Isenberg S A, Lehrer P M, Hochron S
Rutgers-The State University, New Brunswick.
J Psychosom Res. 1992 Dec;36(8):769-76. doi: 10.1016/0022-3999(92)90135-o.
Thirty-three asthmatic subjects were told they were receiving, alternately, an inhaled bronchoconstrictor and inhaled bronchodilator, although they actually were only breathing room air. No subjects showed suggestion-produced effects on FEV1, although two (of the 19 on whom FEF50 was measured) showed effects of greater than 20% on measures of maximal midexpiratory flow. The incidence of the effect is smaller than reported previously, possibly because some subjects in previous studies inhaled saline, a mild bronchoconstrictor, and reversal of effect was not required for classification as a reactor. Higher percentages of subjects in this study showed decreased MMEF in response to the 'bronchoconstrictor', but this appeared to reflect fatigue rather than suggestion effects. However, the fact that the effect occurred in a relatively non-effort-dependent measure suggests that real changes occurred in bronchial caliber, not just in test effort. Suggestion had a significant effect on perception of bronchial changes, but the correlation between actual and perceived changes was minimal. There was an increase in FVC prior to administration of the 'bronchoconstrictor', possibly reflecting a preparatory response to the expected drug. Correlations among self-report variables suggested the existence of three personality dimensions among our population related to suggestion and asthma: cognitive susceptibility to suggestion of bronchial change; feeling of physical vulnerability; and anxiety. However, there was no significant relationship between airway response to suggested changes and hypnotic susceptibility, as measured by the Harvard Group Scale of Hypnotic Susceptibility.
33名哮喘患者被告知他们交替吸入了支气管收缩剂和支气管扩张剂，而实际上他们只是在呼吸室内空气。没有受试者的第一秒用力呼气量（FEV1）显示出暗示产生的效应，不过在接受最大呼气中期流速测量的19名受试者中，有两名的最大呼气中期流速测量值显示出超过20%的效应。该效应的发生率低于先前报道，可能是因为先前研究中的一些受试者吸入了盐水，一种轻度支气管收缩剂，而将其归类为反应者时并不要求效应逆转。本研究中有更高比例的受试者在吸入“支气管收缩剂”后显示最大呼气中期流速（MMEF）降低，但这似乎反映的是疲劳而非暗示效应。然而，该效应出现在相对不依赖用力的测量指标上这一事实表明，支气管管径发生了实际变化，而不仅仅是测试用力方面的变化。暗示对支气管变化的感知有显著影响，但实际变化与感知变化之间的相关性很小。在给予“支气管收缩剂”之前，用力肺活量（FVC）有所增加，这可能反映了对预期药物的一种准备性反应。自我报告变量之间的相关性表明，在我们的研究人群中存在与暗示和哮喘相关的三个人格维度：对支气管变化暗示的认知易感性；身体易损感；以及焦虑。然而，根据哈佛群体催眠易感性量表测量，气道对暗示变化的反应与催眠易感性之间没有显著关系。
