Browsing by Author "Kirsch, Irving"
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- Apresentação da versão portuguesa de uma escala de avaliação da susceptibilidade hipnóticaPublication . Carvalho, Cláudia Maria Constante Ferreira de; Mazzoni, Giuliana; Kirsch, Irving; Leal, Isabel PereiraA hipnose é um procedimento pouco habitual em investigação em Portugal pelo que são inexistentes instrumentos de avaliação do comportamento hipnótico devidamente adaptados à língua portuguesa, que permitam ao investigador estabelecer parâmetros de avaliação válidos e fiáveis. Neste artigo apresentamos a versão Portuguesa da escala de avaliação da susceptibilidade hipnótica Waterloo-Stanford Group C (WSGC) Scale of Hypnotic Susceptibility (Bowers, 1993, 1998). A versão original do instrumento constituída por uma indução hipnótica de cerca de 20m seguida da apresentação de 12 sugestões hipnóticas foi sujeita a um processo de tradução e retroversão e a versão portuguesa resultante foi administrada a uma amostra de 707 estudantes universitários voluntários, de ambos os sexos, com idades compreendidas entre os 17 e os 49 anos. Os resultados mostram valores médios da distribuição semelhantes aos da amostra de referência, correlações com as amostras de referência altamente significativas e um valor de Alpha de Cronbach (0,62) que embora inferior ao das amostras de referência encontra-se numa zona de aceitabilidade para este tipo de instrumento. A versão portuguesa da WSGC:C proposta revela ser um instrumento com boas qualidades psicométricas passível de ser utilizado pelos investigadores interessados em avaliar a susceptibilidade hipnótica de grupos de indivíduos. ------ ABSTRACT ------ Hypnosis is an unusual procedure in Portuguese research. Therefore reliable and valid scales in Portuguese language suitable to assess hypnotic behaviour are inexistent. In this article a Portuguese version of the Waterloo-Stanford Group C (WSGC) Scale of Hypnotic Susceptibility (Bowers, 1993, 1998) is presented. The original scale of a 20m standard induction procedure and 12 hypnotic suggestions was translated to Portuguese and back into English to ensure protocol fidelity. The sample consisted of 707 volunteer’s college students of both sexes, age form 17 to 49 years old. The findings show similar distribution and high significant correlations to the references samples. Although Alpha de Cronbach reliability coefficient is lower than similar coefficient in the reference samples (.62) is still acceptable for this type of scale. The Portuguese version of the WSGC:C has psychometric properties and can be utilized by Portuguese language-based researchers interested in assessing hypnotic susceptibility in group samples.
- Imaginary pills and open-label placebos can reduce test anxiety by means of placebo mechanismsPublication . Buergler, Sarah; Sezer, Dilan; Bagge, Niels; Kirsch, Irving; Locher, Cosima; Carvalho, Claudia; Gaab, JensPlacebos have been shown to be beneficial for various conditions even if administered with full transparency. Hence, so-called open-label placebos (OLPs) offer a new way to harness placebo effects ethically. To take this concept one step further, this study aimed at evaluating placebo effects without the use of a physical placebo, i.e., by imagining taking a pill. Healthy students (N = 173) with self-reported test anxiety were either randomized to an imaginary pill (IP; n = 55), an OLP (n = 59) or a control group (CG; n = 59). Both intervention groups were instructed to take two pills daily for three weeks. Primary outcome was test anxiety, secondary outcomes were sleep quality, general well-being and test performance. Groups test anxiety differed at study-endpoint, F(2,169) = 11.50, p < .001. Test anxiety was lower in the intervention groups compared to the CG, t(169) = − 4.44, p < .001, d = − 0.71. The interventions did not differ significantly, i.e., both were similarly efficacious, t(169) = 0.61, p = .540, d = 0.11. The interaction between group and time in explaining test anxiety was significant, F(5,407.93) = 6.13, p < .001. OLPs and IPs reduced test anxiety in healthy participants compared to the CG. This finding opens the door for a novel and ethical method to harness placebo effects.
- Implications of placebo and nocebo effects for clinical practice: Expert consensusPublication . Evers, Andrea W. M.; Colloca, Luana; Blease, Charlotte; Annoni, Marco; Atlas, Lauren Y.; Benedetti, Fabrizio; Bingel, Ulrike; Buchel, Christian; Carvalho, Cláudia Maria Constante Ferreira de; Colagiuri, Ben; Crum, Alia J.; Enck, Paul; Gaab, Jens; Geers, Andrew L.; Howick, Jeremy; Jensen, Karin B.; Kirsch, Irving; Meissner, Karin; Napadow, Vitaly; Peerdeman, Kaya J.; Raz, Amir; Rief, Winfried; Vase, Lene; Wager, Tor D.; Wampold, Bruce E.; Weimer, Katja; Wiech, Katja; Kaptchuk, Ted J.; Klinger, Regine; Kelley, John M.Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice.
