Efectividad de la hipnosis en cantidad y calidad del sueño en pacientes con depresión post-COVID / Effectiveness of hypnotherapy on sleep quality and quantity in patients with post-COVID depression

Introducción: Se conocen diversos tratamientos para tratar y curar la depresión. Entre los más utilizados se encuentran la psicoterapia y la medicación. La hipnosis clínica utiliza un discurso basado en la sugestión y en los reflejos condicionados del sueño, para lograr la estabilidad en la desregulación del ciclo sueño / vigilia, lo cual es un factor esencial en el tratamiento de las personas deprimidas por la COVID-19. Objetivo: Comparar la evolución en la calidad y cantidad de sueño en pacientes con depresión post-COVID que fueron tratados con medicación e hipnosis. Métodos: Se realizó un estudio explicativo-comparativo, y un diseño cuasi-experimental. La muestra fue de 40 pacientes que fueron ingresados en el Hospital Universitario Clínico Quirúrgico «Cmdte. Manuel Fajardo Rivero», de Santa Clara, entre enero y marzo de 2021, con COVID-19. En un grupo de pacientes se empleó el inventario de depresión de Beck y un cuestionario para evaluar la cantidad y calidad del sueño antes y después de la intervención con medicación; en el otro grupo se empleó la hipnosis. Se utilizó la estadística descriptiva. Resultados: En ambos grupos la terapia empleada fue efectiva, redujo los niveles de depresión y eliminó las alteraciones del sueño. Conclusiones: Ambas formas de tratamiento se pueden emplear para tratar la depresión y los desórdenes propios del sueño. El método sugestivo de despertar de sueño hipnótico a sueño natural fue tan efectivo como los psicofármacos empleados.

Introduction: various treatments are known to treat and cure depression. Psychotherapy and medication are among the most used. Clinical hypnosis uses a discourse based on suggestions and conditioned sleep reflexes to achieve stability in sleep-wake cycle dysregulation, which is an essential factor in the treatment of people depressed by COVID-19. Objective: to compare the evolution in sleep quality and quantity in patients with post-COVID depression who were treated with medication and hypnotherapy. Methods: an explanatory comparative study with a quasi-experimental design was carried out. The sample consisted of 40 patients who were admitted due to COVID-19 at "Cmdte. Manuel Fajardo Rivero" Clinical and Surgical University Hospital from Santa Clara between January and March 2021. Beck Depression Inventory and a questionnaire were used in a group of patients to assess the sleep quality and quantity before and after the intervention with medication; hypnosis was used in the other group. Descriptive statistics was also used. Results: the used therapy was effective in both groups, reduced levels of depression and eliminated sleep disturbances. Conclusions: both forms of treatment can be used to treat depression and sleep disorders. The suggestive method of awakening from hypnotic sleep to natural sleep was as effective as the psychoactive drugs used.

Hypnotic predictors of agency: Responsiveness to specific suggestions in hypnosis is associated with involuntariness in fibromyalgia.

Hypnosis is associated with alterations in the sense of agency which can play a role in its utilization as a nonpharmacological option for pain management. The goal of the current study was to examine the relationships between responsiveness to suggestions in hypnosis and alterations of the sense of agency among patients with fibromyalgia. Ninety-eight participants with fibromyalgia underwent two hypnotizability assessments followed by the Sense of Agency Rating Scale. Clinical pain measures were also collected. Involuntariness was predicted by responsiveness to control, ideomotor, and dissociation suggestions. Effortlessness was predicted by responsiveness to control and ideomotor suggestions, and age. Hypnotizability was associated with main clinical pain outcomes, but agency alterations were not. Results suggest a shared mechanism between responsiveness to specific suggestions and the sense of agency in hypnosis. We discuss theoretical and clinical implications for pain management and the need for further research.

Preserved critical ability and free will in deep hypnosis during oral surgery.

