The recognition and utilization of trance phenomena in clinical pediatrics can energize the practitioner and be therapeutically beneficial for the child. The aim of this paper is to characterize and promote the purposeful inclusion of trance and suggestion in the routine pediatric examination. This includes, but goes beyond, the child-oriented examination skills customarily associated with being a "good," child-friendly pediatrician. While this paper highlights trance recognition from a clinician's perspective, emphasis is placed on utilizing spontaneous hypnotic moments whenever they occur to further the agenda of the encounter, diminish doctor visit anxiety, enhance self empowerment, and improve the milieu for pediatric care.

Am J Clin Hypn. 2007 Oct;50(2):121-9. Berberich FR. Pediatric Medical Group, Berkeley, CA 94705, USA. rberb@sbcglobal.net

The more user friendly medical hypnosis can be, the more readily it will be accepted by patients and the medical community. Hypnosis is user friendly when it is simple to employ, and yields rapid, effective, and clinically significant results. Thus, we should define reasons for the effectiveness of such successful hypnosis methods, and provide this information to students of hypnosis. Some of the elements that may permit hypnosis to be user friendly are establishment of rapport, a belief that a symptom often has a functional role, and a flexible approach to the hypnosis encounter. This case report of a child with habit cough, illustrates the importance of these elements.

Am J Clin Hypn. 2007 Oct;50(2):171-5. Anbar RD. SUNY Upstate Medical University, Syracuse, NY 13210, USA. anbarr@upstate.edu

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder of unknown aetiology. Current pharmacological treatments have limited value. Hypnotherapy has been reported to have beneficial effects for IBS symptoms. OBJECTIVES: To evaluate the efficacy of hypnotherapy for the treatment of irritable bowel syndrome. SEARCH STRATEGY: Published and unpublished randomised clinical trials and quasi-randomised clinical trials were identified through structured searches of MEDLINE (1966 to March 2006), EMBASE (1980 to March 2006), PsycINFO (1806 to March 2006), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to March 2006), AMED (Allied and Complementary Medicine Database, 1985 to March 2006) and The Cochrane Central Register of Controlled trials. Conference proceedings from Digestive Disease Week (1980 to 2005) were also searched. SELECTION CRITERIA: Eligible studies included all randomised and quasi-randomised clinical studies comparing hypnotherapy for the treatment of irritable bowel syndrome with no treatment or another therapeutic intervention. DATA COLLECTION AND ANALYSIS: All studies were evaluated for eligibility for inclusion. Included studies were assessed for quality and data were extracted independently by four authors. The primary outcome measure of interest was the overall bowel symptom severity score which combines abdominal pain, diarrhoea or constipation and bloating. Secondary outcomes included abdominal pain, diarrhoea, constipation, bloating, quality of life, patient's overall assessment of well-being, psychological measures as per validated questionnaires, and adverse events. MAIN RESULTS: Four studies including a total of 147 patients met the inclusion criteria. Only one study compared hypnotherapy to an alternative therapy (psychotherapy and placebo pill), two studies compared hypnotherapy with waiting-list controls and the final study compared hypnotherapy to usual medical management. Data were not pooled for meta-analysis due to differences in outcome measures and study design. The therapeutic effect of hypnotherapy was found to be superior to that of a waiting list control or usual medical management, for abdominal pain and composite primary IBS symptoms, in the short term in patients who fail standard medical therapy. Harmful side-effects were not reported in any of the trials. However, the results of these studies should be interpreted with caution due to poor methodological quality and small size. AUTHORS' CONCLUSIONS: The quality of the included trials was inadequate to allow any conclusion about the efficacy of hypnotherapy for irritable bowel syndrome. More research with high quality trials is needed.

Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005110. Webb AN, Kukuruzovic RH, Catto-Smith AG, Sawyer SM. Royal Children's Hospital Melbourne, Gastroenterology, Flemington Road, Parkville Victoria 3052, Melbourne, Australia. annette.webb@rch.org.au

Self-management strategies for pain hold substantial promise as a means of reducing pain and improving function among older adults with chronic pain, but their use in this age group has not been well defined. Objective. To review the evidence regarding self-management interventions for pain due to musculoskeletal disorders among older adults. Design. We searched the Medline and Cumulative Index to Nursing and Allied Health Literature databases to identify relevant articles for review and analyzed English-language articles that presented outcome data on pain, function, and/or other relevant endpoints and evaluated programs/strategies that could be feasibly implemented in the community. Abstracted information included study sample characteristics, estimates of treatment effect, and other relevant outcomes when present. Results. Retained articles (N = 27) included those that evaluated programs sponsored by the Arthritis Foundation and other programs/strategies including yoga, massage therapy, Tai Chi, and music therapy. Positive outcomes were found in 96% of the studies. Proportionate change in pain scores ranged from an increase of 18% to a reduction of 85% (median = 23% reduction), whereas change in disability scores ranged from an increase of 2% to a reduction of 70% (median = 19% reduction). Generalizability issues identified included limited enrollment of ethnic minority elders, as well as non-ethnic elders aged 80 and above. Conclusions. Our results suggest that a broad range of self-management programs may provide benefits for older adults with chronic pain. Research is needed to establish the efficacy of the programs in diverse age and ethnic groups of older adults and identify strategies that maximize program reach, retention, and methods to ensure continued use of the strategies over time.

