Monocyte chemotactic activity in sera after hypnotically induced emotional states

CHANGES IN OXYTOCIN AND CORTISOL IN ACTIVE-ALERT HYPNOSIS: Hormonal Changes Benefiting Low Hypnotizable Participants

It is increasingly clear that oxytocin and cortisol play an intricate role in the regulation of behavior and emotions impacting health, relationships, and well-being. Their long-term, cross-generational effect makes them an important focus of the present study. This exploratory research examined changes in oxytocin and cortisol levels and their correlations with different phenomenological measures in both hypnotist and subject during active-alert hypnosis. The level of oxytocin increased whereas the level of cortisol decreased in the hypnotist. When comparing the oxytocin changes of subjects with their hypnotizability, those with low hypnotizability scores experienced an increase in oxytocin, and those with medium and high hypnotizability scores showed no change or decrease. This could explain why clients' hypnotizability is not considered an important factor during hypnotherapy.

Oxytocin and cortisol in the hypnotic interaction

Changes in oxytocin and cortisol levels were tested in healthy volunteers during hypnotic interactions in standardized laboratory sessions. Pre- to posthypnosis changes of oxytocin and cortisol were related to the hypnotic susceptibility of subjects and the relational experiences reposted by subjects and hypnotists on several paper-and-pencil tests. Results show that the changes in oxytocin are not related to hypnotic susceptibility but to relational experiences. After the hypnotic interaction, the subject's oxytocin level increased if perceived harmony with the hypnotist was high, whereas it increased in the hypnotist if the subject had memories of less warm emotional relationships with his or her parents. The results are interpreted within the social-psychobiological model of hypnosis.

Experimental pain ratings and reactivity of cortisol and soluble tumor necrosis factor-α receptor II following a trial of hypnosis: results of a randomized controlled pilot study

OBJECTIVE

Current evidence supports the efficacy of hypnosis for reducing the pain associated with experimental stimulation and various acute and chronic conditions; however, the mechanisms explaining how hypnosis exerts its effects remain less clear. The hypothalamic-pituitary-adrenal (HPA) axis and pro-inflammatory cytokines represent potential targets for investigation given their purported roles in the perpetuation of painful conditions; yet, no clinical trials have thus far examined the influence of hypnosis on these mechanisms.

DESIGN

Healthy participants, highly susceptible to the effects of hypnosis, were randomized to either a hypnosis intervention or a no-intervention control. Using a cold pressor task, assessments of pain intensity and pain unpleasantness were collected prior to the intervention (Pre) and following the intervention (Post) along with pain-provoked changes in salivary cortisol and the soluble tumor necrosis factor-α receptor II (sTNFαRII).

RESULTS

Compared with the no-intervention control, data analyses revealed that hypnosis significantly reduced pain intensity and pain unpleasantness. Hypnosis was not significantly associated with suppression of cortisol or sTNFαRII reactivity to acute pain from Pre to Post; however, the effect sizes for these associations were medium-sized.

CONCLUSIONS

Overall, the findings from this randomized controlled pilot study support the importance of a future large-scale study on the effects of hypnosis for modulating pain-related changes of the HPA axis and pro-inflammatory cytokines.

Does positive affect influence health?

This review highlights consistent patterns in the literature associating positive affect (PA) and physical health. However, it also raises serious conceptual and methodological reservations. Evidence suggests an association of trait PA and lower morbidity and of state and trait PA and decreased symptoms and pain. Trait PA is also associated with increased longevity among older community-dwelling individuals. The literature on PA and surviving serious illness is inconsistent. Experimentally inducing intense bouts of activated state PA triggers short-term rises in physiological arousal and associated (potentially harmful) effects on immune, cardiovascular, and pulmonary function. However, arousing effects of state PA are not generally found in naturalistic ambulatory studies in which bouts of PA are typically less intense and often associated with health protective responses. A theoretical framework to guide further study is proposed.