Free will is a complex construct that includes critical reasoning, sense of ownership, and agency. The whole history of hypnosis has been linked to suggestibility. Little agreement has been reached, however, on exactly what we mean by suggestibility, and its role in hypnosis, despite the abundance of studies, hypotheses, and theories published to date. We report on a highly hypnotizable patient with a previous allergy to lidocaine and paradoxical reactions to pharmacological sedation, who underwent oral surgery with mepivacaine for local anesthesia, and hypnosis for sedation. During the procedure, she felt some pain and the hypnotist recommended bupivacaine to ensure lasting anesthesia. While remaining under deep hypnosis, the patient refused to change anesthetic and decided autonomously to continue with mepivacaine (for which she had previously been tested for allergy). Our case clearly shows a preserved, exemplary reasoning and ability to make autonomous decisions diverging from the hypnotist's advice while under deep hypnosis.

False reports of an accomplice in a crime scene: conformity effects on memory confidence and accuracy / Relatos falsos sobre um cúmplice na cena do crime: efeitos da conformidade na confiança e na acurácia da memória / Informes falsos de un cómplice en la escena del crimen: efectos de conformidad en la confianza y precisión de la memoria

The memory reports of a given individual may be altered by preceding memory reports of another individual, a phenomenon termed memory conformity. To investigate this phenomenon, 58 undergraduate students were separated in two groups which watched one of two slightly different movies of a crime scene (one included an accomplice). Subsequently, pairs containing one participant from each group discussed the movie, and then participants responded individually whether there was an accomplice in the scene. The frequency of false reports and their confidence for the presence/absence of the accomplice were analyzed. Only false reports of seeing an accomplice were produced (by 31% of those who saw no accomplice), and confidence were as high for these responses as for correct "no-accomplice" responses. The data is consistent with prior findings, and show that confidence on false reports can be high when involving "insertion" of elements to witnessed events. (AU)

O relato sobre fatos vivenciados por um indivíduo pode ser alterado por relatos anteriores apresentados por outro indivíduo, fenômeno denominado conformidade de memória. Para investigar esse fenômeno, 58 estudantes de graduação foram separados em dois grupos, os quais assistiram cada um a um vídeo ligeiramente diferente de um mesmo crime (em um havia um cúmplice). Posteriormente, foram formados pares de discussão contendo participantes que assistiram às diferentes versões do vídeo, para, em seguida, responderem individualmente sobre se havia um cúmplice na cena testemunhada. A frequência de relatos incorretos e a confiança na presença/ausência do cúmplice foi analisada. Somente relatos falsos da presença do cúmplice foram verificados (por 31% daqueles que não viram o cúmplice no vídeo), e a confiança foi tão alta quanto as respostas corretas. Os resultados confirmam experimentos anteriores e mostram que a confiança em relatos falsos pode ser alta quando se trata de "inserção" de elementos em um evento testemunhado. (AU)

El informe de memoria sobre hechos vividos por un determinado individuo pueden ser modificados por informes de memoria de otro individuo, este fenómeno es denominado conformidad de memoria. Para investigar este fenómeno, 58 estudiantes universitarios fueron divididos en dos grupos, cada uno vio una película de una misma escena del crimen con sutiles diferencias (una de las versiones incluía un cómplice). Posteriormente, se conformaron parejas de discusión con un participante de cada grupo, y luego, de forma individual, cada persona contestó sí hubo un cómplice en la escena presenciada. Fue analizado la frecuencia de los informes falsos y su confianza en la presencia / ausencia del cómplice. Solo fueron analizados los informes falsos de la existencia del cómplice (por el 31% de los que no vieron el cómplice en el video), y la confianza fue tan alta para estas respuestas, como para las respuestas correctas de "no cómplices". Los resultados confirman los experimentos anteriores y muestran que la confianza en los informes falsos puede ser alta cuando se trata de "insertar" elementos en los eventos atestiguados. (AU)

Effect of therapeutic suggestions during general anaesthesia on postoperative pain and opioid use: multicentre randomised controlled trial.

