Akzeptanz und Nutzen zahnärtzlicher Hypnose

Sixty-eight patients suffering from generalized anxiety disorder were allocated to one of four groups to study how hypnotizability (high versus low) and type of suggestion (direct versus indirect) were related to treatment outcome. Patients were assessed on three occasions (Pre-treatment; Post-treatment; and three month Follow-up) using seven anxiety measures and one depression inventory. The Creative Imagination Scale (CIS) was used to assess susceptibility to hypnotic responding. Twenty Ss dropped out prematurely due to both practical and treatment related issues. Interestingly, dropouts were also found to have been significantly more depressed than completers. Patients were given six treatment sessions of hypnotherapy at weekly intervals while the author remained blind to CIS scores. Therapy focused on accessing S's unconscious abilities and resources for symptom resolution, using either direct or indirect suggestion. Patients were provided with self-hypnosis tapes for anxiety reduction in between appointments. Results indicated that completers significantly improved on all dependent measures, but few differences emerged between the four groups. Interestingly, highly hypnotizable patients who received indirect suggestion relapsed slightly on all measures by the Follow-up period, having improved from Pre- to Post-treatment. Discussion is offered on the possible implications these results have for the integrity of the independent variables, concluding that both hypnotizability and type of suggestion have a clinically significant interactive effect. Direct suggestion is recommended for highly hypnotizable generalized anxiety disorder clients, while both direct and indirect suggestion can be used with low hypnotizables, as long as all are couched within permissive language. Limitations of the present research are discussed, along with recommendations for clinical practice and future research

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J. Hilgard (1970, 1972, 1974, 1979), utilizing an interview format, asserted that a personality variable, namely, an individual's capacity to become imaginatively involved in experiences outside of hypnosis, was significantly correlated with his or her hypnotic susceptibility. Tellegen and Atkinson (1974) operationalized the imaginative involvement variable in a 37-item questionnaire, the Tellegen Absorption Scale (TAS) that correlated significantly with hypnotic susceptibility (e.g., Crawford, 1982). However, Council, Kirsch, and Hafner (1986) suggested that the relationship between the TAS and hypnotic susceptibility is a context-mediated artifact in that the two correlate only when the TAS is administered within a context clearly identified as involving hypnosis. As the interviews conducted by J. Hilgard (1970, 1972, 1974, 1979) were done within a context clearly identified as involving hypnosis, the possibility exists that the relationship between imaginative involvement and hypnotic susceptibility is also a context-mediated artifact. In a test of this possibility, 86 subjects were interviewed concerning their imaginative involvements. Forty-three subjects were interviewed within a context defined as "research investigating hypnosis" and 43 subjects were interviewed within a context defined as "research investigating imagination." Hypnotic susceptibility was assessed in sessions separate from the interviews. In the present study, an individual's hypnotic susceptibility was not found to be significantly related to his or her imaginative involvement. It appears J. Hilgard's original finding may have been due to chance correlations compounded by subsequent experimenter expectancy effects. It is recommended that J. Hilgard's work be clarified through more extensive replications in which experimenter blindness is assured.

Abstract Integrated mental training is a method that entails a systematic and long-term training of mental processes (thoughts, images, emotions) that aims to enhance performance as well as gratify feelings and improve thought processes. This training develops an alternative system of control by using substitute state of consciousness and self-hypnosis. The method is concerned with both mindfulness and performance approaches, which is crucial in order to feel and function better. The intent of this study is to highlight the experience of the different steps of integrated mental training to gain an understanding of how, where, and when changes occur. To achieve the objective of this study, a qualitative empirical method was used. As far as analysis is concerned, phenomenology analytic approach was adopted. The study participants were six long-term sick listed women. During the eight meetings they were introduced to the process and in between the meetings they performed the training using self-instructor CD. Their experience of the training was recorded through the diary entries upon which the study’s analysis was based. The finding shows that it takes different time-spans to reach the different stages and that large positive experience of change occur during the first steps. This suggests that a mindfulness approach is instrumental in feelings enhancement. Further, the first part of the mental conceptions gives strengthened self-esteem and increased faith in oneself. There is no illuminating finding with regard to self-creation of mental representations, which may be due to the short training time for this group.

