Clinical Hypnosis for Procedural Pain and Distress in Children: A Scoping Review.

OBJECTIVE: Pain and distress are common in children undergoing medical procedures, exposing them to acute and chronic biopsychosocial impairments if inadequately treated. Clinical hypnosis has emerged as a potentially beneficial treatment for children's procedural pain and distress due to evidence of effectiveness and potential superiority to other psychological interventions. However, systematic reviews of clinical hypnosis for children's procedural pain and distress have been predominantly conducted in children undergoing oncology and needle procedures and are lacking in broader pediatric contexts. This scoping review maps the evidence of clinical hypnosis for children's procedural pain and distress across broad pediatric contexts while highlighting knowledge gaps and areas requiring further investigation. METHODS: Published databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus, and Web of Science) and grey literature were searched in addition to hand-searching reference lists and key journals (up to May 2022). Two independent reviewers screened the titles and abstracts of search results followed by a full-text review against eligibility criteria. Articles were included if they involved a clinical hypnosis intervention comprising an induction followed by therapeutic suggestions for pain and distress in children undergoing medical procedures. This review followed the Arksey and O'Malley (2005) methodology and incorporated additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS: A total of 38 eligible studies involving 2,205 children were included after 4,775 articles were screened. Research on clinical hypnosis for children's procedural pain and distress was marked by a lack of fidelity measures and qualitative data as well as by inadequate intervention reporting and high attrition rates. Evidence regarding the safety of clinical hypnosis, pain unpleasantness outcomes, factors influencing outcomes, as well as barriers and facilitators to implementing hypnosis and study procedures was also lacking. Clinical hypnosis has potential benefits for children's procedural pain and distress based on evidence of superiority to control conditions and nonpharmacological interventions (e.g., distraction, acupressure) with moderate to large effect sizes as reported in 76% of studies. However, heterogeneous interventions, contexts, study designs, and populations were identified, and the certainty of the evidence was not evaluated. CONCLUSIONS: The review suggests potential benefits of clinical hypnosis for children's procedural pain and distress and thus provides a precursor for further systematic reviews and trials investigating the effectiveness of clinical hypnosis. The review also indicates the need to further explore the feasibility, acceptability, implementation, and safety of clinical hypnosis in children undergoing painful procedures. Based on the review, researchers implementing clinical hypnosis should adequately report interventions or use treatment manuals, follow recommended research guidelines, and assess the fidelity of intervention delivery to promote replicating and comparing interventions. The review also highlights common methodological shortcomings of published trials to avoid, such as the lack of implementation frameworks, small sample sizes, inadequate reporting of standard care or control conditions, and limited evidence on pain unpleasantness outcomes.

Exploring the Physiological and Psychological Effects of Group Chanting in Australia: Reduced Stress, Cortisol and Enhanced Social Connection.

Chanting, an ancient ritual practiced in diverse cultures and traditions worldwide, has typically been employed for meditation, healing, self-awareness, and psychological growth. However, there is little understanding of the physiological and psychological benefits of chanting, and how vocalization might contribute to such effects. This study aimed to determine whether 12-minutes of group chanting, through vocal or silent repetition of the sound "om," would reduce stress and anxiety, while increasing feelings of social connection, and whether vocal chanting would yield stronger effects. Thirty-four participants were randomly assigned to vocal or silent group chanting conditions. Saliva samples were collected before and after chanting to assess cortisol levels, while self-report measures included the State Trait Anxiety Inventory and the Adapted Self-Report Altruism Scale (including additional items on cross-cultural altruism). Following chanting, participants also provided a written description of their experiences. Both vocal and silent chanting resulted in significant decreases in cortisol levels and self-reported anxiety. The reduction in cortisol was similar for vocal and silent chanting, but self-reported anxiety decreased more following vocal chanting. Altruism scores increased following both vocal and silent chanting. However, there was no evidence of altruistic tendencies extending toward people from a culture other than one's own. Results are discussed in relation to the phenomenology of chanting, and to current theory and evidence on the physiological and psychological effects of chanting and singing.

Hypnotherapy for Procedural Pain and Distress in Children: A Scoping Review Protocol.

OBJECTIVE: Inadequately treated pain and distress elicited by medical procedures can put children at higher risk of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychologically tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for pediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. METHODS: This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. CONCLUSION: Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.

