The effects of intercessory prayer, positive visualization, and expectancy on the well-being of kidney dialysis patients.

CONTEXT: Little replicable empirical evidence on the effectiveness of prayer is available. OBJECTIVE: To explore the effect of intercessory prayer, positive visualization, and outcome expectancy on a wide range of medical and psychological measures in critically ill patients. DESIGN: 2 x 3 (expectancy x treatment) factorial study. PARTICIPANTS: 95 adult male and female volunteer hemodialysis subjects with end-stage renal disease from an outpatient clinic in Miami, Fla. INTERVENTION: Participants were randomly assigned to 1 of the 6 treatment conditions. MAIN OUTCOME MEASURES: A total of 20 dependent measures (10 medically based and 10 psychological) were used to assess the subjects' overall well-being. Analysis of covariance was used to control for pre-treatment differences between groups. RESULTS: Subjects who expected to receive intercessory prayer reported feeling significantly better than did those who expected to receive positive visualization (F1.93 = 5.42; P < .02). No other statistically significant main effects or interactions were found for either expectancy, intercessory prayer, or positive visualization on the remaining dependent measures. Analysis of effect sizes on all dependent measures failed to indicate even a small magnitude of effect for intercessory prayer as contrasted with expectancy on the medical or psychological variables. CONCLUSIONS: The effects of intercessory prayer and transpersonal positive visualization cannot be distinguished from the effect of expectancy. Therefore, those 2 interventions do not appear to be effective treatments.

Ericksonian approaches to hypnosis and therapy: where are we now?

Ericksonian approaches to psychotherapy and hypnosis have had a significant impact on many clinical practitioners over the last two decades. This article reviews the current empirical research with regard to the efficacy of these treatment approaches as well as for the key Ericksonian assumptions of: (a) belief in an altered state of consciousness and the existence of specific markers indicating an altered state; (b) the superiority of indirect suggestion over direct suggestion; and (c) client hypnotizability is a function of the hypnotist's skill. The current literature provides empirical support neither for efficacy nor for these key assumptions. The article concludes with a discussion of the need for empirically based research to test the efficacy of Ericksonian therapy and its core components, lest this approach become isolated from the scientific hypnosis and therapy communities.

Eye movement desensitization and reprocessing in the treatment of test anxiety: a study of the effects of expectancy and eye movement.

Eye Movement Desensitization and Reprocessing (EMDR) is a recently invented technique acclaimed as a major breakthrough for a range of anxiety-related symptoms. To determine the importance of the eye movement and expectancy variables, we conducted a one-hour session with 41 undergraduate subjects (11 males and 30 females) with test anxiety. A 2 (eye movement vs no eye movement) x 2 (high expectancy vs low expectancy) analysis of variance was performed on three dependent measures: (1) Subjective Units of Disturbance Scale (SUDs). (Wolpe, The Practice of Behavior Therapy, 1982); (2) Validity of Cognition Scale (VOC) (Shapiro, 1992); and (3) the Test Anxiety Inventory (TAI) (Spielberger, TestAnxiety Inventory Preliminary Professional Manual, 1977). The data indicate that all subjects, regardless of treatment condition, showed a significant decrease in anxiety on the TAI. Subjects in the eye-movement condition reported feeling less anxious (SUDs) than those in the no-eye-movement condition. We found no significant main effect or interactions for any of the dependent measures for expectancy.

A comparison of the hypnotic experience between signing deaf and hearing participants.

This study compared the hypnotic responsiveness of 17 hearing and 34 deaf individuals, all of whom received visual induction and hypnotic suggestions via some form of signing. The comparison between deaf and hearing participants was analyzed on five dependent measures: (a) the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C); (b) participants' individual item performance; (c) overall trance depth; (d) a rapport scale; and (e) a resistance scale measuring attitudes of participants toward the hypnotist. Although all participants showed at least a moderate level of hypnotic responsiveness, the data did not indicate a significant main effect between deaf and hearing participants on any of the dependent measures. However, there was a tendency (p < .08) for hearing participants to show a greater hypnotic responsiveness than deaf participants. Additionally, there was a significant difference between all the signing participants combined when compared to the norming population on three items of the SHSS:C. Clinical and theoretical implications of these data are discussed.

Hypnosis with signing deaf and hearing subjects.

Historically hypnosis with deaf people has been an underutilized intervention as the deaf were assumed not to be responsive to hypnotic suggestion. Recent research has begun to challenge these assumptions. Matthews and Isenberg (in press) compared the hypnotic responsiveness of deaf and hearing subjects on the Stanford Hypnotic Susceptibility Scale, form C (SHSS:C) all of whom received the hypnotic suggestions via sign language. Those results supported the notion that deaf subjects are capable of responding to hypnotic suggestion and may be as hypnotically responsive as hearing subjects. The purpose of the present article is to examine the similarities and differences of responses between deaf and hearing subjects to the individual items of the SHSS:C and compare those responses to the SHSS:C norms.

Hypnotic inductions with deaf and hearing subjects--an initial comparison: a brief communication.

