Cognitive Modulation of Psychophysical, Respiratory and Autonomic Responses to Cold Pressor Test

Abstract

In healthy subjects with high hypnotisability (highs) under hypnosis, subjectively effective suggestions for analgesia abolish the increases in blood pressure associated with cold pressor test (cpt) by reducing the peripheral vascular resistance. The aim of the present study was to investigate the effects of the suggestions of analgesia on the responses to cpt in healthy highs (n = 22) and in low hypnotisable participants (lows, n = 22) out of hypnosis. Cpt was administered without (CPT) and with suggestions for analgesia (CPT+AN). Psychophysical (pain intensity, pain threshold, cpt duration (time of immersion) and pain tolerance, defined as the difference between cpt duration and pain threshold), respiratory (amplitude and frequency) and autonomic variables (tonic skin conductance, mean RR interval (RR = 1/heart rate), blood pressure, skin blood flow) were studied. The suggestions for analgesia increased cpt duration and RR in both groups, but decreased pain intensity and enhanced pain threshold only in highs; in both groups they did not modulate systolic blood pressure, tonic skin conductance and skin blood flow; thus, increased parasympathetic activity appears responsible for the heart rate reduction induced by suggestions in both groups. In conclusion, our findings show that suggestions modulate pain experience differentially in highs and lows, and are partially effective also in lows. We hypothesize that the mechanisms responsible for the efficacy of suggestions in healthy lows may be involved also in their efficacy in chronic pain patients with low hypnotisability.

Mechanisms of Hypnosis:Toward the Development of a Biopsychosocial Model

“…For example, researchers are beginning to examine additional biological factors associated with hypnosis such as changes in peripheral hormone levels (Bryant, Hung, Guastella, & Mitchell, 2012; Varga & Kekecs, 2014), heart rate and heart rate variability (Santarcangelo et al, 2012; Santarcangelo, Varanini et al, 2013; Sebastiani, Simoni, Gemignani, Ghelarducci, & Santarcangelo, 2003; Yuksel, Ozcan, & Dane, 2013), respiratory rate (Sebastiani et al, 2003), and blood pressure (Santarcangelo, Paoletti et al, 2013). Doubtless some of these factors as well as other biological, psychological, and social factors not examined here will be identified as being associated with, and may ultimately be shown to influence, hypnotic responding.…”

Individual Traits and Pain Treatment: The Case of Hypnotizability

“…In the absence of explicit suggestions for analgesia, hypnotizability related differences in pain thresholds (Hilgard, 1967 ; Agargün et al, 1998 ; Santarcangelo et al, 2013 ; Kramer et al, 2014 ) and perceived pain intensity (Santarcangelo et al, 2010 ) have been seldom reported. Several studies, however, describe hypnotizability-related differences in genetic polymorphisms and brain neurotransmitters content which may be relevant to pain control in the presence of suggestions and/or to the choice of pain treatments.…”

Hypnotic relaxation results in elevated thresholds of sensory detection but not of pain detection

“…A correlation of the individual hypnotic susceptibility with the analgesic effect has been described for a specific analgesic suggestion with a number of investigations showing that pain reduction was more effective in high than in low hypnotizable subjects [ 8 , 15 , 16 , 32 , 33 ], even without prior induction of a hypnotic state [ 17 , 34 ]. For unspecific effects caused by general effects of hypnosis without specific suggestions the individual susceptibility does not seem to be of importance [ 15 ].…”