The Effectiveness of Hypnoanalgesia Using Conventional and Placebo Hypnosis Induction.

The effectiveness of hypnosis-based pain management is well-established. However, mechanisms of action and specific effective components are not well understood. The sociocognitive theory of hypnosis proposes that the effectiveness of hypnosis for pain management is determined by the nonspecific features of response expectancy and context. We tested this claim by contrasting the effectiveness of 2 hypnoanalgesia procedures in a within subjects design using the cold pressor task. The 2 procedures were identical, including analgesic suggestions, except for the hypnosis induction used. One condition involved a well-established hypnosis induction, including suggestions for focused attention, relaxation, and deepening. The other condition included a sham induction procedure using only white noise. In our confirmatory analysis (N = 46), we found that pain tolerance increased compared to baseline equivalently in the conventional and sham induction conditions (mean increase 13.7 and 12.4 seconds respectively, average within subject difference -1.27 seconds, 90% confidence interval [CI] = -8.46, 5.90). This finding supports the claim of the sociocognitive theory considering that response expectancy for pain reduction was also equivalent between the conditions (average difference 2.30, 90% CI = -2.23, 6.84). However, self-reported hypnosis depth was greater in the conventional induction condition (average difference -.78, 90% CI: -1.36, -.07), which contradicts sociocognitive predictions. Our findings indicate that conventional procedural elements of hypnosis inductions, such as suggestions for focused attention, relaxation, and deepening, may not be necessary to achieve acute pain reduction in an experimental setting when the hypnosis intervention includes analgesic suggestions. PERSPECTIVE: This study assessed the necessary effective components of hypnosis-based analgesia interventions. Our findings suggest that procedural features such as suggestions for focused attention, relaxation, and deepening may not be necessary for hypnoanalgesia as long as pain relief suggestions are present, and the hypnosis context and response expectancy are established. TRIAL REGISTRATION: This trial was registered on Open Science Framework with the registry number e96xk, available at https://osf.io/e96xk.

Gamma power and beta envelope correlation are potential neural predictors of deep hypnosis.

Hypnosis is a psychological intervention that is commonly used to enhance the effectiveness of therapeutic suggestions. Despite extensive fascination and study, the neural mechanisms behind hypnosis remain elusive. In the current study, we undertook a systematic exploration of these neural correlates. We first extracted well-studied neurophysiological features from EEG sensors and source-localized data using spectral analysis and two measures of functional connectivity: weighted phase lag index (wPLI) and power envelope correlation (PEC). Next, we developed classification models that predicted self-rated hypnotic experience based on the extracted feature sets. Our findings reveal that gamma power computed on sensor-level data and beta PEC computed between source-localized brain networks are the top predictors of hypnosis depth. Further, a SHapley Additive exPlanations (SHAP) analysis suggested reduced gamma power in the midline frontal area and increased beta PEC between interhemispheric Dorsal Attention Networks (DAN) contribute to the hypnotic experience. These results broaden our understanding of the neural correlates of deep hypnosis, highlighting potential targets for future research. Moreover, this study demonstrates the potential of using predictive models in understanding the neural underpinnings of self-reported hypnotic depth, offering a template for future investigations.

Correction to: 'Raising the value of research studies in psychological science by increasing the credibility of research reports: The Transparent Psi Project' (2023) by Kekecs et al.

[This corrects the article DOI: 10.1098/rsos.191375.][This corrects the article DOI: 10.1098/rspb.2022.2500.].

Current Practices, Experiences, and Views in Clinical Hypnosis: Findings of an International Survey.

An online survey of 691 clinicians who use hypnosis was conducted in 31 countries to gain a broad real-world picture of current practices, views, and experiences in clinical hypnosis. Among 36 common clinical uses, stress reduction, wellbeing and self-esteem-enhancement, surgery preparations, anxiety interventions, mindfulness facilitation, and labor and childbirth applications were the most frequently rated as highly effective (each by ≥70% of raters) in the clinicians' own experience. Adverse hypnosis-associated effects had been encountered by 55% of clinicians but were generally short-lived and very rarely judged as serious. The most common hypnosis approaches used were Ericksonian (71%), hypnotic relaxation therapy (55%), and traditional hypnosis (50%). Almost all respondents reported regularly using other therapeutic modalities alongside hypnosis. Among a range of client variables potentially affecting therapy, most clinicians rated hypnotist-client rapport (88%) and client motivation (75%) as very or extremely important factors for successful hypnotherapy. The majority of respondents had conducted hypnosis treatment via teletherapy, and 54% of those estimated it to be as effective as in-person treatment.