- Open-label placebo treatment in chronic low back pain: A randomized controlled trialPublication . Carvalho, Cláudia Maria Constante Ferreira de; Joaquim António Machado Caetano; Cunha, Lidia; Rebouta, Paula; Kaptchuk, Ted J.; Kirsch, IrvingThis randomized controlled trial was performed to investigate whether placebo effects in chronic low back pain could be harnessed ethically by adding open-label placebo (OLP) treatment to treatment as usual (TAU) for 3 weeks. Pain severity was assessed on three 0- to 10-point Numeric Rating Scales, scoring maximum pain, minimum pain, and usual pain, and a composite, primary outcome, total pain score. Our other primary outcome was back-related dysfunction, assessed on the Roland-Morris Disability Questionnaire. In an exploratory follow-up, participants on TAU received placebo pills for 3 additional weeks. We randomized 97 adults reporting persistent low back pain for more than 3 months' duration and diagnosed by a board-certified pain specialist. Eighty-three adults completed the trial. Compared to TAU, OLP elicited greater pain reduction on each of the three 0- to 10-point Numeric Rating Scales and on the 0- to 10-point composite pain scale (P < 0.001), with moderate to large effect sizes. Pain reduction on the composite Numeric Rating Scales was 1.5 (95% confidence interval: 1.0-2.0) in the OLP group and 0.2 (-0.3 to 0.8) in the TAU group. Open-label placebo treatment also reduced disability compared to TAU (P < 0.001), with a large effect size. Improvement in disability scores was 2.9 (1.7-4.0) in the OLP group and 0.0 (-1.1 to 1.2) in the TAU group. After being switched to OLP, the TAU group showed significant reductions in both pain (1.5, 0.8-2.3) and disability (3.4, 2.2-4.5). Our findings suggest that OLP pills presented in a positive context may be helpful in chronic low back pain.
- Portuguese Norms for the Waterloo-Stanford Group C (WSGC) Scale of Hypnotic SusceptibilityPublication . Carvalho, Cláudia Maria Constante Ferreira de; Kirsch, Irving; Mazzoni, Giuliana; Leal, Isabel PereiraAbstract: Portuguese norms for the Waterloo-Stanford Group C (WSGC) scale of hypnotic susceptibility are presented. A Portuguese translation of this scale was given to 625 Portuguese college students. Score distribution, item analysis, and reliability of the WSGC are presented and compared to three North American samples. The findings show that normative data from the Portuguese sample are congruent with the reference samples. The only significant difference obtained was a lower proportion of participants scoring within the high range of hypnotic suggestibility on the WSGC.
- A qualitative study of imaginary pills and open-label placebos in test anxietyPublication . Buergler, Sarah; Sezer, Dilan; Busch, Alexander; Enzmann, Marlon; Bakis, Berfin; Locher, Cosima; Bagge, Niels; Kirsch, Irving; Carvalho, Claudia; Gaab, JensBackground The efficacy of open-label placebos (OLPs) has been increasingly demonstrated and their use holds promise for applications compatible with basic ethical principles. Taking this concept one step further an imaginary pill (IP) intervention without the use of a physical pill was developed and tested in a randomized controlled trial (RCT). To explore participants’ experiences and views, we conducted the first qualitative study in the field of IPs. Methods A reflexive thematic analysis (RTA) of semi-structured interviews with test anxious students (N = 20) was nested in an RCT investigating an IP and OLP intervention. In addition, openended questions from the RCT were evaluated (N = 114) to corroborate the RTA and pill characteristics were included to more accurately capture the IP experience. Results Four key themes were identified: (1) attitude towards the intervention, (2) applicability of the intervention, (3) experience of effects, and (4) characteristics of the imagination. The IP intervention was well-accepted, easily applicable, and various effects, pill characteristics and appearances were described. While many participants did not desire a physical pill, either due to the absence of the imagination component or aversion to pills, the approach was considered to be cognitively and time demanding, which in turn, however, encouraged the establishment of a therapeutic ritual that protected against the increase in test anxiety during the preparation phase. OLP findings were comparable, and especially the importance of a treatment rationale was stressed in both groups, counteracting an initial ambivalent attitude. The RTA findings were supported by the open-ended questions of the RCT.IPs appear to be a well-accepted and easily applicable intervention producing a variety of beneficial effects. Thus, the IP approach might serve as an imaginary based alternative to OLPs warranting further investigations on its application to harness placebo effects without a physical pill.
- Suggested visual hallucinations in and out of hypnosisPublication . Mazzoni, Giuliana; Rotriquenz, Elisabetta; Carvalho, Cláudia Maria Constante Ferreira de; Vannucci, Manila; Roberts, Kathrine; Kirsch, IrvingWe administered suggestions to see a gray-scale pattern as colored and a colored pattern in shades of gray to 30 high suggestible and eight low suggestible students. The suggestions were administered twice, once following the induction of hypnosis and once without an induction. Besides rating the degree of color they saw in the stimuli differently, participants also rated their states of consciousness as normal, relaxed, hypnotized, or deeply hypnotized. Reports of being hypnotized were limited to highly suggestible participants and only after the hypnotic induction had been administered. Reports of altered color perception were also limited to high suggestibles, but were roughly comparable regardless of whether hypnosis had been induced. These data indicate that suggestible individuals do not slip into a hypnotic state when given imaginative suggestions without the induction of hypnosis, but nevertheless report experiencing difficult suggestions for profound perceptual alterations that are pheonomenologically similar to what they report in hypnosis.
- The effect of posthypnotic suggestion, hypnotic suggesttibility, and goal intentions on adherence to medical instructionsPublication . Carvalho, Cláudia Maria Constante Ferreira de; Mazzoni, Giuliana; Kirsch, Irving; Meo, Maria; Santandrea, MauraThe effects of implementation intentions and posthypnotic suggestion were investigated in 2 studies. In Experiment 1, participants with high levels of hypnotic suggestibility were instructed to take placebo pills as part of an investigation of how to best enhance compliance with medical instruction. In Experiment 2, participants with high, medium, and low levels of hypnotic suggestibility were asked to run in place, take their pulse rate before, and send an e-mail report to the experimenter each day. Experiment 1 revealed enhanced adherence as a function of both implementation intentions and posthypnotic suggestion. Experiment 2 failed to find any significant main effects but found a significant interacti on between suggestibility and the effects of posthypnotic suggestion. Posthypnotic suggestion enhanced adherence among high suggestible participants but lowered it among low suggestibles.