The status of hypnosis as an empirically validated clinical intervention: a preamble to the special issue.

In his introductory remarks to this Journal's special issue on the status of hypnosis as an empirically supported clinical intervention, the editor briefly describes the dawn of clinical hypnosis research, the logic of the natural science model, the importance of an inspired but tough-minded clinical science, and the auspicious confluence of practice and research purpose in this enterprise. The progenitor of this effort was indeed the Report of the Royal Commission coauthored by Benjamin Franklin and Antoine Lavoisier, among others, more than 215 years ago--a report noted as one of the most important documents in the history of human reason. The ethos and logic of this special issue is grounded on the legacy of that document. Eschewing the conflicting mental health agendas of managed-care, government, patient rights, and professional guild interests, this special issue seeks to present a frank, evenhanded, informed, and dispassionate assessment of what science knows and does not know about clinical hypnosis.

Psychopathology associated with sexual abuse: the importance of complementary designs and common ground.

In their recent longitudinal study of youth victimization and consequent traumatization, S. Boney-McCoy and D. Finkelhor (1996) contrast their position with previous retrospective research (S. Harter, P. Alexander, & R. A. Neimeyer, 1988; M. R. Nash, T. C. Hulsey, M. C. Sexton, T. L. Harralson, & W. Lambert, 1993a), arguing that their data support the impact of victimization per se, independent of the moderating effect of family environment. Because Boney-McCoy and Finkelhor's argument may misrepresent the results of such studies, this article (a) clarifies the actual findings of previous retrospective studies of abuse, (b) suggests methodological limitations both in Boney-McCoy and Finkelhor's research and in that of S. Harter et al., 1998, and M. R. Nash et al., 1993a, that should be remedied by future investigators, and (c) argues that both retrospective clinical research and prospective community surveys converge on a common ground, namely, that specific abuse experiences can best be understood and investigated in the context of the prior, contemporaneous, and subsequent family environments in which they occur.

Why scientific hypnosis needs psychoanalysis (or something like it).

The author contends that some contemporary hypnosis theories are restricted and narrow in scope, rendering them unnecessarily isolated from mainstream models of human development, psychopathology, and personality functioning. They seem to explain hypnosis and little else. The author contrasts this with psychoanalysis, which, although sometimes overly expansive, does nonetheless lend itself to the generation of specific hypothesis via careful deduction from a general theory of human behavior and experience. For illustrative purposes, the author criticizes the sociocognitive perspective of hypnosis contending that at present it is too narrowly inductive in focus, overvalues social influence, and has its own problems with reification. The author suggests remedies for these difficulties.

Ability of the Cognitive Behavioral Driver's Inventory to distinguish malingerers from brain-damaged subjects.

The Cognitive Behavioral Driver's Inventory (CBDI) was analyzed for its ability to discriminate brain-damaged patients from intact subjects who feigned brain-damage. In a sample of 251 neurologically impaired patients and 48 malingering volunteers, the computer-administered distinguished most malingerers from genuine patients. A jackknifed count revealed that the CBDI had 90% sensitivity for detecting malingerers, and 98% specificity for detecting non-malingering brain damaged patients. Success was due to the inability of malingerers to avoid quantitative errors: excessive response latencies, unusual error rates, inflated variability in response latencies, and excessive within-subject, between-item variability. The computer-administered battery may be an effective clinical tool for identifying patients who malinger brain-damage in neuropsychological testing.

Hypnotic responsivity of the deaf: the development of the University of Tennessee Hypnotic Susceptibility Scale for the Deaf.

The purpose of these two studies was to develop and test a measure that assesses the hypnotic responsivity of deaf individuals. The University of Tennessee Hypnotic Susceptibility Scale for the Deaf (UTHSS:D) is a signed, videotaped version of a standard hypnotic induction with 12 standard suggestions. Experiment 1 compared the behavioral and subjective hypnotic responsivity of deaf and hearing individuals using the UTHSS:D and the Field Depth Inventory (FDI), respectively. As compared to hearing subjects, deaf participants were found to be less responsive to hypnosis when assessed behaviorally (UTHSS:D) and equally responsive to hypnosis when assessed subjectively (FDI). Experiment 2 undertook a more comprehensive examination of the hypnotic responsivity of deaf individuals, using hearing individuals as controls. Three dimensions of hypnosis responsivity were assessed: behavioral (UTHSS:D), subjective (FDI), and interpersonal (Archaic Involvement Measure). Additionally, correlates of hypnotic responsivity (absorption, attitudes, expectations) were examined for the two groups. In Experiment 2, no significant differences were found between the deaf and hearing participant groups on any measures of hypnotic responsivity or on any measure of the correlates of hypnotic responsivity.

Memory distortion and sexual trauma: the problem of false negatives and false positives.

Logically, two broad types of mnemonic errors are possible when adult psychotherapy or hypnosis patients reflect on whether they were sexually abused or not as a child. They may believe that they were not abused when in fact they were (false negative error), or they may believe they were abused when in fact they were not (false positive error). The author briefly reviews the empirical evidence for the occurrence of each of these types of errors, and illustrates each with a clinical case. Further, in considering the incidence, importance, and clinical implications of these errors, the author contends that clinical efficacy in no way assures that a false negative or a false positive has been avoided. A plea is made for theorists and researchers to acknowledge that both categories of errors can occur and to conduct future clinical and laboratory research accordingly.

Truth in memory: ramifications for psychotherapy and hypnotherapy.