Chapter 1 reviews the literature. It gives a historical overview of hypnosis. It reviews the literature on dental anxiety, including its prevalence and aetiology. It reviews behavioural and cognitive behavioural treatments of dental fear. Inhalation sedation its mechanism of action, effectiveness and draw-backs are discussed. The literature on hypnosis is selectively reviewed, its use in anxiety and dentistry and lastly, the combination of sedation techniques, particularly IHS, is discussed. It is concluded that evidence for the use of hypnosis for the alleviation of dental anxiety needs to be critically addressed. Chapter 2 presents the published protocol of a Cochrane systematic review followed by qualitative results of this review. 11 studies of generally poor quality were included in the review which concludes that there are significant problems with the evidence due to methodological issues, the different outcome measures used and the generally high or unclear risks of bias. There is some evidence that hypnosis may help patients who have a normal range of dental anxiety but who are undergoing a stressful dental procedure. Studies of phobic patients were characterised by high levels of drop-out behaviour and hypnosis could not be shown to be superior to other forms of behavioural treatment. Chapter 3 describes two studies which aimed to develop a Mood Induction Procedure to induce temporary dental anxiety in volunteers. This was used in two later studies. A non-clinical sample was used as a ‘proof of concept’ study was desirable. Study 1tested excerpts of a film, producing only a medium rise in anxiety (ES r = .49). The second study used a shorter, more concentrated film. This produced a large increase in anxiety (ES r=.86). Heart rate was investigated as a possible physiological measure of anxiety, but was not found useful. Chapter 4 describes two randomised controlled studies aiming to investigate whether hypnosis combined with IHS would reduce the anxiety produced by the film more than a control procedure in which IHS was combined with the reading of a story. These studies suggested there may be some effects attributable to hypnosis, but conclusive benefit was not demonstrated. Chapter 5 presents discussion and the overall conclusions of the thesis. Conclusions include the need for further well designed large scale trials involving hypnosis.

Hypnosis has gained substantial support in the psychological community, as well as related health professions. The intense renewal of interest in hypnosis has also affected our legal-judicial system. Many police investigators trained in hypnosis operate from an exactcopy memory theory. They claim eyewitness eyewitness retrieve veridically stored memory traces from long-term memory, if questioned under hypnosis. Conversely, other researchers ascribe to a reconstructive memory theory. They believe hypnosis increases the likelihood of eliciting erroneous memories from eyewitnesses, especially under leading questioning. The purpose of the present investigation was to test the effects of hypnotic induction and anxiety on the accuracy of subjects' memory for eyewitnessed events when questioned with leading, non-leading, and embedded misinformation questions.