Raising the value of research studies in psychological science by increasing the credibility of research reports: the transparent Psi project.

The low reproducibility rate in social sciences has produced hesitation among researchers in accepting published findings at their face value. Despite the advent of initiatives to increase transparency in research reporting, the field is still lacking tools to verify the credibility of research reports. In the present paper, we describe methodologies that let researchers craft highly credible research and allow their peers to verify this credibility. We demonstrate the application of these methods in a multi-laboratory replication of Bem's Experiment 1 (Bem 2011 J. Pers. Soc. Psychol. 100, 407-425. (doi:10.1037/a0021524)) on extrasensory perception (ESP), which was co-designed by a consensus panel including both proponents and opponents of Bem's original hypothesis. In the study we applied direct data deposition in combination with born-open data and real-time research reports to extend transparency to protocol delivery and data collection. We also used piloting, checklists, laboratory logs and video-documented trial sessions to ascertain as-intended protocol delivery, and external research auditors to monitor research integrity. We found 49.89% successful guesses, while Bem reported 53.07% success rate, with the chance level being 50%. Thus, Bem's findings were not replicated in our study. In the paper, we discuss the implementation, feasibility and perceived usefulness of the credibility-enhancing methodologies used throughout the project.

Electrodermal Orienting Response During Active-Alert Hypnosis: Do Verbal Suggestions Influence Automatic Attentional Processes?

This study explored the influence of suggestions on differences in electrodermal laterality of the skin conductance orienting response (SCR). Thirty-two participants were randomly assigned to either permitting or excluding suggestions. During the dream task in the permitting condition the suggestion was: "You are aware of your surroundings and any distractions that might disturb your dream," while in the excluding condition the wording was: "No outside stimulus will disturb your sleep." Participants were presented with 12 standards and 2 deviant computer-generated tones during active-alert hypnosis and musical control conditions in a mixed within-between design. High hypnotizables produced higher SCRs after permissive compared to excluding suggestions during hypnosis, while low hypnotizables did the same in the control condition. Study limitations include some loss of data due to equipment failure and relative homogeneity of sample, therefore results cannot be considered definitive.

Situational factors shape moral judgements in the trolley dilemma in Eastern, Southern and Western countries in a culturally diverse sample.

The study of moral judgements often centres on moral dilemmas in which options consistent with deontological perspectives (that is, emphasizing rules, individual rights and duties) are in conflict with options consistent with utilitarian judgements (that is, following the greater good based on consequences). Greene et al. (2009) showed that psychological and situational factors (for example, the intent of the agent or the presence of physical contact between the agent and the victim) can play an important role in moral dilemma judgements (for example, the trolley problem). Our knowledge is limited concerning both the universality of these effects outside the United States and the impact of culture on the situational and psychological factors affecting moral judgements. Thus, we empirically tested the universality of the effects of intent and personal force on moral dilemma judgements by replicating the experiments of Greene et al. in 45 countries from all inhabited continents. We found that personal force and its interaction with intention exert influence on moral judgements in the US and Western cultural clusters, replicating and expanding the original findings. Moreover, the personal force effect was present in all cultural clusters, suggesting it is culturally universal. The evidence for the cultural universality of the interaction effect was inconclusive in the Eastern and Southern cultural clusters (depending on exclusion criteria). We found no strong association between collectivism/individualism and moral dilemma judgements.

Guidelines for the Assessment of Efficacy of Clinical Hypnosis Applications.