Teleology and the intentions of supernatural agents.

Teleological beliefs about the natural world often exist implicitly, and there is a positive relationship between teleological endorsement and belief in supernatural agents. In the current study, participants judged a series of scientifically unwarranted teleological explanations of biological organisms and natural non-living objects, under speeded or un-speeded instructions. After controlling for belief in the existence of supernatural agents, rates of implicit (speeded) and explicit (un-speeded) teleological endorsement were moderated by the belief that supernatural agents intentionally interact with the world. Amongst non-religious individuals, rates of implicit endorsement were significantly higher than explicit endorsement, whereas for highly religious individuals the difference was non-significant. This interaction was driven predominantly by explanations of natural non-living objects. These results are consistent with an intention-based theory of teleology, and help to reconcile the finding of a positive relationship between teleological endorsement and belief in supernatural agents, with the those of an enduring teleological bias.

Changes in the sense of agency during hypnosis: The Hungarian version of the Sense of Agency Rating Scale (SOARS-HU) and its relationship with phenomenological aspects of consciousness.

Changes in the sense of agency are defining feature of hypnosis. The Sense of Agency Rating Scale (SOARS) is a 10-item questionnaire, administered after a hypnosis session to assess alteration in the sense of agency. In the present study, a Hungarian version of the measure (SOARS-HU) is presented. The SOARS-HU and the Phenomenology of Consciousness Inventory (PCI) were administered to 197 subjects following hypnotizability screening with the Harvard Group Scale of Hypnotic Susceptibility Scale, Form A (HGSHS:A). Confirmatory factor analysis and correlations with hypnotizability demonstrate the reliability and validity of the SOARS-HU. Changes in the Involuntariness and Effortlessness subscales of the SOARS-HU were associated with alterations in subjective conscious experience, as measured by the PCI. These changes in subjective experience remained significant after controlling for HGSHS:A scores. These results indicate that changes in the sense of agency during hypnosis are associated with alterations of consciousness that are independent of hypnotizability.

A quasi-randomized feasibility pilot study of specific treatments to improve emotion recognition and mental-state reasoning impairments in schizophrenia.

BACKGROUND: Impaired ability to make inferences about what another person might think or feel (i.e., social cognition impairment) is recognised as a core feature of schizophrenia and a key determinant of the poor social functioning that characterizes this illness. The development of treatments to target social cognitive impairments as a causal factor of impaired functioning in schizophrenia is of high priority. In this study, we investigated the acceptability, feasibility, and limited efficacy of 2 programs targeted at specific domains of social cognition in schizophrenia: "SoCog" Mental-State Reasoning Training (SoCog-MSRT) and "SoCog" Emotion Recognition Training (SoCog-ERT). METHOD: Thirty-one participants with schizophrenia or schizoaffective disorder were allocated to either SoCog-MSRT (n = 19) or SoCog-ERT (n = 12). Treatment comprised 12 twice-weekly sessions for 6 weeks. Participants underwent assessments of social cognition, neurocognition and symptoms at baseline, post-training and 3-months after completing training. RESULTS: Attendance at training sessions was high with an average of 89.29 % attendance in the SoCog-MSRT groups and 85.42 % in the SoCog-ERT groups. Participants also reported the 2 programs as enjoyable and beneficial. Both SoCog-MSRT and SoCog-ERT groups showed increased scores on a false belief reasoning task and the Reading the Mind in the Eyes test. The SoCog-MSRT group also showed reduced personalising attributional biases in a small number of participants, while the SoCog-ERT group showed improved emotion recognition. CONCLUSIONS: The results are promising and support the feasibility and acceptability of the 2 SoCog programs as well as limited efficacy to improve social cognitive abilities in schizophrenia. There is also some evidence that skills for the recognition of basic facial expressions need specific training. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613000978763 . Retrospectively registered 3/09/2013.

Is microdosing a placebo? A rapid review of low-dose LSD and psilocybin research.

