Article

Hypnosis for Irritable Bowel Syndrome: The Empirical Evidence of Therapeutic Effects

University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
International Journal of Clinical and Experimental Hypnosis (Impact Factor: 1.38). 02/2006; 54(1):7-20. DOI: 10.1080/00207140500328708
Source: PubMed

ABSTRACT Irritable bowel syndrome (IBS) is a complex and prevalent functional gastrointestinal disorder that is treated with limited effectiveness by standard medical care. Hypnosis treatment is, along with cognitive-behavioral therapy, the psychological therapy best researched as an intervention for IBS. Eleven studies, including 5 controlled studies, have assessed the therapeutic effects of hypnosis for IBS. Although this literature has significant limitations, such as small sample sizes and lack of parallel comparisons with other treatments, this body of research consistently shows hypnosis to have a substantial therapeutic impact on IBS, even for patients unresponsive to standard medical interventions. The median response rate to hypnosis treatment is 87%, bowel symptoms can generally be expected to improve by about half, psychological symptoms and life functioning improve after treatment, and therapeutic gains are well maintained for most patients for years after the end of treatment.

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    • "Within psychological therapies for IBS, cognitive therapy, cognitive behavioral therapy, relaxation, psychodynamic, mindfulness and gut-directed hypnosis models have all been examined [12] [13] [14] [15]. While there is reported efficacy for each of these approaches, psychological treatments which have the same treatment labels (e.g. "
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    ABSTRACT: - Objectives Psychological interventions can alleviate the symptoms of irritable bowel syndrome (IBS) and psychological distress commonly reported among IBS sufferers. However, the theoretical underpinnings and intervention techniques used by such interventions vary considerably. This study aimed to identify which theoretical approaches and techniques lead to greater improvements in IBS symptoms and psychological well-being within psychological interventions for IBS. Methods Outcome data were extracted from 48 randomized controlled trials testing psychological treatments for IBS. Theoretical intervention targets and intervention techniques of each study were identified. Cumulative effect sizes were calculated for pain, bowel dysfunction, composite symptom scores, psychological distress, and health-related quality of life. Comparative analyses contrasted the effect sizes of studies which included each intervention technique to those which did not. Results Cumulatively, interventions significantly improved all outcomes, with effect sizes (Hedges' g) ranging from 0.32 to 0.64. Interventions which stated a theoretical intervention target, prompted self-monitoring of symptoms and cognitions, provided tailored feedback linking symptoms and cognitions, utilized problem solving or assertiveness training and provided general support had greater effects upon symptom and well-being outcomes than interventions which did not (all P < .05). Across all studies, improvements in psychological distress were associated with improvements in composite symptom scores (P < .01). Conclusions This study identifies a set of techniques associated with improvements in IBS symptoms and psychological well-being in existing interventions, and provides initial evidence for the link between improvements in psychological distress and IBS composite symptom scores. These findings can aid the development and refinement of psychological treatments for IBS.
    Journal of Psychosomatic Research 12/2014; 78(3). DOI:10.1016/j.jpsychores.2014.12.009 · 2.84 Impact Factor
    • "Hypnosis can be used as an adjunct treatment for pain (Montgomery et al., 2002), depression (Alladin and Alibhai, 2007), weight loss (Kirsch et al., 1995, 1996), irritable bowel syndrome (Whitehead, 2006; Wilson et al., 2006), and it can also be used to study psychological phenomena (Szechtman et al., 1998; Barnier, 2002; Egner et al., 2005; O&apos;Connor et al., 2008). It is not effective for everyone, however, and certain individuals appear to respond favourably to hypnosis and hypnotic suggestions while others are unaffected (Kirsch and Braffman, 2001). "
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    ABSTRACT: This study explores whether self-reported depth of hypnosis and hypnotic suggestibility are associated with individual differences in neuroanatomy and/or levels of functional connectivity. Twenty-nine people varying in suggestibility were recruited and underwent structural, and after a hypnotic induction, functional magnetic resonance imaging at rest. We used voxel-based morphometry to assess the correlation of grey matter (GM) and white matter (WM) against the independent variables: depth of hypnosis, level of relaxation and hypnotic suggestibility. Functional networks identified with independent components analysis were regressed with the independent variables. Hypnotic depth ratings were positively correlated with GM volume in the frontal cortex and the anterior cingulate cortex (ACC). Hypnotic suggestibility was positively correlated with GM volume in the left temporal-occipital cortex. Relaxation ratings did not correlate significantly with GM volume and none of the independent variables correlated with regional WM volume measures. Self-reported deeper levels of hypnosis were associated with less connectivity within the anterior default mode network. Taken together, the results suggest that the greater GM volume in the medial frontal cortex and ACC, and lower connectivity in the DMN during hypnosis facilitate experiences of greater hypnotic depth. The patterns of results suggest that hypnotic depth and hypnotic suggestibility should not be considered synonyms. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research: Neuroimaging 12/2014; 231(2). DOI:10.1016/j.pscychresns.2014.11.015 · 2.83 Impact Factor
    • "Within psychological therapies for IBS, cognitive therapy, cognitive behavioral therapy, relaxation, psychodynamic, mindfulness and gutdirected hypnosis models have all been examined [12] [13] [14] [15]. While there is reported efficacy for each of these approaches, psychological treatments which have the same treatment labels (e.g. "
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    ABSTRACT: Background: Psychological interventions have been shown to alleviate symptoms of irritable bowel syndrome (IBS). This study aimed to identify effective theoretical approaches and techniques used in such treatments. Methods: 39 randomized controlled trials testing face-to-face non-pharmacological treatments for IBS were assessed for their use of theory and intervention techniques using existing taxonomies. Findings: Overall, interventions had significant cumulative effects upon pain (g¼0.42), bowel dysfunction (g¼0.42), composite symptom scores (g¼0.57), psychological distress (g¼0.33), visceral sensitivity (g¼0.65), and quality of life (g¼0.48). Interventions which targeted theoretical (cognitive) predictors of outcomes, included more treatment sessions, linked symptom monitoring to monitoring of cognitions or stress, or provided tailored feedback or assertiveness training had greater effects upon outcomes than interventions which did not (p<0.05). Discussion: These findings provide evidence for the link between cognitive changes and symptom improvement in IBS patients, and can be used to inform development of future interventions targeting IBS symptoms.
    European Health Psychology Society; 08/2012
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