Pain Med. 2008 Mar 11 Reid MC, Papaleontiou M, Ong A, Breckman R, Wethington E, Pillemer K. Department of Medicine, Weill Cornell Medical College, New York, NY, USA.

Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are highly prevalent in childhood. A substantial proportion of patients continues to experience long-lasting symptoms. Gut-directed hypnotherapy (HT) has been shown to be highly effective in the treatment of adult IBS patients. We undertook a randomized controlled trial and compared clinical effectiveness of HT with standard medical therapy (SMT) in children with FAP or IBS. METHODS: Fifty-three pediatric patients, age 8-18 years, with FAP (n = 31) or IBS (n = 22), were randomized to either HT or SMT. Hypnotherapy consisted of 6 sessions over a 3-month period. Patients in the SMT group received standard medical care and 6 sessions of supportive therapy. Pain intensity, pain frequency, and associated symptoms were scored in weekly standardized abdominal pain diaries at baseline, during therapy, and 6 and 12 months after therapy. RESULTS: Pain scores decreased significantly in both groups: from baseline to 1 year follow-up, pain intensity scores decreased in the HT group from 13.5 to 1.3 and in the SMT group from 14.1 to 8.0. Pain frequency scores decreased from 13.5 to 1.1 in the HT group and from 14.4 to 9.3 in the SMT group. Hypnotherapy was highly superior, with a significantly greater reduction in pain scores compared with SMT (P < .001). At 1 year follow-up, successful treatment was accomplished in 85% of the HT group and 25% of the SMT group (P < .001). CONCLUSIONS: Gut-directed HT is highly effective in the treatment of children with longstanding FAP or IBS.

Gastroenterology. 2007 Nov;133(5):1430-6. Epub 2007 Sep 2. Vlieger AM, Menko-Frankenhuis C, Wolfkamp SC, Tromp E, Benninga MA. Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands. a.vlieger@antonius.net

Roger Jahnke, OMD, is a physician of Chinese medicine with more than 30 years of clinical experience. He is an author, lecturer, health futurist, and one of the nation's most revered tai chi and qigong teachers. He is the CEO of Health Action, which trains mind-body teachers through the Institute of Integral Qigong and Tai Chi. He also trains wellness coaches through the Institute of Health and Wellness Coaching. Jahnke has traveled to China eight times to explore energy (qi and prana) at hospitals, temples, and sacred sites and has led many groups abroad to study energy medicine and qigong. His first book, The Healer Within, an acclaimed introduction to the Chinese mind-body energy practice of qigong, has been embraced by the medical mainstream. His second book, The Healing Promise of Qi, is a best-selling classic in its field.

In Experiment 1, 6- and 9-year-old children and adults were asked to imagine various types of objects. The experimenter then attempted to change the image of those objects in participants' minds by either suggesting that the objects may change against the participants' will, or by asking participants to change the objects as a favor to the experimenter. Two types of suggestive causation were employed: Magical-suggestion (a magic spell was cast with the aim of changing the imagined objects) and ordinary-suggestion (participants were told that the objects in their minds could alter against their will). Ordinary-suggestion was as effective as magical-suggestion in changing the participants' imagined objects. For adults, a direct request for compliance produced a stronger effect than did magical suggestion. This effect was not found in children. In Experiment 2, the two types of suggestion were tested on an alternative type of imagined objects. Adult participants were asked to imagine their futures. It was then proposed that (a) a magic spell could be cast on their futures with the aim of changing them either for the worse or for the better (magical-suggestion), or (b) changing a numerical pattern on a computer screen could change their futures (ordinary-suggestion). All participants denied that changing a numerical pattern on a computer screen could affect their lives, yet in their actions they demonstrated an element of belief in this possibility. As in Experiment 1, in Experiment 2 ordinary suggestion was as effective as magical suggestion. The hypothesis of an historic contiguity between magical causality and ordinary suggestion is discussed.

Br J Psychol. 2007 Nov;98(Pt 4):547-74. Subbotsky E. Psychology Department, Lancaster University, Lancaster, UK. e.subbotsky@lancaster.ac.uk

There is well documented evidence for the increasing widespread use of complementary and alternative medicine in the treatment of physical and psychiatric symptoms and disorders within Western populations. Here we provide a review of the recent literature on evidence for using such interventions in the treatment of anxiety and depression. RECENT FINDINGS: With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression. The association of kava with hepatotoxicity, however, is a significant concern. Promising data continue to emerge for the use of omega-3 fatty acids in managing depression. Evidence for the use of acupuncture in treating anxiety disorders is becoming stronger, although there is currently minimal empirical evidence for the use of aromatherapy or mindfulness-based meditation. SUMMARY: The evidence base for the efficacy of the majority of complementary and alternative interventions used to treat anxiety and depression remains poor. Recent systematic reviews all point to a significant lack of methodologically rigorous studies within the field. This lack of evidence does not diminish the popularity of such interventions within the general Western population.

