Title

Self-hypnosis and sickle cell disease in children: Impact on self-efficacy and the pain experience

Date of Completion

January 2004

Keywords

Psychology, Clinical

Degree

Ph.D.

Abstract

Thirty-one children and adolescents (ages 7–18 years) who carried a diagnosis of sickle cell disease were recruited from a hematological disorders clinic. Baseline measures of psychological pathology, disease-specific self-efficacy, and daily experience of pain were collected. A sampling method using a modified daily diary measure was used to assess daily experience of pain, including self-report, caregiver report, and functional pain. Sixteen participants received a self-hypnosis training intervention after 3 weeks of pain data collection. A control group of 14 did not receive the training. Assignment to control and intervention was not random. Three weeks of follow up pain data and a repeat self-efficacy measure were also collected. Both groups were found to be generally psychologically healthy. Self-hypnosis intervention was found to have significant immediate impact on sickle cell pain during training sessions, but a significant effect on daily pain was not demonstrated. There was significant improvement in participants self-report of pain from the beginning to end of intervention training sessions, but analyses of variance using baseline indices as a covariate indicated that the experience of daily and subjective pain of the intervention and control group did not significantly differ over the period of data collection. Impact of self-hypnosis training on sense of self-efficacy around the disease experience was clearly demonstrated, and the intervention group improved significantly post-intervention. Measures indicated that the intervention group may have had more impairment and a greater number of resources available at baseline that could have influenced participants' motivation and ability to engage in treatment. Pre-existing differences between the groups limit generalizabilty of findings, but inform potential clinical application. Though the study was limited by small sample and lack of randomization, it provides support for the efficacy of self-hypnosis in alleviating some of the distress associated with sickle cell disease, and highlights the potential of self-regulation techniques to impact both pain experience and psychological functioning, including self-efficacy. Implications for future research and clinical application are discussed. ^