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MARK P. JENSEN ET AL.
patients who receive treatment less often, then this would provide an
incentive for scheduling treatment accordingly. Finally, if hypnotic
analgesia is not found to be particularly effective for a specific diagnostic
group or etiology (for example, in patients with SCI for whom effective
pain treatments have been particularly difficult to identify), then those
patients might be spared the time and cost of a low probability treatment.
Another unanswered question concerns the effects of hypnotic anal-
gesia on outcome domains other than pain severity. For the most part,
treatment-outcome measures in hypnosis clinical trials have been lim-
ited to assessment of pain intensity or severity (e.g., Crasilneck, 1995;
Lewis, 1992; Spinhoven & ter Kuile, 2000; ter Kuile et al., 1995), despite
the fact that pain is recognized as a multidimensional biopsychosocial
phenomenon (Chapman & Okifuji, 2004). As an example, pain includes
affective components and may also be associated with a number of
negative outcomes, such as depression (Gallagher, Rollin, & Verma,
2004; Romano & Turner, 1985), anxiety (Gallagher et al., 2004), sleep
disturbance, and both physical and psychosocial dysfunction (Chapman
& Okifuji, 2004; Gallagher et al., 2004).
In one of the rare studies to assess other outcomes in addition to
measures of pain, James et al. (1989) reported on the effects of hypnotic
analgesia on measures of general-health with a locus of control and a
self-concept of physical illness. They found that hypnosis treatment
influenced both of these outcome domains in addition to pain severity.
Similarly, Jensen and Barber (2000) reported the positive effects of
hypnotic-analgesia treatment on sleep interference in addition to pain
severity in their case study of patients with SCI and chronic pain.
Although pain severity is probably the most appropriate primary out-
come measure, there remains a need to better understand the effects of
hypnotic analgesia on other important outcome domains.
The purpose of the current case series is to examine the efficacy of
hypnotic analgesia and to explore predictors of response to hypnotic
treatment in persons with chronic pain and disability. The primary ques-
tion that we sought to address was: What changes in pain intensity occur
following 10 sessions of hypnotic analgesia in a sample of patients with
chronic pain and a physical disability who were not selected based on
their level of general hypnotizability? Two secondary study questions
were: (a) what changes in other domains of pain (unpleasantness, inter-
ference, depressive symptoms, and perceived control) follow hypnotic-
analgesia treatment; and (b) to what extent do general hypnotizability,
treatment-outcome expectancies, initial response to treatment, concentra-
tion of treatment, and patient diagnosis predict treatment outcome? These
questions were addressed in a case series of standardized hypnotic-
analgesia treatment provided to a sample of patients with chronic pain
and a variety of physical disabilities, including SCI, acquired amputation,
MS, NMD (specifically, Charcot-Marie-Tooth disease), CP, and PPS.