The neuro-immuno-cutaneous-endocrine network: relationship between mind and skin

Brain-body(skin) influences are bi-directional and skin should be considered as an active neuro-immuno-endocrine interface, where effector molecules act as common words used in a dynamic dialogue between brain, immune-system and skin. It has been widely demonstrated that stimuli received in the skin can influence the immune, endocrine and nervous systems at both a local and central level. However, the brain can also modulate inflammatory conditions locally induced in the skin. It has been experimentally demonstrated that intracerebral administration of the tridecapeptide alpha-MSH or even its COOH-terminal tripeptide can in fact inhibit cutaneous inflammation induced by the application of topical irritants and intradermal injection of cytokines. The skin can therefore alter the pharmacology of the CNS by releasing large amounts of NPs which obviously do work locally in the skin and beyond the skin. Alpha-MSH may represent a key molecule for understanding this aspect of cutaneous-immune-neuro-endocrine-mental biological communication, being it is also generated in the skin. This molecule may in the future be used as a potent anti-inflammatory agent in clinical dermatology, and preclinical trials are presently in progress.

Hypnosis, differential expression of cytokines by T-cell subsets, and the hypothalamo-pituitary-adrenal axis

This investigation tested the hypothesis that hypnosis can differentially modulate T-cell subsets, and that this effect is mediated by changes in hypothalamo-pituitary-adrenal (HPA) mediators. Seven healthy, highly hypnotizable volunteers participated in three one-day sessions, a baseline and two intervention sessions. Hypnosis intervention entailed a standardized induction, suggestions for ego strengthening and optimally balanced functioning of the immune and neuroendocrine systems, and post-hypnotic suggestions for stress management and continued optimal balance of bodily systems. Blood samples were drawn at five time points between 8:00 a.m. and 3:00 p.m. and were analyzed for T-cell activation and intracellular cytokine expression (Interferon (IFN)-gamma, Interleukin-2, Interleukin-4) and HPA axis mediators (ACTH, cortisol, and beta-endorphin). Following hypnosis intervention, statistically significant immunological effects were noted. Specifically, the proportion of T-cells expressing IFN-gamma (p = .0001) and IL-2 (p = .013) were lower after hypnosis. T-cell activation response to polyclonal stimulation was positively correlated with ACTH (p = .01) and beta-endorphin (p = .001) while IFN-gamma expression was correlated with levels of cortisol (p < .001). Further controlled studies utilizing hypnosis with patients in treatment are warranted in order to examine whether an altered T-cell response can be replicated in the presence of disease.

Skin reactions to histamine of healthy subjects after hypnotically induced emotions of sadness, anger, and happiness

BACKGROUND

The severity of symptoms in asthma and other hypersensitivity-related disorders has been associated with changes in mood but little is known about the mechanisms possibly mediating such a relationship. The purpose of this study was to examine the influence of mood on skin reactivity to histamine by comparing the effects of hypnotically induced emotions on flare and wheal reactions to cutaneous histamine prick tests.

METHODS

Fifteen highly hypnotically susceptible volunteers had their cutaneous reactivity to histamine measured before hypnosis at 1, 2, 3, 4, 5, 10, and 15 min after the histamine prick. These measurements were repeated under three hypnotically induced emotions of sadness, anger, and happiness presented in a counterbalanced order. Skin reactions were measured as change in histamine flare and wheal area in mm2 per minute.

RESULTS

The increase in flare reaction in the time interval from 1 to 3 min during happiness and anger was significantly smaller than flare reactions during sadness (P<0.05). No effect of emotion was found for wheal reactions. Hypnotic susceptibility scores were associated with increased flare reactions at baseline (r=0.56; P<0.05) and during the condition of happiness (r=0.56; P<0.05).

CONCLUSION

Our results agree with previous studies showing mood to be a predictor of cutaneous immediate-type hypersensitivity and histamine skin reactions. The results are also in concordance with earlier findings of an association between hypnotic susceptibility and increased reactivity to an allergen.