17 volunteer deaf Ss were compared with 18 volunteer hearing Ss on the Stanford Hypnotic Clinical Scale (SHCS) of Morgan and J. R. Hilgard (1975), and the Indirect Suggestion Scale (ISS) of Matthews and Mosher (1985) in a 2 x 2 ANOVA design. 5 dependent measures: (a) objective scale score; (b) self-report scale score; (c) S rapport with the hypnotist; (d) S resistance to the hypnotist; and (e) overall subjective rating of trance experience were employed to measure any differences between the 2 groups. For SHCS behavioral items, the two-way ANOVA failed to reveal any significant main effect or interaction differences between either group (deaf/hearing) or method of induction (direct/indirect). There was a significant main effect for deaf/hearing groups in level of resistance to the hypnotist. Deaf Ss reported feeling more resistant to the hypnotist than did hearing Ss. This may be due to the mode of communication or the fact that the hypnotist was hearing. Implications and limitations of the study are discussed.

Working hypnotically with deaf people.

Little attention has been given to the utilization of hypnosis with deaf people. In a recent study, we compared objective and subjective responses to two different hypnotic induction techniques by deaf and hearing undergraduate women. We presented hypnosis techniques orally to hearing subjects and visually, using sign-language, to deaf subjects. Results from this study failed to reveal any significant differences on objective or self-report levels of trance depth between the two populations. Our purpose in this article is to examine the similarities and differences of the induction process and hypnotic responses, including trance indicators, between deaf and hearing subjects.

Toxic exposures and ingestions in Honolulu: I. A prospective pediatric ED cohort; II. A prospective poison center cohort.

Poisonings and toxic exposures are a frequent cause of preventable morbidity in children requiring emergency care. Ingestions and toxic substance exposures were studied in two prospective cohorts in Hawaii to examine the epidemiology of these events in this community in order to assess the effectiveness of current poison prevention practices and to identify additional measures to further prevent and reduce morbidity and mortality. During a 12-month period ending on 11/30/88, data were collected on 286 pediatric patients visiting a pediatric ED with an ingestion or a toxic substance exposure. Most of the younger children were males with unintentional incidents. Most of the adolescents were females with intentional ingestions. Syrup of ipecac was given in 16% of the patients. When given at home, ipecac was given an average of 1.3 hours after an ingestion. Activated charcoal was given to 32% of the patients. During a 13-month period ending 1/31/90, 14,408 phone calls to the Hawaii Poison Center were analyzed. Twenty-six percent of the callers had ipecac at home. Sixty-eight percent of callers with acute ingestions claimed to have called within 30 minutes of the ingestion, and 77% claimed to have called within 60 minutes of the ingestion. Of those calling within 60 minutes, 36% had ipecac at home. Although ipecac is widely recommended as a pre-hospital intervention, it use is limited owing to unavailability in the home and the short period of time during which it must be given. Since the dispensing of pharmaceuticals in limited quantities and in childproof containers began, it appears that other measures to further reduce morbidity and mortality owing to poisonings have had less additional effect. It appears that serious morbidity and mortality from poisonings in this cohort were uncommon.

What do clients think about the metaphors they receive? An initial inquiry.

Research on Ericksonian techniques and claims of effectiveness has been very sparse. Most of the focus on Ericksonian approaches has been on the development of techniques by the clinicians, seemingly independent of the meaning to the client. One of these interventions is the multiple embedded metaphor (MEM), a series of stories within stories. The underlying assumption is that in order to be effective the metaphor(s) needs to be processed outside of conscious awareness. Six clients participated and were given eight session of psychotherapy, three sessions of which involved the use of MEM. A week after each MEM session, clients reviewed that session on videotape with the therapist. Only one of the six clients reported amnesia for the experience. Four of the five nonamnestic clients had changes in their presenting problems and felt the process to be helpful. The limitations and implications for clinicians are discussed.

Randomized, double-blind evaluation of azlocillin for the treatment of pulmonary exacerbations of cystic fibrosis.

Patients with cystic fibrosis hospitalized because of deterioration in their pulmonary disease were randomly assigned to receive ten days of intravenous antibiotic therapy with either ticarcillin plus tobramycin (previously the standard regimen at our hospital), azlocillin plus tobramycin or azlocillin plus placebo. Pulmonary function and microbiological responses were similar in the three treatment groups, although patients receiving azlocillin and placebo tended to have a smaller reduction in the concentration of bacteria in the sputum and a greater rate of acquisition of antibiotic-resistant organisms. Overall, in-hospital treatment was associated with a significant improvement in Shwachman score, pulmonary function tests, and PO2. Improvement was noted by day 5 of therapy, continued through day 10, and was partially maintained at follow-up clinic visit one month after discharge. There was also a statistically significant reduction in sputum bacterial concentration, but patients cultured at the conclusion of antibiotic therapy still had a mean of 10(7) cfu/ml in sputum. Pseudomonas aeruginosa, the principal pathogen recovered from sputum cultures in this study, was transiently suppressed to sub-detectable levels in only one patient. There was no correlation between microbiological response and change in any parameter of pulmonary function. By follow-up clinic visit, sputum bacteria had returned to pre-treatment levels, and antibiotic-resistant organisms persisted in all patients from whom they had been recovered during hospitalization.