Bulimia is often viewed as an extreme expression of eating concerns and body image disturbances that afflicts many adolescent and adult women. The cognitive strategies employed by individuals to inhibit eating and facilitate bingeing and purging are thought to include disattending internal sensations of hunger and satiety while sustaining attention on food, distorted beliefs, and interoceptive experiences (e.g., Heatherton & Baumeister, 1991). To the extent that these attentional and perceptual shifts mediate bulimic symptomatology, individuals with bulimic tendencies should exhibit certain cognitive attributes. Because hypnotizability, dissociation, and absorption have each been invoked (either directly or indirectly) as explanatory constructs for clinical and subclinical bulimia, the present study evaluated the absolute and relative effects of these factors on bulimic symptomatology in a large sample of undergraduate women (N = 309) using structural equation modeling. Following 2 assessments of hypnotic susceptibility (Harvard Group Scale of Hypnotic Susceptibility, Form A [Shor & Orne, 1962] & Group Stanford Hypnotic Susceptibility Scale, Form C [Crawford & Allen, 1982]), participants completed measures of eating disorder symptomatology (Eating Disorders Inventory-2 [Garner, 1991]; Three Factor Eating Questionnaire [Stunkard & Messick, 1985]), dissociation (Dissociative Experiences Scale [Carlson & Putnam, 1986]; Dissociation Questionnaire [Vanderlinden et al., 1993]), and absorption (Tellegen Absorption Scale [Tellegen & Atkinson, 1974]; Differential Attentional Processes Inventory [Crawford, Brown, & Moon, 1993; Grumbles & Crawford, 1981]). A final model including the latent constructs Hypnotizability, Dissociation, Absorption, and Bulimic Symptomatology provided a very good fit to the data (X 2 (58, N = 309) = 31.09, NFI = .932, CFI = .967, & RMSEA = .053). As hypothesized, dissociation was found to a have moderate effect (Standardized coefficient = .32, p < .01) on Bulimic Symptomatology when controlling for Hypnotizability and Absorption. Moreover, contrary to past research, the path between Hypnotizability and Bulimic Symptomatology and the path between Absorption and Bulimic Symptomatology were not significant. Based on these finding, we can now speak with increased confidence of a meaningful link between dissociation and the continuum of bulimic symptomatology. A pathological dissociative style appears to contribute to the development of bulimia. / Ph. D.

Hypnotherapy has been utilised with children and adolescents for more than 200 years. Despite this fact, there has been no documented research on the use of hypnotherapy for children and adolescents in South Africa. This research focused on the perspectives of qualified South African psychologists on the use of hypnosis as a therapeutic technique for children and adolescents. The aim of the research was to expand on current knowledge and understandings of hypnosis and hypnotherapy, to explore how the technique has been adapted to a South African context and to identify drawbacks found in the use of this technique. The research sample comprised eight qualified psychologists who utilise hypnotherapy with children and adolescents. The research design for this study adopted a qualitative approach in which semi-structured interviews were utilised. Although the technique largely relies on foreign practises that have not been adapted to the South African context, it still proved highly valuable. While the psychologists opinions differed on the ages and conditions for which hypnotherapy could be applied, this seemed to be based on their personal experiences and success rates rather than on inherent limitations of the technique. The educational psychologists who specialised in treating children and adolescents found that there were no limitations on the use of the technique and they were confident in its application for all ages. There was also a prevailing belief, on the part of the psychologists, that black individuals appear to be more responsive to hypnotherapy than other races. The overall findings of this research study suggest that hypnotherapy is a beneficial therapeutic technique for children and adolescents in a South African context. The research aimed to further educational psychologists’ knowledge on the applicability of this technique to children and adolescents. With an awareness of its benefits, training by these professionals may be undertaken or the opinions of specialists trained in this area may be sought.

This study evaluated the role of asymmetric processing of information in depression. Depression has been hypothesized to involve a deficit in the global processing of information (Tucker, 1982). This type of global processing has been manipulated through the use of hypnosis by Crawford and Allen (1983). In the current study, a 3 x 2 ANCOVA design allowed the comparison of three groups of subjects on their performance on a perceptual task measuring global perception. The task chosen was designed by Navon (1977) and consisted of designs which differed on global or local features. The groups were screened with the Beck Depression Inventory, the Harvard Group Scale of Hypnotic Susceptibility, and the Edinburgh Handedness Inventory, yielding 46 subjects divided into three groups of right-handed males and females. The experimental group consisted of high susceptible depressives from the community. The controls were one group of high susceptible normals and one of low susceptible depressives. All groups performed the Navon task under both waking and hypnosis conditions. Analysis of the results revealed a main effect for group (F(2, 86) = 9.60, p < .01) on the global scores. In addition, high social desirability scores predicted slower presentation times. However, hypnosis was not effective in creating a significant change in performance on the dependent measure. The results are discussed as support for the hypothesized differences between depressives and normals. Differences between the measures used in the present study and that of Crawford and Allen suggest that hypnosis may mediate imagery at a conceptual level but not at the level of the primary visual-perceptual system.