Curr Opin Psychiatry. 2008 Jan;21(1):37-42. van der Watt G, Laugharne J, Janca A. School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.

The present study examines a new alertness training strategy (Self-Alert Training, SAT) designed to explore the relationship between the top-down control processes governing arousal and sustained attention. In order to maximally target frontal control systems SAT combines a previously validated behavioural self-alerting technique [Robertson, I. H., Tegner, R., Tham, K., Lo, A., & Nimmo-Smith, I. (1995). Sustained attention training for unilateral neglect: Theoretical and rehabilitation implications. Journal of Clinical and Experimental Neuropsychology, 17, 416-430] with an autonomic arousal biofeedback protocol in which participants learn to modulate their own arousal levels. The SAT protocol was first validated with a group of 23 neurologically healthy participants and then independently tested in a group of 18 adults with ADHD to determine its clinical utility. Half of the participants in each group were assigned to a placebo condition to control for non-specific effects. All participants performed the sustained attention to response task (SART) during pre- and post-training testing sessions to assess training effects on sustained attention. By the end of SAT all participants were able to modulate their own arousal levels without external prompting. Comparison of pre- and post-training baseline data indicated that, as predicted, SAT was associated with increased levels of autonomic arousal accompanied by improved accuracy on the SART. In contrast, participants in the placebo condition exhibited a gradual reduction in arousal over time and increased reaction time variability indicative of a vigilance decrement. These data demonstrate that the recruitment of top-down control processes during volitional modulation of arousal leads to improved sustained attention. These findings have important implications for the rehabilitation of attention deficits arising from frontal dysfunction.

Neuropsychologia. 2007 Dec 27 O'Connell RG, Bellgrove MA, Dockree PM, Lau A, Fitzgerald M, Robertson IH. School of Psychology and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.

The aim of this study was to conduct a systematic review of the efficacy of music therapy (MT) on pain and anxiety in children undergoing clinical procedures. METHODS: We searched 16 electronic databases of published and unpublished studies, subject bibliographies, reference lists of relevant articles, and trials registries. Two reviewers independently screened 4559 citations and reviewed the full manuscript of 393 studies. Nineteen studies met the inclusion criteria: randomized controlled trial, children aged 1 month to 18 years were examined, music was used as an intervention, and the study measured pain or anxiety. Music therapy was considered active if a music therapist was involved and music was used as a medium for interactive communication. Passive music therapy was defined as listening to music without the involvement of a music therapist. RESULTS: The 19 included trials involved 1513 subjects. The methodological quality of the studies was generally poor. Overall, MT showed a significant reduction in pain and anxiety (standardized mean difference [SMD] -0.35; 95% confidence interval [CI], -0.55 to -0.14; 9 studies; N = 704; I(2) = 42%). When analyzed by outcome, MT significantly reduced anxiety (SMD -0.39; 95% CI, -0.76 to -0.03; 5 studies; n = 284; I(2) = 52.4%) and pain (SMD -0.39; 95% CI, -0.66 to -0.11; 5 studies; N = 465; I(2) = 49.7%). There was no evidence of publication bias. CONCLUSIONS: Music is effective in reducing anxiety and pain in children undergoing medical and dental procedures. Music can be considered an adjunctive therapy in clinical situations that produce pain or anxiety.

Ambul Pediatr. 2008 Mar-Apr;8(2):117-28. Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L. From the Alberta Research Center for Child Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada.

Hypnosis involves the manipulation of conscious attentional discrimination. The prepulse inhibition (PPI) paradigm assesses primary unconscious information processing. We investigated the correlation between hypnotizability and PPI of the startle reflex. Forty-eight healthy subjects were evaluated with the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) and acoustic PPI. Subjects were divided into low, medium, and high hypnotizable groups. The low-hypnotizable group showed a significantly higher inhibition of the startle response, at lead intervals 60 ms and 120 ms, than did the medium- and high-hypnotizable groups. We conclude that hypnotizability and PPI may be negatively correlated. These findings lend further support for the role of dopaminergic neurotransmission mechanisms in the determination of hypnotizability levels.

Int J Neuropsychopharmacol. 2007 Nov 30;:1-5 Lichtenberg P, Even-Or E, Bar G, Levin R, Brin A, Heresco-Levy U. Hadassah Medical School of the Hebrew University of Jerusalem, Israel.

Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.

Am Fam Physician. 2007 Nov 15;76(10):1477-82. Summary for patients in: Am Fam Physician. 2007 Nov 15;76(10):1483-4. Buescher JJ. Clarkson Family Medicine Residency, Omaha, Nebraska 68131, USA. jbuescher@nebraskamed.com

Electroencephalographic (EEG) biofeedback has been employed in substance use disorder (SUD) over the last three decades. The SUD is a complex series of disorders with frequent comorbidities and EEG abnormalities of several types. EEG biofeedback has been employed in conjunction with other therapies and may be useful in enhancing certain outcomes of therapy. Based on published clinical studies and employing efficacy criteria adapted by the Association for Applied Psychophysiology and Biofeedback and the International Society for Neurofeedback and Research, alpha theta training-either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse and combined with residential treatment programs, is probably efficacious. Considerations of further research design taking these factors into account are discussed and descriptions of contemporary research are given.