Research on the efficacy of hypnosis applications continues to grow, but there remain major gaps between the science and clinical practice. One challenge has been a lack of consensus on which applications of hypnosis are efficacious based on research evidence. In 2018, 6 major hypnosis organizations collaborated to form the Task Force for Establishing Efficacy Standards for Clinical Hypnosis. This paper describes a Guideline for the Assessment of Efficacy of Clinical Hypnosis Applications developed by the Task Force, which makes 10 specific recommendations. The guideline is intended to be a tool for those who want to assess the quality of existing evidence on the efficacy of clinical hypnosis for any particular indication. The paper also discusses methodological issues in the interpretation and implementation of these guidelines. Future papers will report on the other products of the Hypnosis Efficacy Task Force, such as best practice recommendations for outcomes research in hypnosis and an international survey of researchers and clinicians on current practice and attitudes about hypnosis.

Towards a multi-brain framework for hypnosis: a review of quantitative methods.

Most real-world applications of hypnosis involve a pair of actors: a hypnotist and a subject. Accordingly, most current models of hypnosis acknowledge the relevance of social factors in the development of the hypnotic response. Yet, psychophysiological research on hypnosis has been mostly restricted to techniques that are studying one individual, neglecting the complexity of hypnosis as a social phenomenon. In this paper, we review evidence suggesting that a multi-brain approach to studying the psychophysiology of hypnosis could lead to a breakthrough in our understanding of the neural correlates of hypnosis. In particular, we aim to highlight how this approach which relies on the information conveyed by complex verbal stimuli can be utilized to deal with the multifaceted nature of hypnosis. Furthermore, we present analytical approaches to assessing brain-to-brain coupling developed in the field of social cognitive neuroscience in the past decade, to aid the design of similar multi-brain studies in hypnosis research.

Hypnosis Intervention for Sleep Disturbance: Determination of Optimal Dose and Method of Delivery for Postmenopausal Women.

Sleep disturbances are a pervasive problem among postmenopausal women, with an estimated 40 to 64% reporting poor sleep. Hypnosis is a promising intervention for sleep disturbances. This study examined optimal dose and delivery for a manualized hypnosis intervention to improve sleep. Ninety postmenopausal women with poor sleep were randomized to 1 of 4 interventions: 5 in-person, 3 in-person, 5 phone, or 3 phone contacts. All received hypnosis audio recordings, with instructions for daily practice for 5 weeks. Feasibility measures included treatment satisfaction ratings and practice adherence. Sleep outcomes were sleep quality, objective and subjective duration, and bothersomeness of poor sleep. Results showed high treatment satisfaction, adherence, and clinically meaningful (≥ 0.5 SD) sleep improvement for all groups. Sleep quality significantly improved, p < .05, η2 = .70, with no significant differences between groups, with similar results for the other sleep outcomes across all treatment arms. Comparable results between phone and in-person groups suggest that a unique "dose" and delivery strategy is highly feasible and can have clinically meaningful impact. This study provides pilot evidence that an innovative hypnosis intervention for sleep (5 phone contacts with home practice) reduces the burden on participants while achieving maximum treatment benefit.

Test-Retest Reliability of the Stanford Hypnotic Susceptibility Scale, Form C and the Elkins Hypnotizability Scale.

This project aimed to assess the consistency of hypnotizability over repeated assessments when measured by the Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C), and the Elkins Hypnotizability Scale (EHS) and to contrast score distribution and pleasantness of these scales. University students were administered either the SHSS:C or the EHS twice with a one-week delay by separate experimenters. Test-retest reliability of the EHS and the SHSS:C was r s =.82 (.71-.92) and r s =.66, 95% (.47-.86), respectively (Spearman's correlation). Hypnotizability was comparable at test and retest in the EHS group, SHSS:C scores decreased by the retest. We found that the SHSS:C produced higher scores than the EHS, and the pleasantness of the 2 scales was comparable. Overall, our results supported the reliability of the EHS, while SHSS:C scores were more inconsistent between the 2 assessments. More research is warranted.

Patient Safety Education 20 Years After the Institute of Medicine Report: Results From a Cross-sectional National Survey.

