Periorbital Masson's tumor: a case series.

Intravascular papillary endothelial hyperplasia (IPEH) or Masson's tumor is an unusual variety of benign vascular tumor. Involvement of periorbital area is uncommon. We report 2 cases of periorbital IPEH and review relevant literature.

Prevention of tamoxifen induced endometrial polyps using a levonorgestrel releasing intrauterine system long-term follow-up of a randomised control trial.

OBJECTIVES: In a RCT, we have previously shown that the levonorgestrel intrauterine system (LNG-IUS, Mirena) produces a decidual response protecting the endometrium at one year follow-up. We here report on the long-term follow-up of this group of women, to test the hypothesis that a LNG-IUS could prevent the pro-proliferative uterine responses of tamoxifen for up to 4.5 years. METHODS: A randomised-controlled trial of postmenopausal women who had taken at least one year of adjuvant tamoxifen therapy. RESULTS: One hundred twenty-two women were recruited. Nine were found to be ineligible after randomisation. The average duration of follow-up was 26.25 months (IQR 14.5-36 months) in the surveillance group and 24.2 months (IQR 13.75-32.5 months) in the LNG-IUS group. Women with LNG-IUS in situ at the time of final assessment had decidualised endometrium, and no polyps. In the surveillance group new polyps arose in 8 cases. There were 3 new polyps in the group initially randomised to LNG-IUS, one in a patient who did not have the device inserted and 2 occurred in patients following the removal of the LNG-IUS. Univariate Cox proportional hazards regression models identified only endometrial thickness at trial entry as a statistically significant variable (HR 1.12, 95% CI 1.02 to 1.22, p=0.01) for the development of polyps. CONCLUSION: This study confirms that LNG-IUS induces benign endometrial changes and prevents endometrial polyps but only during its use in women taking tamoxifen. Endometrial thickness is a risk factor for the development of polyps.

Symposium part IV: investigative approaches to endocervical pathology.

There is continuing interest in the study of adenocarcinoma of the cervix and its precursors because of its increase in incidence, both absolute and relative, to squamous neoplasia and the complexity of benign glandular lesions with which endocervical neoplasia may be confused. Investigative techniques may be applied as aids to diagnosis, as prognostic markers, and to further our understanding of etiopathogenesis. This article focuses on recent developments in the four areas of epithelial glycoproteins, molecular markers, cell proliferation markers, and human papillomaviruses as applied to endocervical pathology. Although immunohistochemistry remains dominant, a wide range of other techniques is discussed.

Hypnotic theorizing: spring cleaning is long overdue.

Since the beginnings of animal magnetism and hypnosis, clinical and experimental theories have developed mostly in isolation. On the clinical side, armchair theorizing, based on clinicians' observations and interpretations of their clients' narratives, have laid the foundations of most theories, past and present. On the experimental side, attachment to specific theories has guided researchers in their choice of methodologies and designs. What seemed important was to show how correct one's preferred view was or how incorrect the "other" could be. This unfortunate one-sided perception led to an experimental stalemate where most experiments could be interpreted from any point of view. If the tendency to theorize on what one sees, hears, and believes must come to an end, the practice of performing truncated experiments dedicated to the glory of one's preferred theory must also be relegated to the past. And while we are at it, whether clinical or experimental, the use of concepts or constructs that cannot be clearly operationalized should be dismissed to avoid the type of serious social consequences the hypnotic community has been facing in the past decades.

A multivariate approach to the prediction of hypnotic susceptibility.

The present study examined the relation between various self-report measures and two measures of hypnotizability within a multivariate framework. A group of 748 participants was tested on the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), the Tellegen Absorption Scale (TAS), as well as the Preference for an Imagic Cognitive Style (PICS) questionnaire. One hundred ninety of these participants also completed the Paranormal Experiences Questionnaire (PEQ). Data were analyzed using hierarchical multiple regression equations, and the results of the analyses indicated that both the TAS and PICS accounted for significant amounts of unique variance in each of two 373-member samples of HGSHS:A scores. A further sub-sample of participants (n = 161) was tested on the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) to see if these results would generalize to another measure of hypnotizability. Hierarchical multiple regression analyses revealed that although the PEQ predicted significant amounts of unique SHSS:C variance over and above that predicted by the TAS, the PICS failed to do so. This inconsistency in results may be due in part to the generally low intercorrelation between the different hypnotizability scales and points to the need to develop new predictor variables that are orthogonal to each other.

Idiographic approaches to hypnosis research (or how therapeutic practice can inform science).

We argue that both nomothetic and idiographic research strategies can advance scientific knowledge of therapeutic hypnosis. In particular, practitioners can make idiographic contributions to the scientific literature in a manner that will be received positively by a growing number of behavioral scientists. Broad methodological issues and concerns specific to hypnosis research are discussed.

Hypnotic susceptibility and verbal automaticity: automatic and strategic processing differences in the Stroop color-naming task.

The original hypothesis of Dixon, Brunet, and Laurence (1990) that highly hypnotizable (HH) subjects process words more automatically than do low hypnotizable (LH) subjects was retested in a paradigm that separated strategic from automatic processes in the Stroop color-naming task. The words red and blue preceded a color patch that was red or blue. Subjects were told that the word predicted the opposite color 75% of the time. Automatic and strategic processes were assessed by varying the interstimulus interval (ISI) between the word and the color patch. Both HH and LH subjects showed significant strategic effects (faster incongruent-trial, color-naming reaction times than congruent-trial reaction times at ISIs over 400 ms), but only HH subjects showed significant automaticity (significantly faster congruent-trial reaction times than incongruent-trial reaction times at 16.7 ms, the lowest ISI).