Some recent research and commentary have suggested that most or all the effects reported by people who microdose psychedelics may be explained by expectations or placebo effects. In this rapid review, we aimed to evaluate the strength of evidence for a placebo explanation of the reported effects of microdosing. We conducted a PubMed search for all studies investigating psychedelic microdosing with controlled doses and a placebo comparator. We identified 19 placebo-controlled microdosing studies and summarised all positive and null findings across this literature. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomised trials. The reviewed papers indicated that microdosing with LSD and psilocybin leads to changes in neurobiology, physiology, subjective experience, affect, and cognition relative to placebo. We evaluate methodological gaps and challenges in microdosing research and suggest eight reasons why current claims that microdosing is predominately a placebo are premature and possibly wrong: (1) there have been only a small number of controlled studies; (2) studies have had small sample sizes; (3) there is evidence of dose-dependent effects; (4) studies have only investigated the effects of a small number of doses; (5) the doses investigated may have been too small; (6) studies have looked only at non-clinical populations; (7) studies so far have been susceptible to selection bias; and (8) the measured impact of expectancy is small. Considering the available evidence, we conclude that it is not yet possible to determine whether microdosing is a placebo.

The Consequences of Anthropomorphic and Teleological Beliefs in a Global Pandemic.

To describe something in terms of its purpose or function is to describe its teleology. Previous studies have found that teleological beliefs are positively related to anthropomorphism, and that anthropomorphism decreases the perceived unpredictability of non-human agents. In the current study, we explore these relationships using the highly salient example of beliefs about the coronavirus pandemic. Results showed that both anthropomorphism and teleology were negatively associated with perceived uncertainty and threat, and positively associated with self-reported behavioural change in response to the pandemic. These findings suggest that highly anthropomorphic and teleological individuals may view coronavirus as agentive and goal-directed. While anthropomorphic and teleological beliefs may facilitate behavioural change in response to the pandemic, we also found that the associated reduction in uncertainty and threat may be detrimental to behavioural change. We discuss the implications of these findings for messaging about global events more broadly.

Developing the Sense of Agency Rating Scale (SOARS): an empirical measure of agency disruption in hypnosis.

Two experiments report on the construction of the Sense of Agency Rating Scale (SOARS), a new measure for quantifying alterations to agency. In Experiment 1, 370 participants completed a preliminary version of the scale following hypnosis. Factor analysis revealed two underlying factors: Involuntariness and Effortlessness. In Experiment 2, this two factor structure was confirmed in a sample of 113 low, medium and high hypnotisable participants. The two factors, Involuntariness and Effortlessness, correlated significantly with hypnotisability and pass rates for ideomotor, challenge and cognitive items. Twelve week test-retest correlations showed that Involuntariness was highly stable, but Effortlessness only moderately stable. Analysis of the combined datasets from Experiments 1 and 2 showed both SOARS scores were significantly related to the derived factors of Woody, Barnier, and McConkey's (2005) 4-factor model of hypnotisability. This scale clarifies conceptual confusion around agentive action and provides empirical support for a multifactorial account of sense of agency.

A laboratory analogue of mirrored-self misidentification delusion: the role of hypnosis, suggestion, and demand characteristics.

Mirrored-self misidentification is the delusional belief that one's own reflection in the mirror is a stranger. In two experiments, we tested the ability of hypnotic suggestion to model this condition. In Experiment 1, we compared two suggestions based on either the delusion's surface features (seeing a stranger in the mirror) or underlying processes (impaired face processing). Fifty-two high hypnotisable participants received one of these suggestions either with hypnosis or without in a wake control. In Experiment 2, we examined the extent to which social cues and role-playing could account for participants' behaviour by comparing the responses of 14 hypnotised participants to the suggestion for impaired face processing (reals) with those of 14 nonhypnotised participants instructed to fake their responses (simulators). Overall, results from both experiments confirm that we can use hypnotic suggestion to produce a compelling analogue of mirrored-self misidentification that cannot simply be attributed to social cues or role-playing.

An open clinical trial assessing a novel training program for social cognitive impairment in schizophrenia.