OBJECTIVES: Educating healthcare professionals in patient safety is essential to achieving sustainable improvements in care. This study aimed to identify the key constituents of patient safety education alongside its facilitators and barriers from a frontline perspective. METHODS: An electronic survey was sent to 592 healthcare professionals and educators in patient safety education in the United Kingdom. Two independent reviewers conducted a thematic analysis of the free-text data. Themes focused on effective content, learning practices and facilitators and barriers to patient safety education. RESULTS: Of 592 individuals completing the survey, 545 (92%) submitted analyzable responses. Interrater reliability of coding was high with Cohen k value of 0.86. Participants endorsed experiential and interactive learning as ideal modalities for delivery and expressed a need for content to be based on real clinical cases and tailored to the needs of the learners. The most commonly mentioned facilitators were standardization of methods and assessment (49%), dedicated funding (21%), and culture of openness (20%). Staffing problems and high workload (41%) and lack of accessibility of training (23%) were identified as primary barriers of efficacy and uptake. CONCLUSIONS: This study identified key factors to the success of patient safety education in terms of content and delivery alongside facilitators and barriers. Future curricula developers and interventions should improve standardization, funding, culture, and access so as to optimize education programs to enhance patient safety.

Bilateral comparison of traditional and alternate electrodermal measurement sites.

Advances in mobile and wireless technology have expanded the scope of electrodermal research. Since traditional electrodermal measurement sites are not always suitable for laboratory research and are rarely appropriate for ambulatory measurements, there is a need to explore and contrast alternate measurement locations. We evaluated bilateral electrodermal activity (EDA) from five measurement sites (fingers, feet, wrists, shoulders, and calves). In a counterbalanced, randomized, within-subjects design study, participants (N = 115) engaged in a 4-min-long breathing exercise and were exposed to emotionally laden and neutral stimuli. High within-subject correlations were found between the EDA measured from fingers bilaterally (r = .89), between the left fingers and both feet (r = .72). Moderate correlations were found between EDA measured from the left fingers and wrists (r = .30 and r = .33), low correlations between the left fingers and the shoulders (r = -.03 and r = -.06) or calves (r = .05 and r = .14). Response latency was the shortest on the fingers while it was the longest on the lower body. Short response windows would miss some of the responses from the palmar surfaces and a substantial number from other evaluated locations. The fingers and the feet are the most reliable locations to measure from, followed by the wrists. We suggest setting site-specific response windows for different measurement locations. An investigation of repeatability showed that within-subject correlations, response frequencies, response amplitudes show a similar pattern from the first measurement time to a later one.

Author Correction: A consensus-based transparency checklist.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

[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.

Cognitive deficits and psychopathological symptoms among children with medulloblastoma.

Children with medulloblastoma (MB) are predisposed for negative cognitive sequela, which has been widely identified in this population. The purpose of the present study was to explore cognitive deficits and psychopathological symptoms and analyse their relation among MB survivors. The Wechsler Intelligence Scale for Children and the Mini International Neuropsychiatric Interview (MINI-KID) was administered to 34 MB survivors to measure cognitive functioning and psychopathological symptoms. The MB survivors had lower global IQ (86.41 [79.70-93.13]) compared with the control population mean. We found impaired functioning in all IQ subscales in the MB survivors group, of which processing speed (84.15 [77.71-90.58]) was the most affected. Higher radiation dose and high-dose chemotherapy with stem cell rescue were significantly associated factors for lowered global IQ, while age at diagnosis, sex and time period from diagnosis were not significantly associated. Compulsive disorder, generalised anxiety, separation anxiety and posttraumatic stress disorder were significantly more prevalent in the MB survivor group than a group of 46 control participants. No correlation was found between the cognitive deficits and the psychopathological symptoms. Our results identify that MB survivors suffer from cognitive and psychopathological impairments, and these could exist independently from each other.

BILATERAL ELECTRODERMAL ACTIVITY IN THE ACTIVE-ALERT HYPNOTIC INDUCTION.

Shifts in hemispheric dominance were previously proposed to play a role in hypnosis. Participants (N = 32) were exposed to an active-alert hypnosis induction and a music-control condition while electrodermal activity was registered bilaterally, providing information on alterations in hemispheric dominance. The results suggest that highly hypnotizable participants show a shift to right-sided and low hypnotizable participants demonstrated a shift to left-sided electrodermal dominance in response to the induction, whereas no change in laterality is present in the control condition. Additionally, the authors found that self-reported hypnosis experiences were also associated with a shift in laterality. These results underline the importance of the shift to right hemispheric activity in hypnosis and underscore the importance of hemispheric changes in shaping subjective experience.