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.

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.

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.

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.

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.

Hypnosis--there's an app for that: a systematic review of hypnosis apps.

This study systematically reviews the hypnosis apps available via iTunes that were compatible with iPhone or iPad. Of 1455 apps identified on iTunes, 407 met inclusion criteria and were further reviewed. Most common hypnosis app targets were weight loss (23%), boosting self-esteem (20%), and relaxation/stress reduction (19%); 83% of apps delivered hypnosis via audio track, and 37% allowed tailoring. Less than 14% of apps reported disclaimers. None of the apps reported having been tested for efficacy, and none reported being evidence based. Although apps have the potential to enhance hypnosis delivery, it seems as though technology has raced ahead of the supporting science. Recommendations from clinical researchers and policy makers are needed to inform responsible hypnosis app development and use.

The death effect in literary evaluation: reverence for the dead?

It is commonly believed that the value of art and other creative works increases after the death of the artist. In an attempt to examine this so-called death effect we presented a short story to N = 431 undergraduate students asking how much money they would hypothetically spend to purchase a literary work. We experimentally manipulated: 1) whether the author died or moved after publishing a short story, and, 2) the gender of the author. Participants randomly received one of four possible biographical descriptions about the author. We predicted that participants would offer higher purchase prices and subjectively evaluate the work more positively when they believed the author was dead. Results were consistent with this hypothesis perhaps reflecting a certain reverence for the dead. We also found that evaluations of the story were more favorable when the purported gender of the author matched that of the participant.

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.

The Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client version and hypnotizability.

Abstract The present study examined responses on the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client (VSABTH-C) version among a sample of American college students (N = 448) and explored the relationship between VSABTH-C factor scores and measures of hypnotizability, fantasy proneness, and absorption. Scores across three factors (i.e., help, interest, and marginal factors) accounted for 12% of the variance in responsiveness to suggestions administered from the Harvard Group Scale of Hypnotic Susceptibility, Form A. Normative data on the VSABTH-C factors by hypnotizability level and individual VSABTH-C item factor loadings are provided.

The sociocognitive and dissociation theories of hypnosis: toward a rapprochement.

In this introductory article to a special issue on the sociocognitive perspective of hypnosis, the authors contrast two influential hypnosis theories-the sociocognitive and dissociation perspectives-and argue that recent developments in sociocognitive theory (i.e., response set theory) and in the broader field of cognitive psychology pertaining to nonconscious information processing and goal-directed action make possible a rapprochement between theoretical accounts that have vied for attention and empirical support.

Hypnotic responsiveness: expectancy, attitudes, fantasy proneness, absorption, and gender.

This study examines the effect of providing information linking participants' attitudes toward hypnosis with later hypnotic performance. Using total scale scores from McConkey's Opinions About Hypnosis scale, as well as subscale scores, the authors found a weak association between attitudes and performance among 460 student participants; however, the correlation was unaffected by prehypnotic information specifically connecting attitudes and performance. A brief, 3-item measure of hypnotic expectancies generated the strongest correlation with hypnotic responsiveness. The authors also found that the association between fantasy proneness and hypnotizability was unaffected by the order of scale administration. Finally, the study highlighted gender differences across measures of fantasy proneness, absorption, expectancy, and hypnotizability.

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.

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.

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.