Journal of behavioral medicine
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This article reviews controlled trials of hypnotic treatment for chronic pain in terms of: (1) analyses comparing the effects of hypnotic treatment to six types of control conditions; (2) component analyses; and (3) predictor analyses. The findings indicate that hypnotic analgesia produces significantly greater decreases in pain relative to no-treatment and to some non-hypnotic interventions such as medication management, physical therapy, and education/advice. However, the effects of self-hypnosis training on chronic pain tend to be similar, on average, to progressive muscle relaxation and autogenic training, both of which often include hypnotic-like suggestions. ⋯ Component analyses indicate that labeling versus not labeling hypnosis treatment as hypnosis, or including versus not including hand-warming suggestions, have relatively little short-term impact on outcome, although the hypnosis label may have a long-term benefit. Predictor analyses suggest that global hypnotic responsivity and ability to experience vivid images are associated with treatment outcome in hypnosis, progressive relaxation, and autogenic training treatments. The paper concludes with a discussion of the implications of the findings for future hypnosis research and for the clinical applications of hypnotic analgesia.
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Disability associated with headache cannot be fully accounted for by pain intensity and headache frequency. As such, a variety of cognitive and affective factors have been identified to help explain headache-related disability beyond that accounted for by pain levels. Pain-related anxiety, a multidimensional construct, also has been found to contribute to disability in headache sufferers. ⋯ Pain, headache-related control beliefs, and emotional distress accounted for 32%, with locus of control related to health care professionals contributing unique variance. In the full model, with the addition of pain-related anxiety, only pain-related anxiety was a unique predictor of disability. These findings suggest that pain-related anxiety may have a unique and important role in contributing to disability in headache sufferers.