Clinical hypnosis can reduce lower urinary tract symptoms in individuals with chronic pain.

STUDY PURPOSE: Lower urinary tract symptoms (LUTS) can occur in chronic pain populations at high rates and drastically affect quality of life. Hypnosis is a nonpharmacological treatment used in chronic pain known to have beneficial implications to health outside of pain reduction. This study evaluated the potential for hypnosis to reduce LUTS in a sample of individuals with chronic pain, if baseline LUTS severity affected outcomes, and specific LUTS that may respond to hypnosis. METHODS: Sixty-four adults with chronic pain and LUTS at a level of detectable symptom change (American Urological Association Symptom Index, AUASI 3) participated in an 8-week group hypnosis protocol. Participants completed validated assessments of LUTS, pain, and overall functioning before, after, 3- and 6-months posttreatment. Linear mixed effects models assessed improvement in LUTS over time while accounting for known factors associated with outcome (e.g., age, gender). The interaction of baseline symptom severity and treatment assessed the potential effect of baseline symptoms on change scores. RESULTS: Participants experienced significant and meaningful improvements in LUTS following group hypnosis (p = 0.006). There was a significant interaction between baseline symptom severity and treatment (p < 0.001), such that those with severe symptoms experienced the most pronounced gains over time (e.g., an 8.8 point reduction). Gains increased over time for those with moderate and severe symptoms. Changes in LUT symptoms occurred independently of pain relief. CONCLUSIONS: This pilot study suggests hypnosis has the potential to drastically improve LUTS in individuals with chronic pain, even when pain reduction does not occur. Results provide initial evidence for the treatment potential of hypnosis in urologic pain (and possibly non-pain/benign) populations, with randomized trials needed for definitive outcomes.

Self-compassion in mindfulness-based stress reduction: An examination of prediction and mediation of intervention effects.

The current investigation sought to clarify mechanisms of treatment effects in mindfulness-based stress reduction (MBSR). Self-compassion and mindful awareness were assessed first as dispositional influences and then as mediators of outcome in unique models. One hundred thirty individuals participating in the 8-week MBSR intervention were recruited (73.08% female, mean age = 46.97, SD = 14.07). Measures of psychosocial well-being (Brief Stress Inventory [BSI], Perceived Stress Scale-10 [PSS]), mindful awareness (Mindful Awareness and Attention Scale [MAAS]), and self-compassion (Self-Compassion Scale [SCS]) were collected at preintervention and postintervention. Regression was conducted to examine the influence of baseline MAAS and SCS on change in PSS and BSI scores. Serial multiple mediator models were conducted separately with pre/postintervention BSI and PSS values as criterion, and preintervention/postintervention MAAS and SCS values as mediators. Higher levels of baseline self-compassion were predictive of greater reductions in PSS scores (ß = 0.16). Reductions in BSI scores were serially mediated by change in self-compassion both directly (MBSR → ΔSCS → ΔBSI ß = 0.06) and indirectly through mindful awareness (MBSR → ΔMAAS → ΔSCS → ΔBSI ß = 0.09). Results provide support for the role of self-compassion as both a predictor of treatment effect and a process through which MBSR operates. Mechanisms underlying MBSR effects appear to be unique to the outcome of interest.