The response set theory of hypnosis reconsidered: toward an integrative model.

Irving Kirsch is a leading figure in the field of psychological science who has advanced our understanding of hypnosis in key respects that have withstood the tests of time and replication. We honor his prodigious contributions over his distinguished career and extend his response expectancy theory in an integrative model that encompasses predictive coding. We review the construct of expectancies that he articulated and championed for decades and extended in response set theory. We propose novel hypotheses to align his innovative contributions with the most current findings in psychological science and to acknowledge the heuristic value of his work. We especially focus on (I) how the response set theory can be conceptualized in terms of the predictive coding model and (II) psycho-social constructs that need to be considered to better understand the effects of expectancies on hypnotic phenomena in an open and evidence-based integrative model of hypnosis.

Attitudes about hypnosis: factor analyzing the VSABTH-C with an American sample.

In the present study, the authors factor-analyzed responses from 1,141 American undergraduate students to the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client Version. They obtained an 8-factor solution accounting for 66% of the total variance in responses. A confirmatory factor analysis indicated acceptable fit of their model and those reported earlier by Carvalho et al. (2007) and Capafons, Mendoza, et al. (2008) using Portuguese and international samples, respectively. Unlike previous factor analyses of the scale, the authors obtained an independent clusters solution. Distinctions between the authors' model and those reported previously are discussed.

God Locus of Health Control, Paranormal Beliefs, and Hypnotizability.

Belief in the paranormal (e.g., spirits, extrasensory perception, fortune telling, extraterrestrials) is common. Extraordinary and magical beliefs have been linked with hypnotizability. A total of 167 undergraduates completed measures of paranormal and magical beliefs, locus of control, absorption, fantasy proneness, expectancy about being hypnotized, and the God Locus of Health Control scale (GLHC) and were hypnotized with the HGSHS:A. High and medium hypnotizable participants more strongly agreed with statements reflecting paranormal and magical beliefs and the assertion that God directly controls their health, relative to those less responsive to hypnosis. Using stepwise regression, we found that expectations about hypnosis along with scores on the GLHC scale accounted for 26% and 30% of the variance in behavioral and subjective scores on the HGSHS:A, respectively. The authors discuss paranormal beliefs and the link between the GLHC and hypnotizability.

Common paraverbal errors during hypnosis intervention training.

There is growing literature to support the use of hypnosis as an evidence-based behavioral medicine intervention to manage a wide variety of symptoms and side effects associated with cancer and its treatment (e.g., pain, nausea, fatigue). However, formal training in hypnosis is often lacking among cancer care providers. The purpose of this study is to identify common paraverbal errors among hypnosis trainees in order to inform future training efforts. In a sample of 196 hypnosis trainees, paraverbal errors (i.e., tone, pacing, and phrasing) were tracked across hypnotic intervention components. Results revealed that trainees had most difficulty with hypnotic tone, particularly during the Induction, Deepening, and Alerting components. Individual trainee characteristics were unrelated to paraverbal errors.

Predicting animal attachment from hypnotizability, absorption, and dissociation scores.

Using a sample of nearly 300 undergraduate students, we examined whether absorption, dissociation, and hypnotizability were linked with pet attachment, and whether completing assessment scales in the same or different testing contexts affected the association. We found a positive correlation between scores on the Tellegen Absorption Scale (TAS; Tellegen & Atkinson, 1974) and the Companion Animal Bonding Scale (CABS; Poresky, Hendrix, & Mosier, 1987), but failed to find a positive link between animal attachment and scores on the Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986). We observed a small positive correlation between Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A; Shor & Orne, 1962) scores and animal attachment among our female participants. Collectively, absorption, dissociation, hypnotizability, age, gender, years owning a pet, and the testing context accounted for no more than 16% of the variance in CABS scores.

The Perceived Credibility of Complementary and Alternative Medicine: A Survey of Undergraduate and Graduate Students.