Hypnotizability and automaticity: toward a parallel distributed processing model of hypnotic responding.

We tested a hypothesis from parallel distributed processing theory that highly hypnotizable subjects have greater connection strengths along verbal pathways and would show greater Stroop effects than low hypnotizable subjects. Using Cheesman & Merikle's (1986) paradigm, which varied cue visibility and probability, we assessed automatic and strategic effects on Stroop performance. Compared with 9 low and 9 moderately hypnotizable subjects, 9 highly hypnotizable ones showed significantly greater Stroop effects for both visible- and degraded-word trials. No strategic differences emerged for the 3 hypnotizability groups. These findings support the contention that highly hypnotizable persons have stronger verbal connection strengths than their moderately and low susceptible counterparts, and they may account for highly hypnotizable persons' propensity to disregard personal attributions and label their responses in hypnosis as being involuntary.

Hypnosis with a criminal defendant and a crime witness: two recent related cases.

2 legal cases involving hypnosis have recently been adjudicated by American courts. In Rock v. Arkansas (1987), the United States Supreme Court ruled that the hypnotically elicited testimony of a criminal defendant was admissible in court. This decision was grounded upon the constitutional right of a defendant both to testify, and to call witnesses, on his or her own behalf. Shortly afterwards, citing Rock as a precedent, a Texas Court of Appeals admitted the hypnotically elicited testimony of an eyewitness in Zani v. State (1988), on the grounds that it would be unfair to admit the hypnotically elicited testimony of defendants, and proscribe it for victims and witnesses. It is not clear what effect this doctrine of equity will have upon other North American court cases that involve hypnosis.

Potential jurors' opinions on the effects of hypnosis on eyewitness identification: a brief communication.

The present study examined a selected group of potential jurors' opinions on the effects of hypnosis on eyewitness identification and testimony. A group of 78 undergraduate psychology and optometry students completed a 2-part multiple choice questionnaire. The first part assessed Ss' knowledge of several issues concerning eyewitness testimony. The second part of the questionnaire contained 11 items which assessed Ss' beliefs and expectations concerning the effects of hypnosis on eyewitness identification and testimony. It was found that Ss' opinions on the effects of hypnosis on eyewitness testimony and identification were at odds with current empirical findings. These results, in accord with the previous literature, suggest that it is imperative that the courts be informed of the use of hypnosis during police work and that adequate precautions be taken to avoid a potential source of miscarriage of justice.

Hypnotizability, preference for an imagic cognitive style, and memory creation in hypnosis.

We sought to extend the finding (Laurence & Perry, 1983) that it is possible through hypnosis to create a pseudomemory of a specific event. Subjects were compared on their responses to a hypnotic suggestion. We also examined the relation between nonhypnotic measures (Preference for an Imagic Cognitive Style [PICS] test and the Tellegen Absorption Scale [TAS]) and response to the suggestion. Highly (45.45%) and moderately-highly (46.15%) susceptible subjects believed that the pseudomemory was veridical, but none of the low susceptible subjects did so. Together, hypnotic susceptibility, the PICS, and their interaction more strongly predicted pseudomemory creation than any of these main effects alone. Performance on the TAS was also related to the occurrence of pseudomemory, but this relation was redundant with performance on the other measures. These results point to the complexity of the variables involved in pseudomemory creation during hypnosis.

Multiple predictors of hypnotic susceptibility.

In this article, we report two experiments in which various measures thought to be related to hypnotizability were analyzed by stepwise discriminant analysis techniques. Absorption (Tellegen, 1981, 1982; Tellegen & Atkinson, 1974) and preference for an imagic style of thinking (Isaacs, 1982) were robust predictors of hypnotizability; each variable accounted for significant variance in hypnotizability at their respective steps in two samples and correctly classified a significant proportion of low- and high-hypnotizable subjects in the discriminant analyses. The addition of two other variables in Experiment 2--a Sleep-Dream score derived from Evans's (1977) Cognitive Control of Sleep Mentation subscale and Gibson's (1985) Dream Questionnaire, and the Belief in the Supernatural subscale of the Taft (1969) Experience Questionnaire--increased the correct classification of the medium-hypnotizable subjects from chance levels to 74%. It is argued that a confirmatory and hierarchical approach is needed in future studies to explore correlates of hypnotizability more fully.

Hypnotically created memory among highly hypnotizable subjects.

A pseudomemory of having been awakened by some loud noises during a night of the previous week was suggested to 27 highly hypnotizable subjects during hypnosis. Posthypnotically, 13 of them stated that the suggested event had actually occurred. This finding has implications for the investigative use of hypnosis in a legal context.

"Hidden observer" phenomena in hypnosis: an experimental creation?

Spanos and Hewitt (1980) have recently argued, on the basis of an experiment they report, that Hilgard's "hidden observer" phenomenon is pure laboratory artifact. This report reviews their claim and concludes on the following grounds that their experiment does not warrant so sweeping a conclusion: (a) Spanos and Hewitt have posed the issue as fact versus fiction and do not appear to be aware of a third alternative, namely, that the hidden observer effect is a phenomenon encountered in hypnosis that may be influenced both by demand characteristics and by the social-psychological context. (b) They appear to obtain the effect 100% of the time, unlike Hilgard, who has emphasized the phenomenon's differential incidence. (c) In contrast to Hilgard, who furnishes abundant verbal reports of his subjects' phenomenal experience as buttressing evidence for the "genuineness" of the effect in subjects who report having it, Spanos and Hewitt do not. (d) Two major procedural aspects of their experiment are discussed. Either or both may have inadvertently influenced the outcome of their experiment in the direction of their hypothesis that the responses of subjects are entirely the product of experimenter-induced expectations.