Emily Carota Orne

Home management of sickle cell-related pain in children and adolescents : natural history and impact on school attendance

&NA; Some children and adolescents with sickle cell disease experience frequent painful episodes. To gain information about the natural history of the pain and its impact on sleep and school attendance, we developed a home‐based diary system. Eighteen children and adolescents completed 4756 diary days, with an average compliance of 75%. Pain was reported on 30% of days and was managed at home nine‐tenths of the time. Girls reported more days with pain than did boys, and age was positively correlated with the length of the painful episodes. The pain affected school attendance and sleep. Patients were absent from school on 21% of 3186 school days, with half of the absenteeisms on days with reported pain. Of the pain‐associated absenteeisms, two‐thirds occurred when pain was managed at home, and one‐third when patients were hospitalized. The average consecutive number of school days missed was 2.7. These findings have implications for developmentally critical activities.

Assessing performance upon abrupt awakening from naps during quasi-continuous operations

Quasi-continuous work settings often involve sleep loss and requirements to perform at unpredictable times. Napping may alleviate some of the sleep-loss problems, but it increases the risk that the person will have difficulty functioning upon abrupt awakening. This paper describes an experimental approach, techniques, and analyses for investigating performance upon abrupt awakening from 2 h naps placed near either the circadian peak (P) or trough (T) in body temperature and preceded by 6, 18, 30, 42, or 54 h of sleep deprivation. Five groups of healthy young adults performed quasi-continuously for 54 h and were permitted a 2-h nap at one of five times. Reaction time (RT) to answer a phone terminating the nap, subjective estimates, and performance of a brief, challenging cognitive task were related to nap-sleep parameters of each group. Sleep deprivation increased the amount of deep sleep in the naps, and this was associated with greater postnap cognitive performance decrements; subjective estimates were unaffected, and RT performance was related simply to stage of sleep prior to awakening. Circadian placement of the naps also modulated the postnap cognitive decrement: T naps produced greater cognitive decrements than P naps, even when the latter involved more prior sleep loss. These findings have both practical and theoretical significance for evaluating the awakening process, and would not have been possible without the approach, techniques, and procedures described.

The benefits of a nap during prolonged work and wakefulness

Abstract Prolonged work scenarios with demands for sustained performance are increasingly common. Because sleep loss inevitably compromises functioning in such situations, napping has been proposed as a countermeasure. The optimal timing of the nap relative to its benefits for performance and mood is not known, however. To address this issue, 41 healthy adults were permitted a two-hour nap at one of five times during a 56-hour period of intermittent work, with no other sleep. Naps were placed 12 hours apart, near the circadian peak (P) or trough (T), and were preceded by 6(P), 18(T), 30(P), 42(T), or 54(P) hours of wakefulness. Work test bouts occurred every few hours and consisted of a variety of psychomotor and cognitive tasks as well as mood scales completed at the beginning, middle and end of each bout. A total of eight performance and 24 mood parameters were derived from the bouts and compared between groups at all test points prior to and following the naps. An estimate of the extent to which each n...

Psychosocial and immune effects of self-hypnosis training for stress management throughout the first semester of medical school.

This study was a 19-week prospective conducted to determine the effectiveness of a self-hypnosis/relaxation intervention to relieve symptoms of psychological distress and moderate immune system reactivity to examination stress in 35 first-year medical students. Twenty-one subjects were randomly selected for training in the use of self-hypnosis as a coping skill and were encouraged to practice regularly and to maintain daily diary records related to mood, sleep, physical symptoms, and frequency of relaxation practice. An additional 14 subjects received no explicit training in stress-reduction strategies, but completed similar daily diaries. Self-report psychosocial and symptom measures, as well as blood draws, were obtained at four time points: orientation, late semester, examination period, and postsemester recovery. It was found that significant increases in stress and fatigue occurred during the examination period, paralleled by increases in counts of B lymphocytes and activated T lymphocytes, PHA-induced and PWM-induced blastogenesis, and natural killer cell (NK) cytotoxicity. No immune decreases were observed. Subjects in the self-hypnosis condition reported significantly less distress and anxiety than their nonintervention counterparts, but the two groups did not differ with respect to immune function. Nevertheless, within the self-hypnosis group, the quality of the exercises (ie, relaxation ratings) predicted both the number of NK cells and NK activity. It was concluded that stress associated with academic demands affects immune function, but immune suppression is not inevitable. Practice of self-hypnosis reduces distress, without differential immune effects. However, individual responses to the self-hypnosis intervention appear to predict immune outcomes.