The popularity of complementary and alternative medicine (CAM) appears to be increasing, especially among college students. We surveyed 146 undergraduate and graduate students with the CAM Health Belief Questionnaire and obtained credibility and frequency ratings for a select group of CAM therapies: yoga, meditation, massage, chiropractic medicine, biofeedback, hypnosis, acupuncture, spirituality/religion, therapeutic touch, the use of herbs/vitamins, and aromatherapy/essential oils. Graduate students held more favorable views about integrating CAM into conventional medical practice. Female students reported using a wider variety of therapies than male students. Spirituality/religion and herbs/vitamins were the most popular CAM approaches. Students rated yoga, meditation, and massage as being highly credible practices. They rated hypnosis and therapeutic touch low in credibility. We discuss hypnosis as an example of a therapy that suffers from poor public perception despite having a relatively strong evidentiary base.

HYPNOSIS, HYPNOTIC PHENOMENA, AND HYPNOTIC RESPONSIVENESS: Clinical and Research Foundations-A 40-Year Perspective.

The authors summarize research findings, their clinical implications, and directions for future research derived from 40 years of study of hypnosis, hypnotic phenomena, and hypnotic responsiveness at Steven Jay Lynn's Laboratory of Consciousness, Cognition, and Psychopathology and Joseph P. Green's Laboratory of Hypnosis. We discuss (a) the accumulating body of evidence that hypnosis can be used to advantage in psychotherapy; (b) the fact that hypnosis can facilitate a broad array of subjective experiences and suggestions; (c) the failure to find a reliable marker of a trance or radically altered state of consciousness and reservations about conceptualizing hypnosis in such terms; (d) determinants of hypnotic responsiveness, including attitudes and beliefs, personality traits, expectancies, motivation, and rapport; (e) efforts to modify hypnotic suggestibility; and (f) the need to further examine attentional abilities and the role of adopting a readiness response set that the authors argue is key in maximizing hypnotic responsiveness.

Gender-related differences in hypnosis-based treatments for smoking: a follow-up meta-analysis.

In an earlier meta-analysis of 12 studies using hypnosis-based treatments for smoking cessation, we provided preliminary evidence that males fare better than females when trying to quit smoking (Green, Lynn, & Montgomery, 2006). By excluding studies that reported no gender differences, but failed to report final outcome-statistics-by-gender, our previous conclusion may have overestimated the role of gender in hypnosis-based smoking cessation treatment. In the present analysis, we included 12 additional studies that reported no gender differences, but failed to report final outcome-by-gender statistics. Across each of these studies, we calculated identical success rates for male and female participants and then added these results to our database. Among all 24 groups of participants who completed hypnosis-based treatment for smoking, we found a small but significant effect for male participants being more successful in quitting smoking relative to females. Specific suggestions for tailoring hypnosis smoking cessation programs to take gender differences into account are discussed.

An update on age, hypnotic suggestibility, and gender: a brief report.

This study assessed the relationship of age and hypnotic suggestibility in an effort to partially update the findings of Morgan and Hilgard (1973). A total of 2,660 undergraduates were administered the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A; Shor & Orne, 1962) over a 7 year period. Consistent with Morgan and Hilgard's results, we found a general trend for hypnotic suggestibility scores to decrease from age 17 to 40, and then increase thereafter. We also found that female participants scored higher on the HGSHS: A compared with males across the various age ranges that we sampled.

A Multifaceted Hypnosis Smoking-Cessation Program: Enhancing Motivation and Goal Attainment.

Smoking cessation remains a major health priority. Despite public campaigns against smoking and widespread availability of smoking-cessation treatments, many people continue to smoke. The authors argue that the "problem of motivation," that is, suboptimal or fluctuating motivation to resist smoking urges and to comply with the demands of treatment, commonly undermines treatment seeking and adherence, appreciably reducing the success rates of smoking-cessation programs. The authors describe the history of the Winning Edge smoking-cessation program and discuss ways to enhance motivation before, during, and after formal treatment. They illustrate how hypnotic suggestions, administered in the context of their program, can promote cognitive, behavioral, and emotional commitment to treatment and enhance motivation to live a smoke-free life.

The Hypnotic Induction in the Broad Scheme of Hypnosis: A Sociocognitive Perspective.

