Showing papers by "David Spiegel published in 1983"

Group therapy and hypnosis reduce metastatic breast carcinoma pain

Abstract: The pain and mood disturbance of 54 women with metastatic carcinoma of the breast were studied over the course of one year. A random sample was offered weekly group therapy during the year, with or without self-hypnosis training directed toward enhancing their competence at mastering pain and stress related to cancer. Both treatment groups demonstrated significantly less self-rated pain sensation (t = 2.5 p less than 0.02) and suffering (t = 2.17, p less than 0.03) than the control sample. Those who were offered the self-hypnosis training as well as group therapy fared best in controlling the pain sensation (F = 3.1, p less than 0.05). Pain frequency and duration were not affected. Changes in pain measures were significantly correlated with changes in self-rated total mood disturbance on the Profile of Mood States and with its anxiety, depression, and fatigue subscales. Possible mechanisms for the effectiveness of these interventions are discussed.

Pain in metastatic breast cancer

Abstract: The pain experiences of 86 women with metastatic carcinoma of the breast were systematically evaluated over a period of one year. Fifty-six percent of the sample reported experiencing pain, and the intensity of pain was not significantly related to site of metastasis. Multiple regression analysis revealed that 50% of the variance in the pain experience was accounted for by: (1) the amount of mood disturbance as measured by the Profile of Mood States (POMS); (2) the patients' belief that the pain indicated worsening of the illness; and (3) the use of analgesic medication. The nature of family support, social functioning, and coping responses were not significantly associated with pain intensity, nor was mortality during the one-year follow-up period. These data document the significance of psychological factors in accounting for differences in pain experience and document the interaction between pain and mood disturbance. These findings suggest that treatment of metastatic pain should include attention to the patient's mood and adjustment to the illness. Cancer 52:34-345, 1983.

Family Environment as a Predictor of Adjustment to Metastatic Breast Carcinoma

Abstract: The effects of family environment on the psychological adjustment of 54 women with metastatic carcinoma of the breast were studied over a one-year period. Family environment was assessed using the Family Environment Scale (FES) and a descriptive checklist, and adjustment was measured using the Profile of Mood States (POMS). Patients described their families as supportive and relatively free of conflict, and their spouses or other family members agreed moderately with them. Patient mood disturbance during the year was made the dependent variable in a stepwise multiple regression analysis, with FES subscale scores at the beginning of the year and other control variables as predictors. Better adjustment was found to be predicted by more expressiveness and less conflict and moral-religious orientation in the family. These findings are presented as evidence that the family is a crucial factor in patient adjustment, and that 'conspiracies of silence' in the family may be harmful. A clinical illustration is pres...

Effects of group confrontation with death and dying

Abstract: (1983). Effects of Group Confrontation with Death and Dying. International Journal of Group Psychotherapy: Vol. 33, No. 4, pp. 433-447.

Naloxone fails to reverse hypnotic alleviation of chronic pain

Abstract: The hypothesis that the alleviation of chronic pain with hypnosis is mediated by endorphins was tested. Six patients with chronic pain secondary to peripheral nerve irritation were taught to control the pain utilizing selfhypnosis. Each subject was tested at 5-min intervals during four 1-h sessions for the amount of reduction of pain sensation and suffering associated with hypnosis while being given, in a random double-blind crossover fashion, an IV injection of either 10 mg naloxone or a saline placebo through an indwelling catheter. The patients demonstrated significant alleviation of the pain with hypnosis, but this effect was not significantly diminished in the naloxone condition. These findings contradict the hypothesis that endorphins are involved in hypnotic analgesia

Perceptions of family environment among psychiatric patients and their wives.

Abstract: This study compared the perceived family environments of former psychiatric inpatients with thought, affective, and substance abuse disorders to those of normative comparison couples using the Family Environment Scale. Family environment was assessed among patients and wives separately at hospital discharge and at three- and twelve-month follow-ups. Patients and their wives were consistently more incongruent in their perceptions of their shared environment than normative couples. In addition, low-functioning patient couples reported less family cohesion, expressiveness, and recreational emphasis than their higher functioning counterparts; the high-functioning patient couples more closely resembled the norm. The paper discusses possible relationships between positive family contact and better patient functioning.