An Ericksonian hypnosis intervention on psychological distress and immune functioning in HIV-1 seropositive patients

Persons who are HIV+ experience distress both from the prognosis of the disease and the ongoing economic and medical management issues that impact their quality of life. Distress has been shown to negatively impact the immune system in many studies. The purpose of this study was to test a 12 week Ericksonian hypnosis intervention that included daily listening to hypnosis audiotapes. The audiotapes included direct and indirect suggestions for stress release, metaphors for healing, active coping and utilization of inner resources for meeting daily challenges.Forty HIV seropositive medical outpatients were seen in an infectious disease medical practice and randomly assigned to either the treatment intervention group or the assessment-only control group. Psychosocial and immunological measures were taken before and after the intervention. Psychosocial outcome measures were anxiety, depression, anger, fatigue and total mood disturbance. Physiological measures were CD4 cell counts and viral load.There were no significant intervention effects shown for either the distress measures or the immune measures based on group assignment. Frequency of audiotape listening was related to changes in viral load (r = -.50, p = .05). High frequency listeners reduced viral load compared to controls, while low frequency listeners mean viral load increased. Subjects with higher CD4 cells at baseline reduced depression (r = -44, p = .01), fatigue (r = -.35, p = .049) and total mood disturbance (r = -.40, p = .023) more than subjects with lower CD4 cell counts. Subjects who reduced depression (r = -.50, p \u3c .01), fatigue (r = -.35, p = .05 and total mood disturbance (r = -.44, p = .01) tended to have higher CD4 cells at post-test. There was a highly significant relationship between baseline distress (r = .36, p = .04) and anger (r = .55, p = .001) with subsequent increases in viral load. These results highlight the relationships between changes in distress measures and CD4 cell count and viral load. Further research is needed to determine the generalizability of these findings, to other HIV populations. Methodological considerations related to sample size, treatment compliance and possible confounds are discussed