Source localization of EEG activity during hypnotically induced anxiety and relaxation

The engagement of different brain regions which implement subjectively experienced emotional states in normals is not completely clarified. Emotional states can conveniently be induced by hypnosis-based suggestions. We studied brain electric activity during hypnotically induced anxiety and relaxation in 11 right-handed normals (5 males, 6 females, mean age 26.5+/-7.6 years). After induction of light hypnosis, anxiety and then relaxation was suggested using a standardized text (reverse sequence in half of the subjects). Nineteen-channel, eyes-closed EEG (20 artifact-free s/subject) was analyzed (source localization using FFT approximation and low resolution electromagnetic tomography, LORETA). Global tests revealed the strongest difference (P<0.005) between EEG source gravity center locations during the two emotional states in the excitatory beta-2 EEG frequency band (18.5-21 Hz). Post hoc tests showed that the sources were located more right during anxiety than during relaxation (P=0.01). LORETA specified that anxiety showed maximally stronger activity than relaxation in right Brodmann area 10, and relaxation showed maximally stronger activity than anxiety in left Brodmann area 22. Clearly, the two induced emotional states were associated with activity of different neural populations. Our results agree with reports on brain activity shifted to the right (especially fronto-temporal) during negative compared with positive emotions, and support the role of beta-2 EEG frequency in emotional states.

Psychoneuroimmunology: an interpretation of experimental and case study evidence towards a paradigm for predictable results

This paper surveys a number of key experiments and case studies relating to psychoneuroimmunology. It finds that most techniques to influence or even direct the immune system via the mind fall into a series of theoretical categories called passive, active and targeted effects. By examining the results of experiments and studies in the light of these categories a number of important conclusions are drawn. These conclusions explain differences in experimental results, describe those variables that appear to be central to obtaining results, and describe in detail where experimentation should be concentrated to further knowledge of psychoneuroimmunology.

Hypnotherapy for crohn's disease. A promising complementary/alternative therapy

Crohn's disease is a nonspecific chronic syndrome of unknown origin for which, to date, no conventional (i.e., medical or surgical) cure exists. However, recent clinical case studies and anecdotal reports have shown that the use of different forms of hypnotherapy for the treatment of Crohn's have actually resulted in cures. This report reviews and compares the effectiveness of hypnotherapy in the treatment of Crohn's disease vis-a-vis current medical and surgical therapies, in addition to reviewing evidence of the modulation of immune function parameters by hypnosis, while providing support for current etiological hypotheses of Crohn's disease as an autoimmune disorder.

Potential adjunctive applications of hypnosis in the management of periodontal diseases

Many uses of hypnosis in dentistry have been described in the literature including anesthesia, analgesia, anxiety management, treatment for bruxism, to control gagging, and the alteration of salivary flow and bleeding control during treatment. However, very few references have been made specifically regarding the use of hypnosis with patients who have periodontal disease, a wide spread chronic inflammatory disease affecting the oral cavity of about 80% of the population. The purpose of this paper is to describe potential adjunctive applications of hypnosis in the treatment of patients with periodontal diseases. The supporting literature from two broad areas for potential application, health behaviors and psychoneuroimmunology is discussed, followed by proposed hypnotic strategies and suggestions for use with patients with periodontal diseases.

Danish norms for the Harvard group scale of hypnotic susceptibility, form A

Norms for a Danish adaptation of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) are presented. Four samples tested from 1988 to 1991 (n = 166, n = 54, n = 95, and n = 61) were pooled, resulting in an aggregate sample of 376 participants. The normative data were generally congruent with earlier normative studies with regard to score distribution, item difficulty levels, and reliability. Studies using the Danish adaptation of the HGSHS:A as a screening instrument have shown the predictive value of the instrument in a Danish context. Data for a comparable American sample of volunteers (n = 170) tested by the same hypnotist were included in the analysis. A comparison revealed a marked difference for the posthypnotic suggestion item, hinting that cultural differences between the Danish and American samples with regard to expectancies and attitudes toward hypnosis may play a role. Further studies comparing attitudes toward hypnosis across different cultural contexts are needed to clarify this issue.