OBJECTIVE: To investigate the effect of therapeutic suggestions played to patients through earphones during surgery on postoperative pain and opioid use. DESIGN: Blinded randomised controlled study. SETTING: Five tertiary care hospitals in Germany. PARTICIPANTS: 385 of 400 patients consecutively recruited from January to December 2018 who were to undergo surgery for 1-3 hours under general anaesthesia. In the per protocol analysis 191 patients were included in the intervention group and 194 patients in the control group. INTERVENTION: The intervention comprised an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence to patients through earphones during general anaesthesia. Patients in the control group were assigned to a blank tape. MAIN OUTCOME MEASURES: The main outcome was dose of opioid administered by patient controlled analgesia or nurse controlled analgesia within the first postoperative 24 hours, based on regular evaluation of pain intensity on a numerical rating scale (range 0-10, with higher scores representing more severe pain). RESULTS: Compared with the control group, the intervention group required a significantly (P=0.002) lower opioid dose within 24 hours after surgery, with a median of 4.0 mg (interquartile range 0-8) morphine equivalents versus 5.3 (2-12), and an effect size (Cohen's d) of 0.36 (95% confidence interval 0.16 to 0.56). The number of patients who needed opioids postoperatively was significantly (P=0.001) reduced in the intervention group: 121 of 191 (63%, 95% confidence interval 45% to 70%) patients in the intervention group versus 155 of 194 (80%, 74% to 85%) in the control group. The number needed to treat to avoid postoperative opioids was 6. Pain scores were consistently and significantly lower in the intervention group within 24 hours after surgery, with an average reduction of 25%. No adverse events were reported. CONCLUSIONS: Therapeutic suggestions played through earphones during general anaesthesia could provide a safe, feasible, inexpensive, and non-drug technique to reduce postoperative pain and opioid use, with the potential for more general use. Based on the finding of intraoperative perception by a considerable number of patients, surgeons and anaesthetists should be careful about background noise and conversations during surgery. TRIAL REGISTRATION: German Clinical Trial Register DRKS00013800.

The top-down regulation from the prefrontal cortex to insula via hypnotic aversion suggestions reduces smoking craving.

Hypnosis has been shown to have treatment effects on nicotine addiction. However, the neural basis of these effects is poorly understood. This preliminary study investigated the neural mechanisms of hypnosis-based treatment on cigarette smoking, specifically, whether the hypnosis involves a top-down or bottom-up mechanism. Two groups of 45 smokers underwent a smoking aversion suggestion and viewed smoking-related pictures and neutral pictures. One group underwent functional magnetic resonance imaging scanning twice (control and hypnotic states), whereas the other group underwent two electroencephalograph sessions. Our study found that self-reported smoking craving decreased in both groups following hypnosis. Smoking cue-elicited activations in the right dorsal lateral prefrontal cortex (rDLPFC) and left insula (lI) and the functional connectivity between the rDLPFC and lI were increased in the hypnotic state compared with the control state. The delta band source waveforms indicated the activation from 390 to 862 ms at the rDLPFC and from 490 to 900 ms at the lI was significantly different between the smoking and neutral conditions in the hypnotic state, suggesting the activation in the rDLPFC preceded that in the lI. These results suggest that the decreased smoking craving via hypnotic aversion suggestions may arise from the top-down regulation of the rDLPFC to the lI. Our findings provide novel neurobiological evidence for understanding the therapeutic effects of hypnosis on nicotine addiction, and the prefrontal-insula circuit may serve as an imaging biomarker to monitor the treatment efficacy noninvasively.

[Effects of therapeutic suggestions on the recovery of patients undergoing major orthopaedic surgery]. / Az ortopédiai nagymutétek során alkalmazott terápiás szuggesztiók hatása a beteg gyógyulására.

INTRODUCTION AND AIM: Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients' recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient-physician communication. METHOD: In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia. Members of the suggestion group received the therapeutic suggestions during a pre-surgery physician visit, and by listening to an audio recording during surgery. RESULTS: Compared to the control group (n = 50), in the suggestion group (n = 45) the need of medication (pain killer and adjuvant pain medication) during the surgery was lower (p = 0.037), the mean change from baseline in the well-being of the patients was better on the 2nd [1.31 (0.57; 2.04); p<0.001] and 4th [0.97 (0.23; 1.7); p = 0.011] postoperative day and less transfusion had to be administered (OR: 2.37; p = 0.004). However, there was no difference between the two groups in the postoperative need of medications, in the length of hospitalisation and in the frequency of complications. Conslusion: Our results indicate that the administration of therapeutic suggestions in the perioperative period may be beneficial for orthopaedic surgery patients. Orv Hetil. 2018; 159(48): 2011-2020.

