Hypnosis, Placebo, and Suggestion in the Treatment of Warts

N. SPANOS et al.sion. In the first session, and again at the 6-weekfollow-up, subjects' warts were counted by a technicianwho was blind to subjects' treatment assignment.In-session QuestionnairesImmediately after each treatment procedure, subjectswere administered the following questionnaires.Intensity of Imagined Sensations. Subjects ratedthe extent to which they experienced each of the foursensations (i.e., tingling, warmth, shrinking, prickling)described in the suggestion. Each sensation wasrated on a 7-point scale, and the four sensation itemswere totaled to yield a single suggested vividnessscore.Expectation of Treatment Success. Subjects respondedto the following item: "How effective do youthink this treatment will be at removing your warts?"Alternatives ranged from "not at all effective" (scored0) through "moderately effective" (scored 5) to "extremelyeffective" (scored 10).Altered Experience. Field (31) constructed a scaleto assess alterations in experience frequently associatedwith hypnotic induction (e.g., "I felt dazed").We modified the scale by eliminating all items thatmade explicit reference to sleep or hypnosis. Thirtythreeitems remained that tapped a range of alterationsin body image, relaxation, and sensory experiences.All items were scored dichotomously andtotaled to yield a single altered experience score.Relaxation. Subjects rated their degree of relaxationon a six-item scale that was anchored with thedescriptors "very tense" (scored 1) at one end to "veryrelaxed" (scored 6) at the other end.Measures Taken at Follow-upAfter their warts had been counted at the 6-weekfollow-up, subjects were assessed for hypnotizabilityboth on the CURSS and on a 10-item version of theStanford Hypnotic Susceptibility Scale, Form C(SHSS : C) (32). This version of the SHSS :C has beenmodified in our laboratory to yield both an objectivemeasure (SHSS : C/O) and a subjective measure(SHSS : C/S) of hypnotizability (33). The CURSS andSHSS : C were administered at least 1 day apart incounterbalanced order. Before CURSS administrationsubjects completed the version of the Betts imageryscale used in Experiment 1. Before SHSS : Cadministration they completed Tellegen and Atkinson's(30) questionnaire measure of absorption. Thisquestionnaire assesses subjects' propensities for involvementin everyday fantasy (e.g., reading novels).RESULTSThere were no significant treatmentdifferences in number of warts at baseline,F (3, 68) < 1. There were also nosignificant treatment differences in subjects'ages or in the estimated duration oftheir warts. The means involved in theseanalyses are given in Table 6.Slightly more than half the subjects inthis experiment had only one wart at baseline(N = 39, 51.3%), and the large majorityhad three or fewer warts at baseline(N = 64, 84.2%). Because the number ofwarts at baseline was so severely skewedtoward the low end, we measured wartloss exclusively in terms of our dichotomouslost one or more/lost none index.Treatment EffectsTable 7 shows the number of subjectsin each condition who lost and who didnot lose warts. The four conditions differedsignificantly in this regard (X 2(3) = 7.92, p < 0.05). Further analyses indicatedthat the three treated groups failedto differ significantly from one another.Furthermore, subjects in the three treatedgroups combined more frequently lost wartsthan did controls, X 2 (1) = 4.75, p < 0.05.Hypnotic subjects taken alone more frequentlylost warts than did controls, X 2(1) = 4.47, p < 0.05; and suggestion onlysubjects taken alone also more frequentlylost warts than did controls (X 2 (1) = 7.12,p < 0.01). However, relaxation-plus-suggestionsubjects failed to differ significantlyfrom controls in this respect (X 2(1) = 2.11).254 Psychosomatic Medicine 50:245-260 (1988)