Implications of mind-body theory for integration in psychiatry

Recently, several authors have called for an integration of philosophy, psychology, and neuroscience regarding the mind-brain problem (Brothers 1989; Cooper 1985; Hundert 1989). In this essay I review two philosophical theories of mind that lead to very different conclusions regarding integration. Reductionist materialism is the theory that currently has the widest acceptance. Unity theory, a less familiar theory, may present the most plausible alternative to reductionism currently available. Numerous examples from the psychiatric literature are used to illustrate the challenge that faces each of these theories. Critical evaluation of how they meet the challenge, particularly in accounting for apparent psychosomatic causation, shows the strengths and weaknesses of each theory, particularly regarding their clinical utility in psychiatry.

Putting the mind back into the body. A successor scientific medical model

This paper examines today's received scientific medical model with respect to its ability to satisfy two conditions: (1) its explanatory adequacy relative to the full range of findings in the medical literature, including those indicating a correlation between psychosocial variables and disease susceptibility; and (2) the fit between its physicalist patient and disease concepts and what today's basic sciences, so-called sciences of complexity, tell us about the way matter, notably complex systems (e.g. patients), behave and the nature of scientific explanation. I conclude that the received (biomedical) model falls short on both counts and to satisfy these conditions is to articulate a formal successor model. This successor must be guided by premises consistent with the findings and methods of today's basic sciences on which an applied science like medicine depends for its validity. Additionally, the successor model must be able to explain (and predict) the full range of clinical findings, both those that its predecessors explains and at least some of those that it does not. The aim of the paper is to identify such a model.

Influence of perceived psychological stress and distress on antibody response to low dose rDNA hepatitis B vaccine

The present study focused on the relationship between psychological stress and immune reaction to a novel antigen. Participants completed questionnaires on daily hassles, psychoneurotic complaints, coping style, and loneliness, 2 and 6 months after the first of a series injections with a low dose recombinant DNA hepatitis B vaccine. Antibody response was determined 7 months after the first vaccination. Based on the psychological questionnaires two different stress measures were calculated: a Stress Index score-month-2 and a Stress Index score-month-6 indicating stress levels experienced at the beginning and at the end of the study respectively. Antibody levels were found to be negatively related with the Stress Index score-month-2. Although the influence of psychological stress reported on month 6 tended to be in the same direction, this effect was not significant. Coping styles and loneliness were not associated with antibody formation. These results suggest that antibody formation to rDNA hepatitis B vaccine is negatively influenced by psychological stress.

Increase and decrease of delayed cutaneous reactions obtained by hypnotic suggestions during sensitization. Studies on dinitrochlorobenzene and diphenylcyclopropenone

Cutaneous reactivity to challenge with dinitrochlorobenzene (DNCB) and diphenylcyclopropenone (DCP) was studied in 16 volunteers following hypnotic suggestions to increase and decrease response during sensitization. The immunoreactivity to DNCB and DCP was modulated by direct suggestions and guided imagery under hypnosis. The volunteers were highly susceptible subjects selected by means of the Harvard Group Scale of Hypnotic Susceptibility, Form A. Measurement of skin reactions to the challenge 1 month after sensitization was performed double blindly. Results showed a significant (P < 0.01) difference in visually scored reactions to DCP and DNCB between the group instructed to increase reaction to DCP and decrease reaction to DNCB and the group given the opposite instructions. A non-significant difference (P = 0.055) in skin thickness measured by ultrasound was found between the two groups. The study supports previous reports of experimental modulation of immunoreactivity and indicates that the specific immunological processes involved in the development of allergic reactions may be susceptible to psychological factors.