Appl Psychophysiol Biofeedback. 2008 Mar;33(1):1-28. Sokhadze TM, Cannon RL, Trudeau DL. Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA, tato.sokhadze@louisville.edu.

Acute pain is a common experience for hospitalized children. Despite mounting research on treatments for acute procedure-related pain, it remains inadequately treated. OBJECTIVE: To critically appraise all systematic reviews on the effectiveness of acute procedure-related pain management in hospitalized children. METHODS: Published systematic reviews and meta-analyses on pharmacological and nonpharmacological management of acute procedure-related pain in hospitalized children aged one to 18 years were evaluated. Electronic searches were conducted in the Cochrane Database of Systematic Reviews, Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature and PsycINFO. Two reviewers independently selected articles for review and assessed their quality using a validated seven-point quality assessment measure. Any disagreements were resolved by a third reviewer. RESULTS: Of 1469 published articles on interventions for acute pain in hospitalized children, eight systematic reviews met the inclusion criteria and were included in the analysis. However, only five of these reviews were of high quality. Critical appraisal of pharmacological pain interventions indicated that amethocaine was superior to EMLA (AstraZeneca Canada Inc) for reducing needle pain. Distraction and hypnosis were nonpharmacological interventions effective for management of acute procedure-related pain in hospitalized children. CONCLUSIONS: There is growing evidence of rigorous evaluations of both pharmacological and nonpharmacological strategies for acute procedure-related pain in children; however, the evidence underlying some commonly used strategies is limited. The present review will enable the creation of a future research plan to facilitate clinical decision making and to develop clinical policy for managing acute procedure-related pain in children.

Pain Res Manag. 2008 Jan-Feb;13(1):51-7. Stinson J, Yamada J, Dickson A, Lamba J, Stevens B. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.

Dr. Hyman was Co-Medical Director at Canyon Ranch Lenox, an internationally acclaimed health resort where he combined the best of conventional and alternative medicine with a blend of science, intuition, integrity and compassion. He is the co-author of the recent New York Times bestselling book Ultraprevention, the Six Week Plan that Will Make You Healthy for Life, and winner of the Books for Better Life Award. He is also the author and creator of The Detox Box, A Program for Greater Health and Vitality (Sounds True, 2004). He is Editor in Chief of Alternative Therapies in Health and Medicine, the most prestigious journal in the field of Integrative Medicine.

Dr. Hyman frequently lectures on natural approaches to common health conditions, optimal health, cardiovascular health, menopause and women's health, brain wellness, obesity and weight loss, optimal aging and longevity medicine. His appearances on television include the Today Show, CBS's The Early Show, The View with Barbara Walters and CNN, PBS, and he was recently featured on the PBS television special Get a Life. He has been heard on NPR and many other radio programs, and is quoted regularly in popular magazines including Natural Health, Health, Self, Town & Country, Elle, Fitness, Glamour, Shape and Family Circle.

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Somatosensory event-related potentials (SERPs) to painful electric standard stimuli under an odd-ball paradigm were analyzed in 12 high hypnotizable (HH), 12 medium hypnotizable (MH), and 12 low hypnotizable (LH) subjects during waking, hypnosis, and a cued eyes-open posthypnotic condition. In each of these conditions subjects were suggested to produce an obstructive imagery of stimulus perception as a treatment for pain reduction. A No-Analgesia treatment served as a control in waking and hypnosis conditions. The subjects were required to count the number of delivered target stimuli. HH subjects experienced significant pain and distress reductions during posthypnotic analgesia as compared to hypnotic analgesia and between these two analgesic conditions as compared to the two control conditions. Outside of hypnosis, these subjects remembered less pain and distress levels than they reported during hypnotic and posthypnotic analgesia treatments. In contrast, for waking-analgesia treatment, HH subjects remembered similar pain and distress levels to those they reported concurrently with the stimulation. HH subjects, during hypnotic and posthypnotic analgesia treatments, detected a smaller number of target stimuli and displayed a significant amplitude reduction of the midline frontal and central N140 and P200 SERP components. No significant SERP differences were observed for these subjects between treatments in waking condition and between hypnotic and posthypnotic analgesic treatments. For the MH and LH subjects no significant N140 and P200 amplitude changes were observed among analgesic conditions as compared to control conditions. These amplitude findings are seen as indicating that hypnotic analgesia can affect earlier and later stages of stimulus processing.

Pain. 2008 Jan;134(1-2):197-208. De Pascalis V, Cacace I, Massicolle F. University of Rome "La sapienza", Department of Psychology, Via dei Marsi 78, 00185 Rome, Italy. v.depascalis@caspur.it

A defensive dominant was created in rabbits using rhythmic electrocutaneous stimulation of the left forelimb at a frequency of 0.5 Hz. After stimulation ended, the latent excitation state was tested using sound stimuli. Animals responded either with increases in non-rhythmic paw muscle activity or with rhythmic twitching of the paw at a frequency close to that of the electrocutaneous stimulation. After hypnotization, the incidence of rhythmic responses to the stimulation testing the dominant focus increased, while the incidence of non-rhythmic responses decreased.

