Publications

Featured Publications

Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • Shared cognitive mechanisms of hypnotizability with executive functioning and information salience. Scientific reports Faerman, A., Spiegel, D. 2021; 11 (1): 5704

    Abstract

    In recent years, evidence linked hypnotizability to the executive control and information salience networks, brain structures that play a role in cognitive conflict resolution and perseveration (insisting on applying a previously learned logical rule on a new set). Despite the growing body of neuroimaging evidence, the cognitive phenotype of hypnotizability is not well understood. We hypothesized that higher hypnotizability would correspond to lower perseveration and set-shifting. Seventy-two healthy adults were tested for hypnotizability and executive functions (perseveration and set-shifting). Multiple regression analyses were performed to test the relationship between hypnotizability and perseveration and set-shifting. Higher hypnotizability was associated with lower perseveration after accounting for age and education. Hypnotizability significantly predicted perseveration but not set-shifting. Our results indicate an inverse relationship between trait hypnotizability and perseveration, an executive function that utilizes regions of both the executive control and the salience systems. This suggests that hypnotizability may share a common cognitive mechanism with error evaluation and implementation of logical rules.

    View details for DOI 10.1038/s41598-021-84954-8

    View details for PubMedID 33707531

  • Testing Hypnotizability by Phone: Development and Validation of the Remote Hypnotic Induction Profile (rHIP). The International journal of clinical and experimental hypnosis Kittle, J., Zhao, E., Stimpson, K., Weng, Y., Spiegel, D. 2021; 69 (1): 94–111

    Abstract

    Standard hypnotizability scales require physical contact or direct observation by tester and participant. The authors addressed this limitation by developing and testing the remote Hypnotic Induction Profile (rHIP), a hypnotizability test derived from the Hypnotic Induction Profile that is completed by telephone. To assess the validity of the rHIP, 56 volunteers naive to hypnotizability testing completed both the HIP and the rHIP, with order of testing randomized. Results indicate a strong correlation between HIP and rHIP scores, r s=.71(0.53-0.84), p <.0001, and good concordance, difference=.03(-0.53, 0.59), p =.91, independent of testing order. The rHIP had few complications. Possible advantages of using the rHIP include improving patient expectancy prior to scheduling a hypnosis session, increasing access to hypnotizability testing for remote interventions, and obviating resource-intensive in-person hypnotizability screening for trials that exclude subjects with certain scores.

    View details for DOI 10.1080/00207144.2021.1827937

    View details for PubMedID 33513064

  • When Physicians Engage in Practices That Threaten the Nation's Health. JAMA Pizzo, P. A., Spiegel, D. n., Mello, M. M. 2021

    View details for DOI 10.1001/jama.2021.0122

    View details for PubMedID 33538765

  • International Prevalence and Correlates of Psychological Stress during the Global COVID-19 Pandemic. International journal of environmental research and public health Adamson, M. M., Phillips, A. n., Seenivasan, S. n., Martinez, J. n., Grewal, H. n., Kang, X. n., Coetzee, J. n., Luttenbacher, I. n., Jester, A. n., Harris, O. A., Spiegel, D. n. 2020; 17 (24)

    Abstract

    This study reports perceived stress and associated sociodemographic factors from an international sample of adults, during the COVID-19 pandemic. The Perceived Stress Scale (PSS-10) along with socio-demographic questions were conducted between 8 April 2020 and 11 May 2020. The survey was translated from English into five languages. Recruitment was conducted worldwide using social media. A total of 1685 survey responses were collected across 57 countries with eleven countries (≥30 responses/country) included in the sub-analyses. Overall, the mean PSS-10 score was 19.08 (SD = 7.17), reflecting moderate stress compared to previously reported norms. Female gender was associated with a higher PSS score (3.03, p < 0.05) as well as four-year degree holders (3.29, p < 0.05), while adults over 75 years (-7.46, p < 0.05) had lower PSS scores. Personal care composite score (including hours of sleep, exercise, and meditation) was associated with lower PSS scores (-0.39, p < 0.01). Increases in personal care and changes in work expectations were associated with lower PSS scores (-1.30 (p < 0.05) and -0.38 (p < 0.01), respectively). Lower total PSS scores were reported in Germany (-4.82, p < 0.01) compared to the global response sample mean. This information, collected during the initial period of global mitigation orders, provides insight into potential mental health risks and protective factors during crises.

    View details for DOI 10.3390/ijerph17249248

    View details for PubMedID 33321950

  • "Not just another meta-analysis": Sources of heterogeneity in psychosocial treatment effect on cancer survival. Cancer medicine Mirosevic, S., Jo, B., Kraemer, H. C., Ershadi, M., Neri, E., Spiegel, D. 2019

    Abstract

    BACKGROUND: Currently, there are eight meta-analyses that address the question whether psychosocial intervention can prolong survival with widely disparate conclusions. One reason for inconsistent findings may be the methods by which previous meta-analyses were conducted.METHODS: Databases were searched to identify valid randomized controlled trials that compared psychosocial intervention with usual care. Hazard ratios (HRs) and their confidence intervals were pooled to estimate the strength of the treatment effect on survival time, and z-tests were performed to assess possible heterogeneity of effect sizes associated with different patient and treatment characteristics.RESULTS: Twelve trials involving 2439 cancer patients that met screening criteria were included. The overall effect favored the treatment group with a HR of 0.71 (95% Cl 0.58-0.88; P=0.002). An effect size favoring treatment group was observed in studies sampling lower vs higher percentage of married patients' (NNT=4.3 vs NNT=15.4), when Cognitive-Behavioral Therapy was applied at early vs late cancer stage (NNT=2.3 vs NNT=-28.6), and among patients' older vs younger than 50 (NNT=4.2 vs NNT=-20.5).CONCLUSIONS: Psychosocial interventions may have an important effect on survival. Reviewed interventions appear to be more effective in unmarried patients, patients who are older, and those with an early cancer stage who attend CBT. Limitations of previous meta-analysis are discussed.