Literatura de autoajuda, sugestão e contemporaneidade: uma leitura psicanalítica / Self-help literature, suggestion and contemporary times: a psychoanalytic reading / Literatura de autoayuda, sugestión y contemporaneidad: una lectura psicoanalítica

Um dos fenômenos da atualidade que merece destaque é a alta popularidade da literatura de autoajuda. As obras desse gênero propõem o cultivo de práticas de influência interpessoal, que incorrem geralmente no recurso à sugestão, criticada por Freud desde antes do século XX. Com efeito, utilizando como principal referencial teórico a psicanálise freudiana, privilegiando a noção de sugestão e, de maneira complementar, a análise de conteúdo de uma obra representativa da autoajuda, o presente estudo objetivou analisar alguns dos mecanismos presentes em tal modalidade literária e discutir os fatores que influenciam na sua ampla aceitação hoje. Em termos conclusivos, aponta que a relação estabelecida entre autor e leitor na autoajuda, pautada por processos psíquicos de identificação e transferência em favor da adesão às propostas do autor, permite que este renove continuamente a promessa de conduzir o leitor ao sucesso. (AU)

One of the phenomena of contemporary times that deserve mention is the high popularity of self-help literature. The works of this genre encourage practices of interpersonal influence, which usually incur in the use of suggestion, criticized by Freud since before the twentieth century. Indeed, using Freudian psychoanalysis as the main theoretical framework, focusing the notion of suggestion and, in a complementary way, the content analysis of a representative work of self-help, this study aimed to analyze some of mechanisms present in such literary genre and discuss the factors that influence its wide acceptance today. Thus, points out that the relationship between author and reader in self-help, guided by psychological processes of identification and transfer in favor of accession to the proposals of the author, allows him continually to renew this promise to lead the reader to success. (AU)

Las obras de la literatura de autoayuda proponen prácticas de cultivo de influencia interpersonal, que generalmente incurren en el uso de la sugestión, criticado por Freud desde antes del siglo XX. El psicoanálisis freudiano fue el principal recurso teórico y metodológico para revisión de la literatura, privilegiando la noción de la sugestión y, de manera complementaria, el análisis de contenido de una obra representativa de la autoayuda, este estudio tuvo como objetivo analizar algunos de mecanismos presentes en tal literatura y discutir los factores que influyen en su amplia aceptación en la actualidad. En términos concluyentes, señala que la relación entre el autor y el lector en la autoayuda, guiada por los procesos psicológicos de la identificación y la transferencia a favor de la adhesión a las propuestas del autor, permite renovar continuamente esta promesa de conducir al lector hacia el éxito. (AU)

An Extension Study Using Hypnotic Suggestion as an Adjunct to Intravenous Sedation.

The effects of hypnosis/therapeutic suggestion in connection with intravenous sedation and surgery have been described in many clinical publications; however, few randomized, controlled, and blind studies have been performed in the outpatient area. The original study published in 2010 aimed to evaluate the use of hypnosis/therapeutic suggestion as an adjunct to intravenous sedation in patients having third molar removal in an outpatient setting. The patients were randomly assigned to a treatment or control group. The treatment group listened to a rapid conversational induction and therapeutic suggestions via headphones throughout the entire surgical procedure along with a standard sedation dose of intravenous anesthetic. The control group received intravenous anesthesia but listened to only music without any hypnotic intervention. The current replication study addressed several of the limitations of the original. Sample size was increased and selection of participants from a different geographic area in Pennsylvania. Intra-operative propofol administration, patient post-operative pain ratings, and post-operative prescription pain reliever consumption were all significantly reduced in the treatment compared to the control group. Implications of these results are discussed.

Therapeutic suggestions with critically ill in palliative care.

Suggestions can be used without formal hypnosis, especially with critically ill patients, due to their spontaneous trance state. In this paper we outline data on the effectiveness of therapeutic suggestions. We interpret the possible mechanism of therapeutic suggestions in the context of stress cognition. Basic principles of formulating suggestions are discussed and some recommended versions of non-pharmacological pain control are provided. Case vignettes are given of how suggestions are used with critically ill ICU patients.

Dopaminergic tone does not influence pain levels during placebo interventions in patients with chronic neuropathic pain.