Neurosci Behav Physiol. 2008 Jan;38(1):23-30. Galashina AG, Kulikov MA, Bogdanov AV. Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, bogdav@mail.ru.

Mention the possibility of surgery to a patient and most will react with a feeling of apprehension at best. Some will be horrified at the mere thought of being 'cut open'. For others, it will be the suggestion of entering a hospital for anything longer than an out patient appointment. Newspaper reports of healthcare-acquired infections (HAIs) may spring to mind: 'Will I leave with more than I came in for?'; 'What if it goes wrong?'; 'Who will look after the family?'. All this worrying leads to increased anxiety and stress, and the patient has not even been put on the waiting list yet, let alone been admitted.

J Perioper Pract. 2008 Jan;18(1):14-6. Fern PA. Day Surgery Unit, Royal Wolverhampton NHS Trust.

Joyce Hawkes is a biophysicist and cell-biologist by training. She completed her doctorate in biophysics at Pennsylvania State University, and was a postdoctoral fellow with the National Institutes of Health before settling in Seattle to work in research for the National Marine Fisheries Research Center, a part of the National Oceanic and Atmospheric Administration. While there, she was honored with a National Achievement Award for her work.

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To provide an understanding of Hong Kong registered nurses' personal and professional use of complementary and alternative medicine. DESIGN. Cross-sectional questionnaire study. PARTICIPANTS. Registered nurses who were members of the Hong Kong College of Nursing were invited to participate. MAIN OUTCOME MEASURES. Demographic data of the respondents, prevalence of personal and professional use of complementary and alternative medicines, including their use for detailed clinical conditions. RESULTS. A total of 187 nurses participated in this study. Nearly four fifths (80%; 95% confidence interval, 74-86%) of the participants had used at least one form of complementary/alternative medicine. In addition to the personal use of such treatment, over two fifths (41%; 95% confidence interval, 34-48%) had recommended at least one form of complementary/alternative medicine to their patients. These included bone-setting (20%), Chinese remedial massage (tuina, 19%), and meditation (19%). Specifically, registered nurses recommended acupuncture or acupressure to patients with musculoskeletal disorders, chronic pain, or headaches/migraines. CONCLUSIONS. Personal use and professional recommendations for complementary and alternative medicine by registered nurses in Hong Kong is substantial. Registered nurses played an active role in advising such treatment for their patients based on their personal knowledge of perceived benefit in specific conditions. Further investigations with a larger sample size should focus on registered nurses' educational needs in respect of complementary and alternative medicine and the advice they recommended.

Hong Kong Med J. 2008 Apr;14(2):110-5. Xue CC, Zhang AL, Holroyd E, Suen LK. Division of Chinese Medicine, School of Health Sciences, The WHO Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, Australia.

Data supporting the effectiveness of nonpharmacologic psychocutaneous techniques continues to accumulate. These interventions are used for the treatment of common and psychocutaneous skin conditions. They are most commonly used as adjuncts to traditional therapies. This article will review the data on the effectiveness of hypnosis, biofeedback, psychotherapy, meditation, support groups, guided imagery and progressive muscle relaxation, and psychotherapy. Data supporting the effectiveness of nonpharmacologic psychocutaneous techniques continues to accumulate. These interventions are used for the treatment of common and psychocutaneous skin conditions. They are most commonly used as adjuncts to traditional therapies. This article will review the data on the effectiveness of hypnosis, biofeedback, psychotherapy, meditation, support groups, guided imagery and progressive muscle relaxation, and psychotherapy.

Dermatol Ther. 2008 Jan-Feb;21(1):60-8. Fried RG, Hussain SH. Yardley Dermatology and Yardley Skin Enhancement and Wellness Center, Yardley, Pennsylvania, USA. dermshrink@aol.com

Kenneth V. Hardy, Ph.D. is a professor in the department of the Marriage and Family Therapy at Syracuse University and a senior faculty at the Ackerman Institute for the Family. Dr. Hardy is internationally known for his work in the area of family therapy and diversity. He is the author of numerous publications devoted to working effectively with diverse and oppressed families. Dr. Hardy, a former recipient of the prestigious Teacher/Scholar of the Year award at Syracuse University, also maintains a private practice specializing in family therapy with oppressed populations.

This case report describes an effort to control two primary side-effects of breast cancer radiotherapy (fatigue and skin discomfort) that used a combination of cognitive-behavioral therapy with hypnosis (CBTH). Two patients, matched on demographic and medical variables (marital status, employment status, number of children, cancer diagnosis, surgical history, radiation dose), were compared: one who received a CBTH intervention and one who received standard care. Results were consistent with the view that CBTH was effective in managing fatigue and skin discomfort, and increasing relaxation.

