Clinical hypnosis with children: first steps toward empirical support.

A review of controlled studies on the efficacy of clinical hypnosis with children reveals promising findings, particularly for reduction of acute pain, chemotherapy-related distress, and enuresis. However, no child hypnosis interventions currently qualify as "efficacious" according to criteria for empirically supported therapies (EST). A major limitation of the existing literature relative to EST guidelines is the lack of treatment specification via a manual or its equivalent.

Suggestion difficulty as a hypothesized moderator of the relation between absorption and suggestibility: a new spectral analysis.

Measures of hypnotic suggestibility and absorption were administered to 146 participants in the guise of different experiments. A spectral analysis was performed by correlating the difficulty of individual hypnotic suggestions with the magnitude of the association between suggestions and absorption. Contrary to the two-component model, absorption was not more highly correlated with passing difficult suggestions than easier suggestions. This was confirmed by a meta-analysis of this and other spectral analysis studies. In addition, cross-study correlations revealed that the magnitude of the association between absorption and individual suggestions is highly variable, rendering the two-component model very difficult to test. These findings indicate that discrepant results in previous spectral analyses may have been due to low reliability of associations with individual scale items, as well as the relatively small number of correlations that constitute the raw data of these analyses.

An analysis of factors that contribute to the magnitude of placebo analgesia in an experimental paradigm.

Placebo analgesia was produced by conditioning trials wherein heat induced experimental pain was surreptitiously reduced in order to test psychological factors of expectancy and desire for pain reduction as possible mediators of placebo analgesia. The magnitudes of placebo effects were assessed after these conditioning trials and during trials wherein stimulus intensities were reestablished to original baseline levels. In addition, analyses were made of the influence of these psychological factors on concurrently assessed pain and remembered pain intensities. Statistically reliable placebo effects on sensory and affective measures of pain were graded according to the extent of surreptitious lowering of stimulus strength during the manipulation trials, consistent with conditioning. However, all of these effects were strongly associated with expectancy but not desire for relief. These results show that although conditioning may be sufficient for placebo analgesia, it is likely to be mediated by expectancy. The results further demonstrated that placebo effects based on remembered pain were 3 to 4 times greater than those based on concurrently assessed placebo effects, primarily because baseline pain was remembered as being much more intense than it actually was. However, similar to concurrent placebo effects, remembered placebo effects were strongly associated with expected pain levels that occurred just after conditioning. Taken together, these results suggest that magnitudes of placebo effect are dependent on multiple factors, including conditioning, expectancy, and whether analgesia is assessed concurrently or retrospectively.

Brief modification of suggestibility and hypnotic analgesia: too good to be true?

A 10-minute training procedure, based on the Carleton Skill Training Program, has previously been reported to produce substantial increments in responsiveness to hypnotic suggestion. The authors attempted to replicate this effect and also assessed the impact of the training procedure on hypnotically suggested analgesia. Ninety-eight students who had been preselected for high, medium, and low levels of initial suggestibility were randomly assigned to experimental and control groups. Training failed to increase overall suggestibility scores or to enhance the effects of a suggestion for pain reduction. Suggested pain reduction was more highly correlated with posttreatment suggestibility scores than with pretreatment suggestibility and, in a regression analysis, only posttreatment suggestibility predicted pain reduction uniquely.

Experiential scoring for the Waterloo-Stanford Group C scale.

A scale is presented that assesses subjective experiences associated with the test suggestions contained in the Waterloo-Stanford Group C scale (WSGC), a group adaptation of the Stanford Hypnotic Susceptibility Scale: Form (SHSS:C). This scale, along with the standard behavioral scoring system of the WSGC, was given to 926 students at the University of Connecticut. Normative data from this sample indicate that the experiential scoring scale is both reliable and valid as a measure of suggestibility. It is suggested that it may be useful to supplement behavioral scoring with experiential scoring when the WSGC is used.