Placebo effects have been reported in patients with chronic neuropathic pain. Expected pain levels and positive emotions are involved in the observed pain relief, but the underlying neurobiology is largely unknown. Patients with neuropathic pain are highly motivated for pain relief, and as motivational factors such as expectations of reward, as well as pain processing in itself, are related to the dopaminergic system, it can be speculated that dopamine release contributes to placebo effects in neuropathic pain. Nineteen patients with neuropathic pain after thoracic surgery were tested during a placebo intervention consisting of open and hidden applications of the pain-relieving agent lidocaine (2 mL) and no treatment. The dopamine antagonist haloperidol (2 mg) and the agonist levodopa/carbidopa (100/25 mg) were administered to test the involvement of dopamine. Expected pain levels, desire for pain relief, and ongoing and evoked pain were assessed on mechanical visual analog scales (0-10). Significant placebo effects on ongoing (P ≤ 0.003) and evoked (P ≤ 0.002) pain were observed. Expectancy and desire accounted for up to 41.2% and 71.5% of the variance in ongoing and evoked pain, respectively, after the open application of lidocaine. We found no evidence for an effect of haloperidol and levodopa/carbidopa on neuropathic pain levels (P = 0.071-0.963). Dopamine seemed to influence the levels of expectancy and desire, yet there was no evidence for indirect or interaction effects on the placebo effect. This is the first study to suggest that dopamine does not contribute to placebo effects in chronic neuropathic pain.

Future-Focused Therapeutic Strategies for Integrative Health.

For many years, the therapy field was dominated by a focus on the past. In this context, many clinicians were trained to use hypnosis as a tool to explore the past, and there is a rich literature documenting the use of hypnosis as a tool to induce age regression and the uncovering of traumatic memories. This article presents a therapeutic paradigm that focuses on the future. Hypnosis is used to induce creativity, flexibility, and openness to the future. In the context of health care, hypnosis is used to explore the best possible treatment outcome, which may be pharmacological, surgical, or a combination of both as well as other nonsurgical interventions. This article elaborates on the effective use of a therapeutic hypnosis strategy and technique focused on the future.

Suggestions to Reduce Clinical Fibromyalgia Pain and Experimentally Induced Pain Produce Parallel Effects on Perceived Pain but Divergent Functional MRI-Based Brain Activity.

OBJECTIVE: Hypnotic suggestion is an empirically validated form of pain control; however, the underlying mechanism remains unclear. METHODS: Thirteen fibromyalgia patients received suggestions to alter their clinical pain, and 15 healthy controls received suggestions to alter experimental heat pain. Suggestions were delivered before and after hypnotic induction with blood oxygen level-dependent (BOLD) activity measured concurrently. RESULTS: Across groups, suggestion produced substantial changes in pain report (main effect of suggestion, F2, 312 = 585.8; p < .0001), with marginally larger changes after induction (main effect of induction, F1, 312 = 3.6; p = .060). In patients, BOLD response increased with pain report in regions previously associated with pain, including thalamus and anterior cingulate cortex. In controls, BOLD response decreased with pain report. All changes were greater after induction. Region-of-interest analysis revealed largely linear patient responses with increasing pain report. Control responses, however, were higher after suggestion to increase or decrease pain from baseline. CONCLUSIONS: Based on behavioral report alone, the mechanism of suggestion could be interpreted as largely similar regardless of the induction or type of pain experience. The functional magnetic resonance imaging data, however, demonstrated larger changes in brain activity after induction and a radically different pattern of brain activity for clinical pain compared with experimental pain. These findings imply that induction has an important effect on underlying neural activity mediating the effects of suggestion, and the mechanism of suggestion in patients altering clinical pain differs from that in controls altering experimental pain. Patient responses imply that suggestions altered pain experience via corresponding changes in pain-related brain regions, whereas control responses imply suggestion engaged cognitive control.