Am J Clin Hypn. 2008 Jan;50(3):209-15. Schnur JB, Montgomery GH. Department of Oncological Sciences, Box 1130 Mount Sinai School of Medicine, 1425 Madison Avenue, New York, NY 10029-6574, USA. julie.schnur@mssm.edu

The rapid pace of life, eating habits, and environmental pollution have increased stress levels and its related disorders. The complex molecular response to stress is mediated by stress genes and a variety of regulatory pathways. Oxidative stress is internal damage caused by reactive oxygen species. Increasing evidence suggests that chronic psychosocial stress may increase oxidative stress, which in turn may contribute to aging, and etiology of coronary diseases, cancer, arthritis, etc. Psychophysiological concomitants of meditation have been extensively researched, but there are very little data available on biochemical activity leading to relieving stress by causing a relaxation response by Sudarshan Kriya (SK). SK is a breathing technique that involves breathing in three different rhythms. It is preceded by Ujjayi Pranayam (long and deep breaths with constriction at the base of throat) and Bhastrika (fast and forceful breaths through nose along with arm movements). METHODS: Forty-two SK practitioners and 42 normal healthy controls were recruited for our study. The practitioners had practiced SK for at least 1 year. Selected normal healthy controls did not perform any conventional physical exercise or any formal stress management technique. Whole blood was used for glutathione peroxidase estimation and red blood cell lysate was used for superoxide dismutase activity assay and for glutathione estimation. White blood cells were isolated from fresh blood and assayed for gene expression using reverse transcriptase-polymerase chain reaction. The parameters studied are antioxidant enzymes, genes involved in oxidative stress, DNA damage, cell cycle control, aging, and apoptosis. RESULTS: A better antioxidant status both at the enzyme activity and RNA level was seen in SK practitioners. This was accompanied by better stress regulation and better immune status due to prolonged life span of lymphocytes by up-regulation of antiapoptotic genes and prosurvival genes in these subjects. CONCLUSIONS: Our pilot study provides the first evidence suggesting that SK practice may exert effects on immunity, aging, cell death, and stress regulation through transcriptional regulation.

J Psychosom Res. 2008 Feb;64(2):213-8. Sharma H, Datta P, Singh A, Sen S, Bhardwaj NK, Kochupillai V, Singh N. Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Therapeutic Touch (TT) is a complementary healing modality used by health care providers to reduce anxiety, accelerate relaxation, decrease pain, and enhance immunity. Research studies report outcomes of TT treatments, but few describe the specific process. This qualitative research study was conducted to describe the nature of the core process of TT in adults and full term infants as practiced by five professional nurses, each treating one adult and one infant. Analysis of data obtained from interviews and focused participant observations was conducted. Findings provide empirical data to depict an overall process divided into three phases: (a) preparation, (b) treatment, and (c) termination, that adheres to the standard process as described by Krieger. It expands on the description of each phase, including two new subcomponents, orienting and disengagement, not previously seen in the literature. Lastly, the study describes the modification of the TT process with infants compared to adults.

J Holist Nurs. 2008 Mar;26(1):17-24. Coppa D. University of Rhode Island.

I portray health-related research outcomes in an arts-informed representation that disrupts the traditional discursive-scholarly format of journal writing to privilege better the participants' accounts and communicate these experientially. The representation uncovers meaning through alternative ways of communicating and conveys the ineffable quality of music in a manner that may be understood through and beyond words. This expands the convention of health-related research outcomes, including ways of knowing, what can be known and how this can be represented. I elaborate my intentions for this experiential report, discuss theoretical underpinnings of this methodology and describe a music therapy support group model.

J Health Psychol. 2008 Mar;13(2):190-200. Rykov MH. PO Box 142, Station C, Toronto, Ontario, M6J 3M9, Canada. info@musictherapyservices.org.

Hypnosis is attempting to come to grips with the EST (Empirically Supported Therapy) revolution in mental health practice. However, there are ways to account for outcome outside of simple empirical validation of treatment models. In this light, strategic eclecticism as a broader research-based consideration is used to illustrate empirical principles within Eriksonian hypnotherapeutic approaches.

Am J Clin Hypn. 2008 Jan;50(3):233-45. Amundson JK, Nuttgens SA. Amundson & Associates, 1614 8th Avenue NW, Calgary. aapsych@telus.net

The purpose of this study was to determine whether an Ericksonian approach to therapy using hypnosis (ET) was as effective as brief dynamic therapy (BDT), a long-standing and well-researched form of psychotherapy. The study used a comparative pretest/posttest design with four paper and pencil tests [Clark Personal and Social Adjustment Scale (CPSAS), Hopkins Symptom Checklist (HSCL), Target Complaint (TC), and Global Improvement (GI)] and six therapy sessions. The investigators attempted to choose design features that would not interfere with the unique qualities of ET while maintaining empirical regularity. No statistically significant difference was found except on HSCL where ET was superior. An interesting finding was that without direct discussion of the target complaint, ET brought about the same improvement on targeted problems as BDT. ET subjects reported gaining understanding of their problems as much as BDT subjects, but from a different source. The results of this study are a step toward empirical confirmation of ET as an evidence-based treatment alternative for psychotherapy.