OBJECTIVE: Social cognition is profoundly impaired in patients with schizophrenia. This study describes 'Mental-State Reasoning Training for Social Cognitive Impairment' (SoCog-MSRT), a 5-week program developed to improve social cognition in patients with schizophrenia. We aimed to investigate the feasibility of implementing SoCog-MSRT in a rehabilitation setting and to evaluate whether our training methods produced improvements. METHOD The feasibility and benefits of SoCog-MSRT were evaluated in an open clinical trial with 14 participants with schizophrenia or schizoaffective disorder. Training comprised 10 twice-weekly sessions, for 5 weeks, with a pre- and post-training assessment. RESULTS: There were significant improvements on: (a) a classic false-belief test of Theory of Mind (ToM); (b) inferring complex mental states from the eyes; and (c) a self-reported measure of social understanding. Some of these improvements were associated with baseline levels of working memory and premorbid Intelligence Quotient (IQ). CONCLUSIONS SoCog-MSRT can improve ToM abilities and social understanding, but individuals with poorer working memory and lower premorbid IQ may be less able to benefit from this type of training.

A Comprehensive Review of the Current Status of the Cellular Neurobiology of Psychedelics.

Psychedelic substances have gained significant attention in recent years for their potential therapeutic effects on various psychiatric disorders. This review delves into the intricate cellular neurobiology of psychedelics, emphasizing their potential therapeutic applications in addressing the global burden of mental illness. It focuses on contemporary research into the pharmacological and molecular mechanisms underlying these substances, particularly the role of 5-HT2A receptor signaling and the promotion of plasticity through the TrkB-BDNF pathway. The review also discusses how psychedelics affect various receptors and pathways and explores their potential as anti-inflammatory agents. Overall, this research represents a significant development in biomedical sciences with the potential to transform mental health treatments.

The "Reading the Mind in the Eyes" Test Shows Poor Psychometric Properties in a Large, Demographically Representative U.S. Sample.

The Reading the Mind in the Eyes test (RMET) is a widely used measure of theory of mind (ToM). Despite its popularity, there are questions regarding the RMET's psychometric properties. In the current study, we examined the RMET in a representative U.S. sample of 1,181 adults. Key analyses included conducting an exploratory factor analysis on the full sample and examining whether there is a different factor structure in individuals with high versus low scores on the 28-item autism spectrum quotient (AQ-28). We identified overlapping, but distinct, three-factor models for the full sample and the two subgroups. In all cases, each of the three models showed inadequate model fit. We also found other limitations of the RMET, including that nearly a quarter of the RMET items did not meet the criteria for inclusion in the RMET that were established in the original validation study. Due to the RMET's weak psychometric properties and the uncertain validity of individual items, as indicated by our study and previous studies, we conclude that significant caution is warranted when using the RMET as a measure of ToM.

The emerging science of microdosing: A systematic review of research on low dose psychedelics (1955-2021) and recommendations for the field.

The use of low doses of psychedelic substances (microdosing) is attracting increasing interest. This systematic review summarises all empirical microdosing research to date, including a set of infrequently cited studies that took place prior to prohibition. Specifically, we reviewed 44 studies published between 1955 and 2021, and summarised reported effects across six categories: mood and mental health; wellbeing and attitude; cognition and creativity; personality; changes in conscious state; and neurobiology and physiology. Studies showed a wide range in risk of bias, depending on design, age, and other study characteristics. Laboratory studies found changes in pain perception, time perception, conscious state, and neurophysiology. Self-report studies found changes in cognitive processing and mental health. We review data related to expectation and placebo effects, but argue that claims that microdosing effects are largely due to expectancy are premature and possibly wrong. In addition, we attempt to clarify definitional inconsistencies in the microdosing literature by providing suggested dose ranges across different substances. Finally, we provide specific design suggestions to facilitate more rigorous future research.

Meditation in the Workplace: Does Mindfulness Reduce Bias and Increase Organisational Citizenship Behaviours?

Mindfulness is becoming increasingly popular in the workplace. This likely relates to a growing body of research linking mindfulness to a range of psychological outcomes such as reduced anxiety, depression and increased subjective wellbeing. However, while mindfulness has received a great deal of attention in clinical research, the evidence for workplace relevant benefits is less established. Additionally, outside of clinical research, mindfulness studies have rarely been replicated. Recent evidence suggests that the cognitive skills cultivated during meditation may be instrumental in reducing biased thinking and increasing prosocial behaviour, but these findings have not been previously tested in a workplace setting. Specifically, mindfulness has been linked to reductions in implicit age bias, sunk-cost decision-making bias and increases in organisational citizenship behaviours (OCB). In two experiments using a workplace and laboratory sample, the present investigation aimed to test the reliability and generalisability of previous findings that a brief mindfulness meditation can reduce age and sunk-cost decision-making biases. To more directly test the potential positive benefits of mindfulness in a workplace setting, this study also investigated the impact of a mindfulness intervention on intention to perform OCB. While meditation significantly increased OCB intent, predictions relating to bias were not supported. Considerations for the degree to which empirical evidence aligns with claims in popular culture, along with implications for the practical uses of mindfulness in the workplace are explored.

