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Hypnotic analgesia and stress inoculation in the reduction of pain
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Comparing physical and behavioral therapy for chronic low back pain on physical abilities, psychological distress and patients’ perceptions. - R.L. Heinrich, M.J. Cohen, B.D. Naliboff, G.A. Collins and A.D. Bonebakker, J. behav. Med., 8 (1985) 61-78. The impact of behavior and physical therapy on components of the chronic pain low back syndrome were investigated in a treatment outcome study. Behavior therapy was given to 18 patients while 15 received physical therapy. All had at least a 6-month history of seeking treatment for chronic low back pain. Before treatment patients were assessed in 4 major areas of function: (1) physical abilities; (2) current physical functioning; (3) psychological and psychosocial functioning; and (4) pain intensity and pain perception. Treatments were conducted in a group of 5-8 patients in an outpatient setting. Both behavior therapy and physical therapy groups met for 10 weekly sessions, each lasting 2 h. Behavior therapy was designed to address the environmental, social and emotional components of the low back pain syndrome as well as the depression and decreased activity that result from chronic low back pain. Physical therapy was based on traditional rehabilitation therapy and was designed to improve low back function. Patients were re-evaluated at post-treatment, 6 months, and 1 year. Patients in both groups showed a general improvement and there were a few treatment-specific differences in outcome measures. Hypnotic analgesia and stress inoculation in the reduction of pain. - M.E. Miller and K.S. Bowers, J. abnorm. Psychol., 95 (1986) 6-14. The effects of hypnotic ability on 3 methods of reducing cold-pressor pain were investigated. After a baseline emersion, 30 high and 30 low hypnotizable undergraduate volunteers were assigned randomly to 1 of 3 treatment groups: stress inoculation training, stress inoculation training defined as hypnosis, or hypnotic analgesia. Pain report data indicated a significant hypnotic ability X treatment interaction. Among subjects who received hypnotic analgesia, high hypnotizables reported significantly less intense pain than low hypnotizables. There was no differential response for high and low hypnotizable subjects receiving stress inoculation training whether or not it was defined as hypnotic. In the stress inoculation condition (whether or not defined as hypnosis) subjects reported using cognitive strategies to reduce pain but this was not the case for subjects in the hypnotic analgesia condition. These outcomes seem inconsistent with the social psychological account of hypnosis and were discussed by the authors from a dissociation perspective in which hypnosis is viewed as involving changes in the way information is processed.
Comparing physical and behavioral therapy for chronic low back pain on physical abilities, psychological distress and patients’ perceptions. - R.L. Heinrich, M.J. Cohen, B.D. Naliboff, G.A. Collins and A.D. Bonebakker, J. behav. Med., 8 (1985) 61-78. The impact of behavior and physical therapy on components of the chronic pain low back syndrome were investigated in a treatment outcome study. Behavior therapy was given to 18 patients while 15 received physical therapy. All had at least a 6-month history of seeking treatment for chronic low back pain. Before treatment patients were assessed in 4 major areas of function: (1) physical abilities; (2) current physical functioning; (3) psychological and psychosocial functioning; and (4) pain intensity and pain perception. Treatments were conducted in a group of 5-8 patients in an outpatient setting. Both behavior therapy and physical therapy groups met for 10 weekly sessions, each lasting 2 h. Behavior therapy was designed to address the environmental, social and emotional components of the low back pain syndrome as well as the depression and decreased activity that result from chronic low back pain. Physical therapy was based on traditional rehabilitation therapy and was designed to improve low back function. Patients were re-evaluated at post-treatment, 6 months, and 1 year. Patients in both groups showed a general improvement and there were a few treatment-specific differences in outcome measures. Hypnotic analgesia and stress inoculation in the reduction of pain. - M.E. Miller and K.S. Bowers, J. abnorm. Psychol., 95 (1986) 6-14. The effects of hypnotic ability on 3 methods of reducing cold-pressor pain were investigated. After a baseline emersion, 30 high and 30 low hypnotizable undergraduate volunteers were assigned randomly to 1 of 3 treatment groups: stress inoculation training, stress inoculation training defined as hypnosis, or hypnotic analgesia. Pain report data indicated a significant hypnotic ability X treatment interaction. Among subjects who received hypnotic analgesia, high hypnotizables reported significantly less intense pain than low hypnotizables. There was no differential response for high and low hypnotizable subjects receiving stress inoculation training whether or not it was defined as hypnotic. In the stress inoculation condition (whether or not defined as hypnosis) subjects reported using cognitive strategies to reduce pain but this was not the case for subjects in the hypnotic analgesia condition. These outcomes seem inconsistent with the social psychological account of hypnosis and were discussed by the authors from a dissociation perspective in which hypnosis is viewed as involving changes in the way information is processed.