Am J Clin Hypn. 2008 Jan;50(3):217-32. Simpkins CA, Simpkins AM. AMCAS123@aol.com

This research is based on previous studies which identified a specific respiratory pattern and inhalation-exhalation ratio, with which we were able to obtain significantly greater reductions in psychophysiological activation than with other respiratory patterns. The present study aimed to check the effectiveness of this respiratory pattern in learning based on biofeedback from the electrical conductance of the skin. The results obtained demonstrated that biofeedback combined with this respiratory pattern produced a significant reduction in psychophysiological activation and improved learning through biofeedback techniques.

Appl Psychophysiol Biofeedback. 2008 Mar;33(1):49-54. Conde Pastor M, Javier Menéndez F, Sanz MT, Vila Abad E. Department of Basic Psychology II, Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), C/ Juan del Rosal, 10, 28040, Madrid, Spain, mconde@psi.uned.es.

The relationship between metaphor and the practice of utilization in therapy and hypnosis can be seen as dependent on metaphor's role in structuring experience. The work of Gregory Bateson and others is used to illustrate how metaphor functions. Bateson's comparison of two forms of syllogistic logic provides a background for distinguishing between the experiential effects of metaphor in contrast to the categorical thinking inherent in simile and analogy. Clinical examples are given to demonstrate how utilization is structured by metaphor, particularly as Bateson has described it in his analysis of the Syllogism in Grass.

Am J Clin Hypn. 2008 Jan;50(3):247-57. Roffman AE. New York University, Child Study Center, 577 First Avenue, New York, NY 10016, USA. roffma01@med.nyu.edu

Since 1980 Dr. Grossman has helped many people maintain healthy vision and even improve eyesight. He is best described as a Developmental/Behavioral Optometrist, dedicated to helping people with such conditions ranging from myopia and dry eyes to potentially vision threatening diseases as macular degeneration and glaucoma. His combined multi-disciplinary approach using nutrition, eye exercises, lifestyle changes and Chinese Medicine provides him with a wide array of tools and approaches to tackle difficult eye problems.

Dr. Grossman founded the Rye Learning Center in 1980, a multidisciplinary center for learning problems, and more recently in 1996 co-founded Integral Health Associates in New Paltz, New York.

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In an earlier meta-analysis of 12 studies using hypnosis-based treatments for smoking cessation, we provided preliminary evidence that males fare better than females when trying to quit smoking (Green, Lynn, & Montgomery, 2006). By excluding studies that reported no gender differences, but failed to report final outcome-statistics-by-gender, our previous conclusion may have overestimated the role of gender in hypnosis-based smoking cessation treatment. In the present analysis, we included 12 additional studies that reported no gender differences, but failed to report final outcome-by-gender statistics. Across each of these studies, we calculated identical success rates for male and female participants and then added these results to our database. Among all 24 groups of participants who completed hypnosis-based treatment for smoking, we found a small but significant effect for male participants being more successful in quitting smoking relative to females. Specific suggestions for tailoring hypnosis smoking cessation programs to take gender differences into account are discussed.

Am J Clin Hypn. 2008 Jan;50(3):259-71. Green JP, Lynn SJ, Montgomery GH. The Ohio State University, 4240 Campus Drive Lima, OH 45804, USA. green.301@osu.edu

Systemic contact dermatitis from nickel has been reported from a number of sources including medical devices and following experimental oral exposure. OBJECTIVE: To identify other potential sources of systemic nickel exposure. METHODS: The internet and published medical literature were searched for complementary and alternative remedies which contain nickel. RESULTS: We identified and evaluated sources of nickel exposure in 4 homeopathic preparations, which are advertised to treat common skin diseases, as well as in a number of other homeopathic remedies, several herbal products and multivitamin mineral complexes. CONCLUSION: Complementary and alternative remedies are an additional source of systemic nickel exposure and at highest doses the potential risk for systemic contact dermatitis in nickel allergic patients should be considered.

Contact Dermatitis. 2008 Feb;58(2):97-100. de Medeiros LM, Fransway AF, Taylor JS, Wyman M, Janes J, Fowler JF Jr, Rietschel RL. Section of Industrial Dermatology, Department of Dermatology (A-61), Cleveland Clinic, Cleveland, OH 44195, USA.

The development of studies on neuroimaging applied to hypnosis and to the study of pain not only helps to validate the existence of a hypnotic state but also to ratify its therapeutic effects. These studies also enable us to understand how hypnosis is effective on the cortical level. It also helps us see, from another perspective, the mechanisms of pain leading perhaps to a different definition of pain. This article develops the latest knowledge in the domain of hypnosis and pain, and approaches the clinical practices and their applications in the management of pain in children.

J Pain Symptom Manage. 2008 Feb 1 Wood C, Bioy A. Pain Unit (C.W.), Robert Debré Hospital, Paris; and Pain Unit (A.B.), Kremlin Bicêtre Hospital, Le Kremlin Bicêtre, and Laboratory of Psychopathology and Medical Psychology, Bourgogne University, Dijon, France.

