: Data was collected at baseline, after program completion, and at 18-month follow-up. Results: Results on primary outcomes indicated significant increases, with medium to large effect sizes, in growth related outcomes. Specifically, there was a significant increase in scores by 54% on the posttraumatic growth outcome measure (PTGI-X) from baseline (M = 50.2, SD = 31.1) to endpoint (M = 77.4, SD = 29.6), t(183) = -8.78, p < 0.001. Also, results indicate that immediately following training (Day 7), participants reported a significant decrease of 49% on the PCL-5 from baseline (M = 39.7, SD = 17.6) to endpoint (M = 20.1, SD = 13.2), t(183) = 11.75, p < 0.001. Depression subscale scores decreased by 60% from baseline (M = 8.0, SD = 5.2) to endpoint (M = 3.2, SD = 3.0), t(183) = 10.68, p < 0.001; Anxiety scores decreased by 28% from baseline (M = 5.8, SD = 4.3) to endpoint (M = 4.2, SD = 3.5), t(183) = 4.08, p < 0.001; and Stress scores decreased by 50% from baseline (M = 10.0, SD = 4.4) to endpoint (M = 5.0, SD = 3.3), t(183) = 12.21, p < 0.001. Eighteen-month follow-up data was available for 74 participants and indicated that all significant changes in growth-related outcomes were maintained. Further, all significant changes in symptomatology-related outcomes were also maintained at follow-up. Discussion: These findings demonstrate both the immediate and the long-lasting impact of an integrative posttraumatic growth-oriented training program on psychological growth and PTSD symptom reduction among U.S. military veterans.

Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: a 20-year perspective.

Introduction: Documented use and investigation of hypnosis spans centuries and its therapeutic use has received endorsement by multiple medical associations. We conducted a comprehensive overview of meta-analyses examining the efficacy of hypnosis to provide a foundational understanding of hypnosis in evidence-based healthcare, insight into the safety of hypnosis interventions, and identification of gaps in the current research literature. Methods: In our systematic review, meta-analyses of randomized controlled trials on the efficacy of hypnosis in patients with mental or somatic health problems compared to any control condition published after the year 2000 were included. A comprehensive literature search using Medline, Scopus, PsycINFO, The Cochrane Library, HTA Database, Web of Science and a manual search was conducted to identify eligible reviews. Methodological quality of the included meta-analyses was rated using the AMSTAR 2 tool. Effect estimates on various outcomes including at least three comparisons (k ≥ 3) were extracted and transformed into a common effect size metric (Cohen's d). If available, information on the certainty of evidence for these outcomes (GRADE assessment) was obtained. Results: We included 49 meta-analyses with 261 distinct primary studies. Most robust evidence was reported for hypnosis in patients undergoing medical procedures (12 reviews, 79 distinct primary studies) and in patients with pain (4 reviews, 65 primary studies). There was a considerable overlap of the primary studies across the meta-analyses. Only nine meta-analyses were rated to have high methodological quality. Reported effect sizes comparing hypnosis against control conditions ranged from d = -0.04 to d = 2.72. Of the reported effects, 25.4% were medium (d ≥ 0.5), and 28.8% were large (d ≥ 0.8). Discussion: Our findings underline the potential of hypnosis to positively impact various mental and somatic treatment outcomes, with the largest effects found in patients experiencing pain, patients undergoing medical procedures, and in populations of children/adolescents. Future research should focus on the investigation of moderators of efficacy, on comparing hypnosis to established interventions, on the efficacy of hypnosis for children and adolescents, and on identifying patients who do not benefit from hypnosis. Clinical Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023395514, identifier CRD42023395514.

Recent Developments in Group Psychotherapy Research.

This article reviews group psychotherapy research published within the past 30 years, predominantly focusing on outcomes of group treatments for patients with various mental disorders. Additionally, meta-analyses on the efficacy of group treatments for patients with cancer or chronic pain are summarized. Results strongly support the use of group therapy and demonstrate outcomes equivalent to those of individual psychotherapy. The research also appears to emphasize the effect of feedback on outcomes in group treatments and an association between treatment outcomes and group cohesion and alliance. Other promising developments in the field of group therapy are discussed.

Alliance Rupture Detection and Repair in Group Therapy: Using the Group Questionnaire--GQ.

The identification of relationship ruptures in group therapy coupled with repair efforts by the group leader are addressed from a measurement-based care (MBC) perspective. Several MBC systems are now recognized as evidence-based treatments, and these systems typically use self-report assessment of both outcome and relationship measures. After laying a brief foundation of alliance rupture and repair from an individual therapy perspective, the complexity of applying alliance and repair across the multiple therapeutic relationships and constructs found in the group treatment literature is considered. The Group Questionnaire (GQ) is an empirically derived measure designed to capture the multiple relationship structures (member-member, member-leader, and member-group) and constructs (alliance, cohesion, climate, and empathy) in group therapy. Similarities and differences between the GQ and alliance rupture and repair measures are considered, followed by algorithms used to identify rupture and repair in group therapy on the three GQ subscales-positive bond, positive work, and negative relationship. MBC clinical reports are used to illustrate how rupture is identified at both a group and individual member perspective along with information to support repair interventions. Finally, both clinical and empirical reasons for using the MBC approach are considered along with clinical observations.