David R Patterson

David R Patterson
University of Washington Seattle | UW · Department of Rehabilitation Medicine

About

224
Publications
36,748
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
10,952
Citations
Introduction

Publications

Publications (224)
Article
Although strong evidence exists for using individual hypnosis to treat pain, evidence regarding group applications is limited. This project evaluated changes in multiple outcome measures in persons with chronic pain treated with 8 weeks of group hypnosis. Eighty-five adults with diverse chronic pain etiologies completed an 8-session, structured gro...
Article
This randomized, controlled trial tested the impact that hypnosis delivered through immersive virtual reality technology on background pain, anxiety, opioid use, and hospital length of stay in a sample of patients hospitalized for trauma. Participants were randomly assigned to receive either virtual-reality-induced hypnosis, virtual reality for dis...
Article
Purpose Non-pharmacologic adjuncts to opioid analgesics for burn wound debridement enhance safety and cost effectiveness in care. The current study explored the feasibility of using a custom portable water-friendly immersive VR hardware during burn debridement in adults, and tested whether interactive VR would reduce pain more effectively than natu...
Article
Effective, rigorously evaluated nonpharmacological treatments for chronic pain are needed. This study compared the effectiveness of training in hypnosis (HYP) and mindfulness meditation (MM) to an active education control (ED). Veterans (N=328) were randomly assigned to 8 manualized, group-based, in-person sessions of HYP (n = 110), MM (n = 108), o...
Article
Excessive pain during medical procedures is a pervasive health challenge. This study tested the (additive) analgesic efficacy of combining hypnotic analgesia and virtual reality (VR) pain distraction. A single blind, randomized, and controlled trial was used to study 205 undergraduate volunteers aged 18 to 20. The individual and combined effects of...
Article
Full-text available
Immersive virtual reality is proving effective as a non-pharmacologic analgesic for a growing number of painful medical procedures. External fixator surgical pins provide adjunctive stability to a broken pelvic bone until the bones heal back together, then pins are removed. The purpose of the present case study was to measure for the first time, wh...
Article
Full-text available
The objective of this study was to compare the effect of adjunctive virtual reality vs. standard analgesic pain medications during burn wound cleaning/debridement. Participants were predominantly Hispanic children aged 6–17 years of age, with large severe burn injuries (TBSA = 44%) reporting moderate or higher baseline pain during burn wound care....
Article
Chronic pain is a significant health problem worldwide with limited pharmacological treatment options. This study evaluated the relative efficacy of four treatment sessions each of four non-pharmacological treatments: (1) hypnotic cognitive therapy (using hypnosis to alter the meaning of pain); (2) standard cognitive therapy; (3) hypnosis focused o...
Chapter
Excessive pain during medical procedures is a widespread problem. Severe pain is especially problematic for severe burn patients who often endure dozens of wound cleanings/debridements and dozens of physical therapy sessions over a period of weeks or months after their initial injury. Pain medications help substantially, but are typically inadequat...
Article
Full-text available
Background/Aim: Using a within-subjects, within-wound care design, this pilot study tested for the first time, whether immersive virtual reality (VR) can serve as an adjunctive non-opioid analgesic for children with large severe burn wounds during burn wound cleaning in the ICU, in a regional burn center in the United States, between 2014–2016. Met...
Article
Full-text available
Background: Venipuncture is described by children as one of the most painful and frightening medical procedures.Objective: To evaluate the effectiveness of Virtual Reality (VR) as a distraction technique to help control pain in children and adolescents undergoing venipuncture.Methods: Using a within-subjects design, fifteen patients (mean age 10.92...
Article
Background Nearly 2.8 million people are hospitalized in the USA annually for traumatic injuries, which include orthopedic and internal organ injuries. Early post-injury pain is predictive of poor outcomes, including inability to eventually return to work, and long-term psychological distress. The goal of the present study was to improve our scient...
Article
Objective: We conducted a randomized controlled study to determine the effects of virtual reality (VR) distraction on pain and range of motion (ROM) in patients hospitalized for burn care during active physical therapy exercises. Method: Thirty-nine participants aged 15 to 66 (M = 36) years with significant burn injuries (mean burn size = 14% TB...
Article
Mindfulness-based interventions and hypnosis are efficacious treatments for addressing a large number of psychological and physical conditions, including chronic pain. However, there continues to be debate surrounding the relative uniqueness of the theorized mechanisms of these treatments—reflected by measures of mindfulness facets and hypnotizabil...
Article
Objective: Immersive virtual reality (VR) distraction provides clinically effective pain relief and increases subjective reports of "fun" in medical settings of procedural pain. The goal of this study was to better describe the variable of "fun" associated with VR distraction analgesia using the circumplex model (pleasure/arousal) of affect. Mate...