The purpose of this study was to describe the use of hypnotic suggestion as a means of precipitating nonepileptic events in children while they are undergoing video electroencephalographic monitoring (VEEG) for differential diagnosis of seizurelike behavior. METHODS: Nine children aged 8-16 years were referred for VEEG to differentiate between epileptic seizures and nonepileptic events. All subjects underwent psychiatric consultation. Hypnosis was attempted in all subjects to try to provoke typical seizurelike events. RESULTS: In eight of nine patients, their typical seizurelike events were provoked by hypnosis. In all eight children, video and EEG analysis of the provoked events demonstrated them to be nonepileptic. No epileptiform abnormalities were present on interictal EEGs. No epileptic seizures occurred. CONCLUSION: Hypnosis is a useful and ethical means of provoking psychogenic nonepileptic events in children. Hypnotic suggestion should be considered as a provocative method when possibly psychogenic nonepileptic events have not occurred spontaneously during diagnostic evaluation.

Epilepsy Behav. 2008 Jan 11 Olson DM, Howard N, Shaw RJ. Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.

Amit Goswami, Ph. D. is professor emeritus in the physics department of the University of Oregon, Eugene, Oregon where he has served since 1968. He is a pioneer of the new paradigm of science called science within consciousness.

Goswami is the author of the highly successful textbook Quantum Mechanics. His two volume textbook for nonscientists The Physicist's View of Nature traces the decline and rediscovery of the concept of God within science.

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Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. METHODS: Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures. RESULTS: Groups did not differ in terms of the following: demographics (age, education, ethnicity, marital status, all P's > 0.28); medical variables (presurgery diagnosis, previous excisional biopsy, previous breast cancer, all P's > 0.11); or preintervention distress (SV-POMS P > 0.74) assessed on the day of surgery. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. CONCLUSIONS: The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

Anesth Analg. 2008 Feb;106(2):440-4, table of contents. Schnur JB, Bovbjerg DH, David D, Tatrow K, Goldfarb AB, Silverstein JH, Weltz CR, Montgomery GH. Department of Oncological Sciences, Box 1130, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York City, NY 10029-6574, USA. julie.schnur@mssm.edu

A total of 52 pharmacologically untreated subjects with essential hypertension were randomly allocated to either 8 weeks of contemplative meditation combined with breathing techniques (CMBT) or no intervention in this observer-blind controlled pilot trial. CMBT induced clinically relevant and consistent decreases in heart rate, systolic and diastolic blood pressure if measured during office readings, 24-h ambulatory monitoring and mental stress test. Longer-term studies should evaluate CMBT as an antihypertensive strategy.

J Hum Hypertens. 2008 Feb;22(2):138-40. Manikonda JP, Störk S, Tögel S, Lobmüller A, Grünberg I, Bedel S, Schardt F, Angermann CE, Jahns R, Voelker W.

The effects of alpha-neurofeedback (ANF) on electroencephalographic alpha-activity were investigated. Each session consisted of a 2.5-min eye-opened state and 17.5-min of ANF, which was divided into 16 1.25-min bins. Alpha amplitudes were gradually increased as the session was repeated. The maximum value at the start of ANF gradually decreased as time passed, but the slowdown of alpha-activity during each session was decreased as the session was repeated. The correlation between alpha-activity at the end of ANF and at the following session's eye-opened state was highly significant. These results showed that ANF enhances the ability of alpha-activity to maintain itself rather than the increase of alpha-amplitude during intrasession and that the maintained alpha-activity during former training remained until the next session.

Neuroreport. 2008 Feb 12;19(3):315-7. Cho MK, Jang HS, Jeong SH, Jang IS, Choi BJ, Lee MG. Department of Pharmacology, Kyungpook National University, Daegu, Republic of Korea.

Migraine is very common in school-aged children, but despite a number of pharmacological and non-pharmacological options for prophylaxis, randomized controlled evidence in children is small. Evidence-based prophylactic drugs may have considerable side effects. OBJECTIVE: This study was to assess efficacy of a butterbur root extract (Petadolex) and music therapy in primary school children with migraine. DESIGN: Prospective, randomized, partly double-blind, placebo-controlled, parallel-group trial. METHODS: Following a 8-week baseline patients were randomized and received either butterbur root extract (n=19), music therapy (n=20) or placebo (n=19) over 12 weeks. All participants received additionally headache education ("treatment as usual") from the baseline onwards. Reduction of headache frequency after treatment (8-week post-treatment) as well as 6 months later (8-week follow-up) was the efficacy variable. RESULTS: Data analysis of subjects completing the respective study phase showed that during post-treatment, only music therapy was superior to placebo (p=0.005), whereas in the follow-up period both music therapy and butterbur root extract were superior to placebo (p=0.018 and p=0.044, respectively). All groups showed a substantial reduction of attack frequency already during baseline. CONCLUSION: Butterbur root extract and music therapy might be superior to placebo and may represent promising treatment approaches in the prophylaxis of paediatric migraine.

Eur J Pain. 2008 Apr;12(3):301-13. Epub 2007 Jul 30. Oelkers-Ax R, Leins A, Parzer P, Hillecke T, Bolay HV, Fischer J, Bender S, Hermanns U, Resch F. Department of Child and Adolescent Psychiatry, University of Heidelberg, Blumenstrasse 8, D-69115 Heidelberg, Germany. rieke_oelkers@med.uni-heidelberg.de