Pain perception, somatosensory event-related potentials and skin conductance responses to painful stimuli in high, mid, and low hypnotizable subjects: effects of differential pain reduction strategies.

In this study, pain perception, somatosensory event-related potential (SERP) and skin conductance response (SCR) changes during hypnotic suggestions of Deep Relaxation, Dissociated Imagery, Focused Analgesia, and Placebo, compared with a Waking baseline condition, were investigated. SERPs were recorded from frontal, temporal, central, and parietal scalp sites. Ten high, 9 mid, and 10 low hypnotizable right-handed women participated in the experiment. The following measures were obtained: (1) pain and distress tolerance ratings; (2) sensory and pain thresholds to biphasic electrical stimulation delivered to the right wrist; (3) reaction time and number of omitted responses; (4) N2 (280+/-11 ms) and P3 (405+/-19 ms) peak amplitudes of SERPs to target stimuli delivered using an odd-ball paradigm; (5) number of evoked SCRs and SCR amplitudes as a function of stimulus repetition. Results showed, high, mid and low hypnotizables exhibited significant reductions of reported pain and distress ratings during conditions of Deep Relaxation/Suggestion of Analgesia, Dissociated Imagery and Focused Analgesia. High hypnotizable subjects displayed significant reductions in pain and distress levels compared to mid and low hypnotizables during Dissociated Imagery, Focused Analgesia and, to a lesser degree, during Deep Relaxation. Placebo condition did not display significant differences among hypnotizability groups. High hypnotizables, compared to mid and low hypnotizables, also showed significant increases in sensory and pain thresholds during Dissociated Imagery and Focused Analgesia. High, mid, and low groups showed significant reductions in P3 peak amplitudes across all hypnosis conditions and, to a lesser degree, during Placebo. The temporal cortical region was the most sensitive in differentiating SERP responses among hypnotizability groups. On this recording area the subjects highly susceptible to hypnosis displayed significantly smaller P3 and greater N2 peaks during Focused Analgesia than did the other hypnotizable groups. In this condition highly susceptible subjects also reported the highest number of omitted responses and the shortest Reaction Times. These subjects also showed faster habituation of SCRs when compared with mid and low hypnotizables. During Dissociated Imagery and Focused Analgesia, highly hypnotizable subjects also disclosed a smaller total number of evoked SCRs than did mid and low hypnotizable subjects. The results are discussed considering possible common and different mechanisms to account for the effects of different hypnotic suggestions.

RCT Entities:   Population Interventions Outcomes