Article
This protocol has been withdrawn due to the author team being unavailable to complete the full review.
Article
Abstract For daily burn wound care and therapeutic physical therapy skin stretching procedures, powerful pain medications alone are often inadequate. This feasibility study provides the first evidence that entering an immersive virtual environment using very inexpensive (∼$400) wide field of view Oculus Rift Virtual Reality (VR) goggles can elicit...
Article
The empirical support for hypnosis for chronic pain management has flourished over the past two decades. Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain contr...
Article
The current study explored whether immersive virtual reality (VR) continues to reduce pain (via distraction) during more than one wound care session per patient. Thirty-six patients aged 8 to 57 years (mean age, 27.7 years), with an average of 8.4% TBSA burned (range, 0.25-25.5 TBSA) received bandage changes, and wound cleaning. Each patient receiv...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the efficacy of clinical hypnosis, relative to no treatment, other viable psychological pain treatments (e.g., relaxation, neurofeedback, cognitive therapy), and experimental conditions that are thought to have minimal effects on outcome but that...
Article
Objective: Repetitive transcranial magnetic stimulation (rTMS) has been shown to effectively treat depression, and its potential value in pain management is emphasized by recent studies. Transcranial magnetic stimulation (TMS)-evoked activity in the prefrontal cortex may be associated with corticolimbic inhibitory circuits capable of decreasing pa...
Article
Addresses the physical and psychological needs of individuals who require burn injury rehabilitation. The literature on the psychological impact of burn injuries is grouped into that which examined premorbid psychopathology, examined patients' psychological reactions during hospitalization, and focused on long-term adjustment in burn patients after...
Article
This case series evaluated the use of virtual reality hypnosis (VRH) for the treatment of pain associated with multiple fractures from traumatic injuries. VRH treatment was administered on 2 consecutive days, and pain and anxiety were assessed each day before and after VRH treatment as well as on Day 3, which was 24 hours after the second treatment...
Article
Full-text available
Excessive pain during medical procedures is a widespread problem but is especially problematic during daily wound care of patients with severe burn injuries. Burn patients report 35-50% reductions in procedural pain while in a distracting immersive virtual reality, and fMRI brain scans show associated reductions in pain-related brain activity durin...
Article
There is emerging evidence that transcranial magnetic stimulation (TMS) can produce analgesic effects in clinical samples and in healthy adults undergoing experimentally induced pain; and the field of minimally invasive brain stimulation for the management of pain is expanding rapidly. Although motor cortex is the most widely used cortical target f...
Article
This randomized, controlled, within-subjects (crossover design) study examined the effects of immersive virtual reality as an adjunctive analgesic technique for hospitalized pediatric burn inpatients undergoing painful physical therapy. Fifty-four subjects (6-19 years old) performed range-of-motion exercises under a therapist's direction for 1-5 da...
Article
This case report describes the use of hypnotic analgesia induced through immersive three-dimensional computer-generated virtual reality, better known as virtual reality hypnosis (VRH), in the treatment of a patient with ongoing pain associated with gluteal hidradenitis, The patient participated in the study for two consecutive days white hospitaliz...
Article
The prefrontal cortex may be a promising target for transcranial magnetic stimulation (TMS) in the management of pain. It is not clear how prefrontal TMS affects pain perception, but previous findings suggest that ventral lateral and medial prefrontal circuits may comprise an important part of a circuit of perceived controllability regarding pain,...
Article
Pain following traumatic injuries is common, can impair injury recovery and is often inadequately treated. In particular, the role of adjunctive nonpharmacologic analgesic techniques is unclear. The authors report a randomized, controlled study of 21 hospitalized trauma patients to assess the analgesic efficacy of virtual reality hypnosis (VRH)-hyp...
Article
Hypnosis is perhaps best known for its efficacy for treating pain; certainly, the largest number of research studies have been performed in this area. Yet pain is often treated in the hypnosis literature as a single entity rather than a collection of many different processes and problems. When one discusses the use of hypnosis for pain management,...
Article
Clinical hypnosis for pain control is a compelling argument for the use of hypnotic analgesia as a viable alternative to psychopharmacological interventions for controlling acute, chronic, and perioperative pain, as well as pain from nonsurgical procedures. Yet clinical hypnosis is not an "alternative" medicine, the author argues; rather, it is an...
Article
Two decades ago, if a clinician suggested hypnosis in a medical setting, this form of treatment would have most likely been greeted with skepticism. Today, this is still the case in many medical settings. The difference is that 2 decades ago, much of the reluctance to accept hypnotic analgesia on a scientific basis was at least partially justified....
Article
Few studies have empirically investigated the effects of immersive virtual reality (VR) on postburn physical therapy pain control and range of motion (ROM). We performed a prospective, randomized controlled study of the effects of adding VR to standard therapy in adults receiving active-assisted ROM physical therapy, by assessing pain scores and ma...