In this article we address a number of issues relevant to the practice of psychotherapy and hypnotherapy: How reliable is memory? How are therapists' and clients' beliefs and expectancies related to pseudomemory formation? Are certain clients particularly vulnerable to pseudomemory creation? Does hypnosis pose special hazards for pseudomemory reports? What are the variables or factors that mediate hypnotic pseudomemories? In addition to reviewing the literature on these topics, we intend to sensitize the clinician to the potential pitfalls of critical reliance on the patient's memories, as well as uncritically accepted clinical beliefs and practices.

Characteristics of sexual abuse associated with greater psychological impairment among children.

The psychiatric histories and projective test responses of 102 sexually abused girls (ages 5 to 16) were examined to determine if some particular characteristics of sexual abuse were reliably associated with more serious impairment. Characteristics of abuse significantly associated with greater psychological disturbance were: more than one perpetrator, an early age of abuse onset (before age 7 or 8), and periods of intense and frequent abuse episodes (more than 3 or 4 times per month). What enhanced the child's capacity to recover was the presence of a relatively stable two-parent household. Implications for prognosis and treatment are discussed.

Long-term sequelae of childhood sexual abuse: perceived family environment, psychopathology, and dissociation.

In this study, 105 abused and nonabused women were examined for patterns of adult psychopathology associated with childhood sexual abuse and to test the extent to which these patterns are independent of other pathogenic properties of the family environment. Clinical and nonclinical Ss completed the Family Environment Scale, the Minnesota Multiphasic Personality Inventory (MMPI), the Rorschach, and the Stanford Hypnotic Susceptibility Scale. Greater nonspecific impairment among abused women may be a consequence, at least in part, of pathogenic family structure rather than sexual abuse per se. However, MMPI and Rorschach responses suggest sexual abuse may render victims especially vulnerable to specific disturbances i involving soma and self. Abuse was associated with greater use of dissociation, but covariance analysis revealed this effect to be accounted for by family pathology. There was no evidence that sexual trauma is associated with hypnotizability.

A Rorschach study of narcissism, defense, and aggression in borderline, narcissistic, and cluster C personality disorders.

We examined the differences between narcissism, mode of defense, and level of aggression on the Rorschach. We also investigated differences in borderline, narcissistic, and Cluster C personality disorders by examining responses to Rorschach content variables. The Lerner Defense Scale (P. Lerner & H. Lerner, 1980), the aggressive content section of the Holt (1977) method for assessing primary process manifestations, a modified version of Exner's (1986a) Egocentricity Index, Wagner's (1965) exhibitionistic M score, and grandiosity were scored on the Rorschach protocols of 17 borderline, 17 narcissistic, and 17 Cluster C personality disorders. Borderlines were found to employ primitive defensive structures to a greater degree and severity, show more intense and overall aggression as well as more responses on the three forms of aggression in the Holt method, and have higher levels of grandiosity. Narcissists evinced significantly higher levels of egocentricity than borderlines and higher levels of idealization than the Cluster C group. Convergent validity was found on the measures of defense and aggression, which showed a strong relationship between primitive aggression and primitive defense.

Perceptions of family functioning and the occurrence of childhood sexual abuse.

The wide variety of sequelae attributed to childhood sexual abuse has led some authors to posit that it is the complex interaction between the object-relational developmental world of the child and the event and nature of the abuse that determines the enduring effects of the abusive experience. The authors addressed this hypothesis by examining the correlation between the occurrence of childhood sexual abuse and subjects' perceptions of the nature of their childhood family. Results revealed significant differences in the subjects' recollections of family functioning based on abuse status. Abused subjects recalled families that were isolative, rigidly ruled in an authoritarian style, and unable to foster the development of autonomy in family members. The authors discuss the study results in light of the interactions between memories of the childhood family and the experience of sexual abuse.

EEG correlates of hypnotic susceptibility based upon fast Fourier power spectral analysis.

The purpose of the present study was to determine if there were differences between high and low hypnotic susceptible subjects based upon fast Fourier power spectral analysis of the EEG recorded both before and during hypnotic tasks from frontal-temporal and occipital-parietal locations. Significant differences were obtained based upon EEG recording electrode location, EEG frequency within six different frequency domains, and hypnotic tasks. However, no main effect differences were obtained based upon hypnotic susceptibility. In contrast to some evoked potential studies in which a few differences have been obtained based on hypnotic susceptibility the lack of any EEG differences in this study even when positive and negative hallucination tasks were employed may have implications for the role of the neocortex in mediating hypnotic phenomena.

Hypnosis and transference: a measure of archaic involvement.

20 Likert-type items were derived directly from Shor's theoretical propositions concerning the occurrence of transference-like experiences among hypnotic Ss. In 3 separate experiments, this 20-item Archaic Involvement Measure (AIM) was administered to a total of 452 Ss following termination of both group and individually administered hypnosis procedures. Results suggest that: (a) AIM is internally consistent, and is significantly correlated with hypnotizability; (b) among high hypnotizable Ss, AIM scores assess an important aspect of hypnotic experience which is relatively unrelated to behavioral response to hypnotic suggestions; (c) there is no change in AIM scores associated with the sex of the hypnotist or S; and (d) there are 3 clusters of AIM items: perceived power of the hypnotist, positive emotional bond to the hypnotist, and fear of negative appraisal. Possible validational and clinical research applications of AIM are presented, along with a plea for further empirical examination of the relational dimensions of hypnosis.