Efficacy of therapeutic suggestions under general anesthesia: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: General anesthesia does not block central nervous processing of auditive information. Therefore, positive suggestions even given during surgery might have the potential to encourage well-being and recovery of patients. Aim of this review was to summarize the evidence on the efficacy of therapeutic suggestions under general anesthesia in adults undergoing surgery compared to an attention control (i.e. white noise). METHODS: We included randomized controlled trials that investigated therapeutic suggestions presented during general anesthesia to adult patients undergoing surgery or medical procedures. Outcomes on pain intensity, mental distress, recovery, use of medication, measured postoperatively within hospitalization were considered. Electronic searches were carried out in the following databases (last search February 23, 2015): MEDLINE, CENTRAL, Web of Science, PsycINFO, ProQuest Dissertations and Theses. RESULTS: Thirty-two eligible randomized controlled trials were included, comprising a total of 2102 patients. All studies used taped suggestions. Random effects meta-analyses revealed no effects on pain intensity (Hedges' g = 0.04, CI 95% [-0.04; 0.12], number needed to treat [NNT] = 44.3) and mental distress (g = 0.03, CI 95% [-0.11; 0.16], NNT = 68.2). In contrast, we found small but significant positive effects on use of medication (g = 0.19, CI 95% [0.09; 0.29], NNT = 9.2) and on recovery (g = 0.14, CI 95% [0.03; 0.25], NNT = 13.0). All effects were homogeneous and robust. CONCLUSIONS: Even though effects were small, our results provide indications that intraoperative suggestions can have the potential to reduce the need for medication and enhance recovery. Further high quality trials are needed to strengthen the promising evidence on the efficacy of therapeutic suggestions under general anesthesia for patients undergoing surgery.

O manejo transferencial em Freud: Uma análise da relação entre transferência e sugestão / Transference management in freud: an analysis of the relationship between transference and suggestion

Pretende-se elucidar a relação entre transferência e sugestão, tomando por referência a produção freudiana da primeira e segunda décadas, tendo por destaque os trabalhos sobre a técnica psicanalítica. Visa-se, assim, desvelar como o manejo da transferência impediria o método clínico psicanalítico de ter sua eficácia reduzida à sugestão. A partir da categoria neurose de transferência, é possível pensar estratégias epistemológicas para responder às críticas de outras áreas do conhecimento que alegam ser a psicanálise uma terapêutica que tem sua eficácia garantida pelo fenômeno da sugestibilidade do cliente na figura do analista.

Transference management in Freud: an analysis of the relationship between transference and suggestion. This article intends to elucidate the relationship between transference and suggestion taking Freud's production from the first and second decade as the reference, highlighting the work on psychoanalytic technique. The aim is to reveal how the management of transference would prevent the psychoanalytic clinical method from having its efficacy reduced by suggestion. From the category of transference neurosis, it is possible to think of epistemological strategies to respond to the criticisms from other areas of knowledge, which claim that psychoanalysis is a therapy that has its effectiveness guaranteed due to the phenomenon of client suggestibility faced with the figure of the analyst.

Effects of Positive Suggestions on the Need for Red Blood Cell Transfusion in Orthopedic Surgery.

This study examined whether positive suggestions applied without a hypnotic induction in the perioperative period reduces the need for red blood cell transfusions in patients who underwent total hip or knee arthroplasties with spinal anesthesia. No hypnotic assessment was performed. Ninety-five patients were randomly assigned to the suggestion group (n = 45) and to the control group (n = 50). Patients in the suggestion group received verbal suggestions before and audiotaped suggestions during the surgery for reducing blood loss, anxiety, postoperative pain, and fast recovery. Our study showed that using positive suggestions in the perioperative period significantly decreases the necessity for transfusion.

Uso de la sugestión en el manejo de la conducta del niño en odontología pediátrica / Use of suggestion in behavior management children in pediatric dentistry

La sugestión siempre ha sido utilizada por los seres humanos en otros seres humanos, tanto de forma consciente como inconsciente. Desde que la humanidad comenzó a ser consciente de si, comenzaron los intentos para influir en los demás. En la práctica clínica, muchos odontopediatras usan la sugestión de forma intuitiva en el manejo de la conducta del paciente. El objetivo de este articulo hacer una revisión bibliográfica sobre el uso de la sugestión en odontopediatria, los tipos de sugestión y algunas técnicas de sugestión usadas en el manejo de la conducta del niño...

The suggestion has always been used by humans over other human beings, both consciously and unconsciously. Since mankind began to be conscious of itself, began attempts to influence others. In clinical practice many pediatric dentists use intuitively suggestion in the management of the patient's behavior. The aim of this paper to review the literature on the use of suggestion in pediatric dentistry, types of suggestion and some suggestion techniques used in managing children's behavior...