Researchers and clinicians typically divide hypnosis into two distinct parts: the induction and the suggestions that follow. We suggest that this distinction is arbitrary and artificial. Different definitions of hypnosis ascribe different roles to the hypnotic induction, yet none clearly specifies the mechanisms that mediate or moderate subjective and behavioral responses to hypnotic suggestions. Researchers have identified few if any differences in responding across diverse hypnotic inductions, and surprisingly little research has focused on the specific ingredients that optimize responsiveness. From a sociocognitive perspective, we consider the role of inductions in the broader scheme of hypnosis and suggest that there is no clear line of demarcation between prehypnotic information, the induction, suggestions, and other constituents of the hypnotic context. We describe research efforts to maximize responses to hypnotic suggestions, which encompass the induction and other aspects of the broader hypnotic framework, and conclude with a call for more research on inductions and suggestions to better understand their role within hypnotic interventions in research and clinical contexts.

A meta-analysis of gender, smoking cessation, and hypnosis:a brief communication.

Results of a meta-analysis showed that males were more likely to report smoking abstinence than female participants following hypnosis-based treatments for smoking. Across 12 studies that used hypnosis in the treatment of smoking and reported outcome statistics by gender, the authors found that the odds of achieving smoking abstinence were 1.37 times greater for male than female participants. The results are consistent with the nonhypnosis literature suggesting that females have a more difficult time achieving smoking abstinence compared to males.

Cultural views and attitudes about hypnosis: a survey of college students across four countries.

The present investigation surveyed attitudes and beliefs about hypnosis across 4 samples of students attending college at the University of New South Wales, Australia; Dortman University, Germany; The Ohio State University, United States; and Shaheed Beheshti University of Medical Sciences, Iran. A total of 280 undergraduate students (70 from each country sampled), ranging in age from 18 to 25 years, completed 3 different questionnaires assessing their opinions and beliefs about hypnosis. Although responses to some items varied by country, there was remarkable similarity across many items suggesting that certain views and attitudes about hypnosis are not culture specific.

Forging ahead: the 2003 APA Division 30 definition of hypnosis.

The article describes the rationale for and the process of developing a new definition of hypnosis by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association. Both theoretical and practical implications led to the production of the definition, which is targeted toward informing clinicians, researchers, and the lay public alike. The definition is presented at the conclusion of the article.

Experiencing hypnotizability scale motor items by an amputee: a brief report.

The following brief report describes the experiences of a hand and arm amputee following the administration of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and Orne, 1962. The participant passed two of the three motor items involving his missing limb. This report discusses the results of a postsession interview regarding our participant's experiences during hypnosis and briefly discusses phantom limb sensations in general.

Diurnal variations in hypnotic responsiveness: is there an optimal time to be hypnotized?

With a sample of nearly 700 undergraduate students, the authors found support for diurnal variations in hypnotic responsiveness. Administering the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) in the morning or evening resulted in higher average scores than from afternoon sessions. The authors replicated this finding using a second independent sample. In the primary study, participants indicated the time of day that they are most alert. Matching self-reported preferred time of the day with HGSHS:A administration time did not improve hypnotic responsiveness. Considering this as well as past research, the authors argue that mid-morning may be the optimal time to be hypnotized and afternoon the least favorable.

Beliefs about hypnosis: popular beliefs, misconceptions, and the importance of experience.

Contemporary views and opinions about hypnosis were sampled with a modified version of McConkey's Opinions About Hypnosis (OAH) scale. The OAH was administered at 2 different times, 1 month apart, to 276 undergraduate students. Approximately half of the participants completed the Harvard Group Scale of Hypnotic Susceptibility, Form A, between the survey sessions. Results indicated that the experience of being hypnotized modified a majority of the opinions sampled, with participants expressing less stereotypic views about hypnosis after being hypnotized. Expressed opinions and beliefs about hypnosis failed to meaningfully correlate with hypnotizability scores.

Examining the absorption-hypnotizability link: the roles of acquiescence and consistency motivation.

The Tellegen Absorption Scale (TAS) is one of the few personality measures commonly found to correlate with hypnotizability. However, a number of studies have found that the correlation is strongly influenced by contextual factors. Three studies examined acquiescence (or "yea-saying") and consistency motivation as possible contributors to context effects on the absorption-hypnotizability link. Results indicate that acquiescence and consistency effects are likely to influence the level of association between the TAS and hypnotic responsiveness.