Article
Full-text available
Thirty-seven adults with spinal-cord injury and chronic pain were randomly assigned to receive 10 sessions of self-hypnosis (HYP) or EMG biofeedback relaxation (BIO) training for pain management. Participants in both treatment conditions reported substantial, but similar, decreases in pain intensity from before to after the treatment sessions. Howe...
Article
Little is known about how pain and depression after burn injury may influence long-term outcomes such as physical functioning. This prospective study examined associations between pain, depression, and physical functioning in a sample of burn injury survivors. Questionnaires assessing pain, depression, and physical functioning were completed by 64...
Article
Full-text available
Twenty-two patients with multiple sclerosis (MS) and chronic pain we recruited into a quasi-experimental trial comparing the effects of self-hypnosis training (HYP) with progressive muscle relaxation (PMR) on pain intensity and pain interference; 8 received HYP and the remaining 14 participants were randomly assigned to receive either HYP or PMR. H...
Article
Despite medication with opioids and other powerful pharmacologic pain medications, most patients rate their pain during severe burn wound care as severe to excruciating. Excessive pain is a widespread medical problem in a wide range of patient populations. Immersive virtual reality (VR) distraction may help reduce pain associated with medical proce...
Article
Full-text available
The proper management of acute pain has been identified as a primary indicator of quality assurance in US trauma centers. Nearly half of all trauma patients are injured while intoxicated and 75% of these patients have chronic alcohol problems. The management of pain caused by injuries in patients with alcohol problems poses unique challenges. Biase...
Article
This article both summarizes the previous reviews of randomized, controlled trials of hypnotic analgesia for the treatment of chronic and acute pain in adults, and reviews similar trials which have recently been published in the scientific literature. The results indicate that for both chronic and acute pain conditions: (1) hypnotic analgesia consi...
Article
Scientific evidence for the viability of hypnosis as a treatment for pain has flourished over the past two decades (Rainville, Duncan, Price, Carrier and Bushnell, 1997; Montgomery, DuHamel and Redd, 2000; Lang and Rosen, 2002; Patterson and Jensen, 2003). However its widespread use has been limited by factors such as the advanced expertise, time a...
Article
Full-text available
Reasons for distress after burn injuries have not been codified based on any type of acceptable empirical or statistical technique. The unique design methodology proposed in this study can identify the most common reasons cited for causing distress in burn survivors after discharge. A Q-sort task was developed with the assistance of our burn adviso...
Article
The pain associated with burn injuries is intense, unremitting and often exacerbated by anxiety, depression and other complicating patient factors. On top of this, modern burn care involves the repetitive performance - often on a daily basis for weeks to months - of painful and anxiety-provoking procedures that create additional treatment-related p...
Article
Patients with severe blunt force trauma injuries (e.g., multiple fractures and/or internal injuries) often experience severe to excruciating pain during medical procedures. We explored the adjunctive use of immersive virtual reality (VR) to distract a patient with multiple blunt trauma injuries from his procedural pain during physical therapy. The...
Article
This case report evaluates virtual reality hypnosis (VRH) in treating chronic neuropathic pain in a patient with a 5-year history of failed treatments. The patient participated in a 6-month trial of VRH, and her pain ratings of intensity and unpleasantness dropped on average 36% and 33%, respectively, over the course of 33 sessions. In addition, sh...
Article
Our hypothesis was that hypnotic analgesia reduces pain and anxiety during electromyography (EMG). We performed a prospective randomized, controlled clinical trial at outpatient electrodiagnostic clinics in teaching hospitals. Just before EMG, 26 subjects were randomized to one of three 20-min audio programs: education about EMG (EDU) (n = 8); hypn...
Article
Most burn-injured patients rate their pain during burn wound debridement as severe to excruciating. We explored the adjunctive use of water-friendly, immersive virtual reality (VR) to distract patients from their pain during burn wound debridement in the hydrotherapy tank (hydrotank). This study was conducted on inpatients at a major regional burn...
Article
Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. Practitioners in the field have been concerned about the suboptimal management of acute pain in this population. Recent studies have shown that greater levels of acute pain are associated with negative long-term psychologic effects such as depr...
Article
Full-text available
Data from 26 participants in a case series of hypnotic analgesia for chronic pain were examined to determine the long-term effects of hypnosis treatment. Statistically significant decreases in average daily pain intensity, relative to pretreatment values, were observed at posttreatment and at 3- and 9-month follow-up but not at 6- or 12-month follo...
Article
Hypnosis has been used for centuries to treat various types of pain problems. Anecdotal reports of its efficacy have been around since the early 1800 s, but only recently has sophisticated research advanced the field. This paper will summarize the theoretical and clinical foundations of hypnotic analgesia, as well as offer recommendations for incre...