Influência da idade, desejabilidade social e memória na sugestionabilidade infantil / Influence of age, social desirability and memory in children's suggestibility

A sugestionabilidade infantil é influenciada pela capacidade de memória, idade ou desejabilidade social. Este estudo teve como objetivo estudar estes fatores em três grupos de crianças com idades de 5/6 anos, 8/9 anos e 10/11 anos. Para tanto procedemos à construção de uma escala de avaliação da sugestionabilidade infantil baseada na Escala de Sugestionabilidade de Gudjonsson (GSS; Gudjonsson, 1997). Os resultados obtidos revelaram que as crianças mais novas foram as mais sugestionáveis, fenômeno que parece estar associado ao elevado grau de desejabilidade social das suas respostas. Relativamente à memória fonológica, verificamos que a sua menor amplitude esteve também relacionada com maior sugestionabilidade infantil. Sugere-se que as variáveis memória e desejabilidade social sejam cuidadosamente consideradas no momento de obtenção do testemunho de crianças. (AU)

Children's suggestibility is influenced by several factors such as memory, age or social desirability. The main objective of this study was to analyze how these factors are associated with the degree of suggestibility in 5/6 year-old, 8/9 year-old and 10/11 year-old children. For a suggestibility measure, a new scale based on the Gudjonsson Suggestibility Scale was developed (GSS; Gudjonsson, 1997). Results showed that: younger children are more suggestible than older children; a higher degree of social desirability is associated with stronger suggestibility responses; and a smaller memory span is related to greater children's suggestibility. Conclusions highlight that memory and social desirability should be analyzed carefully when eyewitness accounts of children are considered. (AU)

Conformidade entre testemunhas oculares: efeitos de falsas informações nos relatos criminais / Conformity among eyewitnesses: effect of false information on criminal reports / Conformidad entre testigos oculares: efectos de falsas informaciones en testimonios criminales

Este estudo investigou como informações falsas fornecidas a testemunhas oculares podem afetar a fidedignidade de seus relatos. Os participantes foram divididos em duas condições experimentais. Todos assistiram ao vídeo de um crime e responderam a um questionário sobre informações nele descritas. Em uma condição, os participantes preencheram o questionário individualmente e, em seguida, discutiram suas respostas com um confederado, que fornecia informações falsas ao participante. Após discutirem tais informações, os participantes eram requisitados a fazer um novo relato. Em outra condição, os participantes realizaram todo o procedimento individualmente, sem receberem informações falsas. O número de erros na presença do confederado foi maior quando comparado com a condição sem o confederado. São discutidos possíveis fatores que envolvem a distorção da memória por meio de conformidade, assim como implicações práticas dos resultados encontrados...

The current study investigated how misinformation presented to eyewitnesses can affect the reliability of their reports. An experiment was conducted with 54 participants, divided in two conditions. All participants watched a video of a crime scene, and then answered a questionnaire about the content of the video. In one condition participants filled the questionnaire individually and then discussed their answers with a confederate, instructed to provide misinformation to participants. After the discussion participants were required to provide a new report. In another condition participants made the whole procedure individually, without receiving any misinformation. Mistakes in the presence of the confederate were higher when compared to the condition with no confederate. Potential factors underlying the distortion of memories through conformity, as well as practical implications of the results are discussed...

Este estudio investigó cómo información falsa proporcionada a testigos oculares puede afectar la veracidad de los testimonios. Los participantes fueron divididos en dos condiciones experimentales, y todos asistieron el video de un delito y luego respondieron a un cuestionario sobre la información contenida en el mismo. En un grupo los participantes completaron el cuestionario de forma individual y luego discutieron sus respuestas con un asociado que les proporcionaba informaciones falsas. Después de discutir esas informaciones se les solicitaba hacer un nuevo testimonio. En el otro grupo los participantes realizaron todo el procedimiento individualmente, sin recibir información falsa. El número de errores fue mayor en la presencia del asociado. Se discuten los posibles factores implicados en la distorsión de la memoria mediante la conformidad, así como las implicaciones prácticas de los resultados...