How Chanting Relates to Cognitive Function, Altered States and Quality of Life.

Chanting is practiced in many religious and secular traditions and involves rhythmic vocalization or mental repetition of a sound or phrase. This study examined how chanting relates to cognitive function, altered states, and quality of life across a wide range of traditions. A global survey was used to assess experiences during chanting including flow states, mystical experiences, mindfulness, and mind wandering. Further, attributes of chanting were assessed to determine their association with altered states and cognitive benefits, and whether psychological correlates of chanting are associated with quality of life. Responses were analyzed from 456 English speaking participants who regularly chant across 32 countries and various chanting traditions. Results revealed that different aspects of chanting were associated with distinctive experiential outcomes. Stronger intentionality (devotion, intention, sound) and higher chanting engagement (experience, practice duration, regularity) were associated with altered states and cognitive benefits. Participants whose main practice was call and response chanting reported higher scores of mystical experiences. Participants whose main practice was repetitive prayer reported lower mind wandering. Lastly, intentionality and engagement were associated with quality of life indirectly through altered states and cognitive benefits. This research sheds new light on the phenomenology and psychological consequences of chanting across a range of practices and traditions.

Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: a feasibility and acceptability study protocol.

BACKGROUND: Burns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively affect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are beneficial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of benefit for itch and superior effectiveness in comparison to other non-pharmacological interventions for children's procedural pain and state anxiety. Thus, children with burns can benefit from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of effectiveness are limited and no studies have been identified that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns. METHODS: An observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children's hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fidelity in delivery), reach, potential effectiveness, and adoption of evaluation procedures and intervention as secondary outcomes. DISCUSSION: Ethical approval was obtained from the Queensland Children's Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings. The findings will guide the design of future trials on the effectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000988954.

Rhythmic Chanting and Mystical States across Traditions.

Chanting is a form of rhythmic, repetitive vocalization practiced in a wide range of cultures. It is used in spiritual practice to strengthen community, heal illness, and overcome psychological and emotional difficulties. In many traditions, chanting is used to induce mystical states, an altered state of consciousness characterised by a profound sense of peace. Despite the global prevalence of chanting, its psychological effects are poorly understood. This investigation examined the psychological and contextual factors associated with mystical states during chanting. Data were analyzed from 464 participants across 33 countries who regularly engaged in chanting. Results showed that 60% of participants experienced mystical states during chanting. Absorption, altruism, and religiosity were higher among people who reported mystical states while chanting compared to those who did not report mystical states. There was no difference in mystical experience scores between vocal, silent, group or individual chanting and no difference in the prevalence of mystical states across chanting traditions. However, an analysis of subscales suggested that mystical experiences were especially characterised by positive mood and feelings of ineffability. The research sheds new light on factors that impact upon chanting experiences. A framework for understanding mystical states during chanting is proposed.

The design stance, intentional stance, and teleological beliefs about biological and nonbiological natural entities.

Teleology involves an appeal to function to explain why things are the way they are. Among scientists and philosophers, teleological explanations are widely accepted for human-made artifacts and biological traits, yet controversial for biological and nonbiological natural entities. Prior research shows a positive relationship between religiosity and acceptance of such controversial teleological explanations. Across three large online studies, we show that the relationship between religiosity and teleological acceptance cannot be explained by acceptance of objectively false explanations. Furthermore, we show that anthropomorphism and a belief in supernatural agents each independently predict teleological acceptance. In contrast, the tendency to inhibit intuitively appealing, yet incorrect responses to simple reasoning problems was associated with lower teleological acceptance. These results provide strong support for an intention-based account of teleology, and further contribute to the existing literature which situates teleological reasoning within a dual-process framework. Several avenues of future research are discussed, including the need to dissociate implicit and explicit measures of teleological belief, and the need for a greater focus on cross-cultural variation in teleological beliefs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).