Article
The NIDRR burn injury rehabilitation model system program: selected findings. The quality of burn care has improved over the past few decades, and consequently many more survivors with large-area burn injuries have long-term rehabilitation needs. The National Institute on Disability Rehabilitation Research recognized that the rehabilitation of peop...
Article
Full-text available
To determine the extent to which pain contributes to risk for suicidal ideation after burn injury. This longitudinal cohort study evaluated participants at discharge, 6 months, and 1 year after burn injury. Inpatient rehabilitation units of multiple regional burn centers. Survivors of major burns (N=128). Not applicable. Pain severity, assessed usi...
Article
To assess the efficacy and side effects of immersive virtual reality (VR) distraction analgesia, as well as patient factors associated with VR analgesic efficacy in burn patients who require passive range-of-motion (ROM) physical therapy (PT). Prospective, randomized, controlled, within-subject trials. Regional level I burn center in a university-a...
Article
Full-text available
The adverse consequences of burn injuries include pain and psychological distress, which show bidirectional associations. However, much of the existing research has relied on global measures of distress that do not separate distinct symptoms of anxiety and depression. The purpose is to assess the prospective effects of anxiety and depression on pai...
Article
Purpose/Objective: There have been few randomized controlled studies on the effectiveness of clinical hypnotic analgesia. The authors' goal was to improve on previous methodologies and gain a better understanding of the effects of hypnosis on different components of pain in a clinical setting. Research Method/Design: This study used a randomized co...
Article
This article reviews controlled prospective trials of hypnosis for the treatment of chronic pain. Thirteen studies, excluding studies of headaches, were identified that compared outcomes from hypnosis for the treatment of chronic pain to either baseline data or a control condition. The findings indicate that hypnosis interventions consistently prod...
Article
Full-text available
To track the prevalence and stability of clinically significant psychological distress and to identify potentially modifiable in-hospital symptoms predictive of long-term distress (physical, psychological, and social impairment). We obtained data from the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury surviv...
Article
To better understand the role of homesickness in children's adjustment to hospitalization, we culled self-report and observational data from hospital staff, primary caregivers, and children (n = 50) in a variety of inpatient units (psychiatric, burn, rehabilitation). Homesickness was more severe and less predictable than in comparable samples of ch...
Article
Full-text available
Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the c...
Article
The individual and combined effects of posthypnotic suggestion (PHS) and virtual reality distraction (VRD) on experimentally induced thermal pain were examined using a 2 x 2, between-groups design. After receiving baseline thermal pain, each participant received hypnosis or no hypnosis, followed by VRD or no VRD during another pain stimulus. Consis...
Article
Unlabelled: Immersive Virtual Reality (VR) distraction can be used in addition to traditional opioids to reduce procedural pain. The current study explored whether a High-Tech-VR helmet (ie, a 60-degree field-of-view head-mounted display) reduces pain more effectively than a Low-Tech-VR helmet (a 35-degree field-of-view head-mounted display). Usin...
Article
Full-text available
Case study research suggests that hypnosis treatment may provide benefits that are not necessarily the target of specific suggestions. To better understand satisfaction with and the beneficial "side effects" of hypnosis treatment, questions inquiring about treatment satisfaction and treatment benefits were administered to a group of 30 patients wit...
Article
The purpose of this investigation was to examine the amount of anxiety patients believed tolerable and the amount of anxiety experienced during routine burn wound care. Participants included 47 hospitalized adults who provided data for four consecutive assessment periods. Patients (mean TBSA, 16%; range, 2-70%) were primarily Caucasian (87%) and ha...
Article
Acute pain after medical procedures is often undertreated, opioid analgesics are used far too sparingly, and patients are forced to suffer needlessly as a result. Attempts to change health care practitioner behavior in the area of pain control are often futile. The purpose of the current study was to provide empirical evidence that supports the del...
Article
This study is the first to use virtual-reality technology on a series of clinical patients to make hypnotic analgesia less effortful for patients and to increase the efficiency of hypnosis by eliminating the need for the presence of a trained clinician. This technologically based hypnotic induction was used to deliver hypnotic analgesia to burn-inj...
Article
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-trea...
Article
Behavioral Methods for Chronic Pain and Illness was written by W. E. Fordyce (1976) at a time when psychological contributions to pain were poorly understood, much less the applications of nonpharmacologic methods for addressing this substantial problem. Fordyce's work created a new paradigm for treating pain and other chronic medical problems and...
Article
Case studies and controlled clinical trials indicate that hypnotic analgesia can effectively reduce pain in patients with a number of different chronic pain conditions. However, because none of the studies published to date have included a credible control condition that adequately controls for expectancy effects, at this point we cannot conclude t...