On the differential diagnosis of multiple personality in the forensic context

Abstract The problems of diagnosing multiple personality disorder in a forensic context are discussed, and illustrated by the case of Stute u. Kenneth Birrnchi (1979), a defendant who was both charged with first degree murder and suspected of having the disorder. Because of the secondary gain (e.g., avoiding the death penalty) associated with the diagnosis of multiplicity in such a case, hypotheses had to be developed to permit an informed differential diagnosis between multiple personality and malingering. If a true multiple personality disorder existed, then (a) the structure and content of the various personalities should have been consistent over time, (b) the boundaries between different personalities should have been stable and not readily altered by social cues, (c) the response to hypnosis should have been similar to that of other deeply hypnotized subjects, and (d) those who had known him over a period of years should have been able to provide examples of sudden, inexplicable changes in behavior ...

Evaluating hypnotic memory enhancement (hypermnesia and reminiscence) using multitrial forced recall

Two experiments investigated whether hypnosis enhances memory retrieval per se or merely increases a persons willingness to report recollections. Both experiments assessed immediate and delayed (i.e., 1 week) recall for pictorial stimuli. In Experiment 1, following an initial waking baseline recall, subjects of high or low hypnotic ability completed a series of recall trials conducted either in hypnosis or in the walking condition. The classic hypermnesia effect was obtained, but with no supplemental contribution of hypnosis. In Experiment 2, hypnosis was introduced only after 6 waking-recall trials. Hypnosis again failed to enhance retrieval of new correct items, although it increased the production of new incorrect recall among hypnotizable individuals. The findings provide no evidence for alleged hypermnesic properties of hypnosis.

The relation between the Hypnotic Induction Profile and the Stanford Hypnotic Susceptibility Scales, forms A and C.

Abstract Measures from the clinically derived Hypnotic Induction Profile (HIP) of Spiegel (1974a) were correlated with those from the laboratory derived Stanford Hypnotic Susceptibility Scales, Forms A and C (SHSS:A, SHSS:C) of Weitzenhoffer and Hilgard (1959, 1962), and with some scores from the related Harvard Group Scale of Hypnotic Susceptibility, Form A (Shor & E. Orne, 1962). Ss were paid volunteers from student populations at the University of Pennsylvania (N = 87) and from Stanford University (N = 58). Some differences in sampling procedures and orders of testing are discussed, but only minimal differences between the 2 samples resulted. Positive but nonsignificant correlations were found between the Eye-Roll sign alone and SHSS in the 2 samples. Both the Induction (IND) and Profile scoring methods of HIP were compared with SHSS. The IND, an actuarial scale, was positively correlated with SHSS. A representative value is the significant correlation of .34 between IND and SHSS:(A + C)/2 scores when ...

Restricted Use of Success Cues in Retrieval During Posthypnotic Amnesia

Memory for successful and unsuccessful responses to hypnotic suggestions was evaluated in partially amnesic subjects and in those subjects with normal forgetting. Two analyses (N = 278) demonstrated that highly hypnotizable subjects experiencing partial posthypnotic amnesia tended to show no selective recall for their successes or failures during amnesia, whereas the remainder of the subjects showed definite selective recall of hypnotic success posthypnotically. These findings lend support to the hypothesis put forth by Evans and Kihlstrom that posthypnotic amnesia involves a disruption of memory organization and suggests that the phenomenon may be mediated by a restriction in the use of normally employed retrieval cues.

Rethinking per se exclusions of hypnotically elicited recall as legal testimony.

In 1993, Boggs argued for a rethinking of the per se exclusion of hypnotically elicited testimony. This article analyzes the Minnesota v. Mack (1980) case that initiated this exclusion and the two Illinois cases Boggs cites in favor of her position. The scientific data on the effect of hypnosis on memory do not support Boggss position. Rather than providing reasons for rethinking this per se position, these data suggest that it should be retained.

Behavioral Persistence in Carrying Out a Posthypnotic Suggestion Beyond the Hypnotic Context: A Consideration of the Role of Perceived Demand Characteristics

Abstract Compliance with a posthypnotic suggestion (PHS) to carry out a specific behavior in a subsequent nonhypnotic setting was investigated in high and medium hypnotizable participants. The target behavior—solicited by either a PHS given during hypnosis, a waking social request, or both—was to be performed daily for an unspecified period of time. Findings indicated that the waking request alone yielded a high level of compliance, particularly among medium hypnotizable participants. In contrast, highly hypnotizable participants who received the PHS coupled with instructions for posthypnotic amnesia exhibited considerable variation in responding, whereas high hypnotizables, who received either a waking request, or a combination of PHS and waking request, performed similarly to medium hypnotizables. Postexperimental interview data suggest that perceived demand characteristics may contribute to variation in the persistence of posthypnotic behavior outside the hypnotic context.