    View details for PubMedID 30600642

  • Modulation of Nociception in Multiple Brain Systems-The Strain in Pain. JAMA neurology Spiegel, D. 2018

    View details for PubMedID 30073248

  • Post-traumatic stress disorder and cancer. The lancet. Psychiatry Cordova, M. J., Riba, M. B., Spiegel, D. 2017

    Abstract

    Being diagnosed with and treated for cancer is highly stressful and potentially traumatic. An extensive literature has evaluated the prevalence, predictors, and correlates of cancer-related post-traumatic stress disorder (PTSD) symptoms and diagnoses. In this qualitative review of cancer-related PTSD literature, we highlight conceptual, methodological, and diagnostic issues, and identify clinical implications and areas for future research. Cancer-related PTSD has been documented in a minority of patients with cancer and their family members, is positively associated with other indices of distress and reduced quality of life, and has several correlates and risk factors (eg, prior trauma history, pre-existing psychiatric conditions, poor social support). The literature on treatment of cancer-related PTSD is sparse. Existing literature on cancer-related PTSD has used DSM-IV-TR diagnostic criteria; the revised DSM-5 PTSD criteria have important implications for the assessment of cancer-related distress. Application of PTSD diagnosis to patients with cancer has been critiqued on conceptual and methodological grounds, and important differential diagnosis considerations should be taken into account. Psychosocial assessment of patients with cancer should include careful evaluation of pre-cancer diagnosis trauma and psychiatric history, and diagnostic interviewing should consider concurrent conditions (eg, adjustment disorder). Treatment of cancer-related PTSD should be approached with caution and be informed by existing evidence-based approaches for traumatic stress.

    View details for DOI 10.1016/S2215-0366(17)30014-7

    View details for PubMedID 28109647

  • Brain Activity and Functional Connectivity Associated with Hypnosis. Cerebral cortex Jiang, H., White, M. P., Greicius, M. D., Waelde, L. C., Spiegel, D. 2016: -?

    Abstract

    Hypnosis has proven clinical utility, yet changes in brain activity underlying the hypnotic state have not yet been fully identified. Previous research suggests that hypnosis is associated with decreased default mode network (DMN) activity and that high hypnotizability is associated with greater functional connectivity between the executive control network (ECN) and the salience network (SN). We used functional magnetic resonance imaging to investigate activity and functional connectivity among these three networks in hypnosis. We selected 57 of 545 healthy subjects with very high or low hypnotizability using two hypnotizability scales. All subjects underwent four conditions in the scanner: rest, memory retrieval, and two different hypnosis experiences guided by standard pre-recorded instructions in counterbalanced order. Seeds for the ECN, SN, and DMN were left and right dorsolateral prefrontal cortex, dorsal anterior cingulate cortex (dACC), and posterior cingulate cortex (PCC), respectively. During hypnosis there was reduced activity in the dACC, increased functional connectivity between the dorsolateral prefrontal cortex (DLPFC;ECN) and the insula in the SN, and reduced connectivity between the ECN (DLPFC) and the DMN (PCC). These changes in neural activity underlie the focused attention, enhanced somatic and emotional control, and lack of self-consciousness that characterizes hypnosis.

    View details for PubMedID 27469596

  • Aberrant nocturnal cortisol and disease progression in women with breast cancer BREAST CANCER RESEARCH AND TREATMENT Zeitzer, J. M., Nouriani, B., Rissling, M. B., Sledge, G. W., Kaplan, K. A., Aasly, L., Palesh, O., Jo, B., Neri, E., Dhabhar, F. S., Spiegel, D. 2016; 158 (1): 43-50

    Abstract

    While a relationship between disruption of circadian rhythms and the progression of cancer has been hypothesized in field and epidemiologic studies, it has never been unequivocally demonstrated. We determined the circadian rhythm of cortisol and sleep in women with advanced breast cancer (ABC) under the conditions necessary to allow for the precise measurement of these variables. Women with ABC (n = 97) and age-matched controls (n = 24) took part in a 24-h intensive physiological monitoring study involving polysomnographic sleep measures and high-density plasma sampling. Sleep was scored using both standard clinical metrics and power spectral analysis. Three-harmonic regression analysis and functional data analysis were used to assess the 24-h and sleep-associated patterns of plasma cortisol, respectively. The circadian pattern of plasma cortisol as described by its timing, timing relative to sleep, or amplitude was indistinguishable between women with ABC and age-matched controls (p's > 0.11, t-tests). There was, however, an aberrant spike of cortisol during the sleep of a subset of women, during which there was an eightfold increase in the amount of objectively measured wake time (p < 0.004, Wilcoxon Signed-Rank). This cortisol aberration was associated with cancer progression such that the larger the aberration, the shorter the disease-free interval (time from initial diagnosis to metastasis; r = -0.30, p = 0.004; linear regression). The same aberrant spike was present in a similar percent of women without ABC and associated with concomitant sleep disruption. A greater understanding of this sleep-related cortisol abnormality, possibly a vulnerability trait, is likely important in our understanding of individual variation in the progression of cancer.

    View details for DOI 10.1007/s10549-016-3864-2

    View details for Web of Science ID 000379494200005

    View details for PubMedID 27314577

    View details for PubMedCentralID PMC4938753

  • Higher Vagal Activity as Related to Survival in Patients With Advanced Breast Cancer: An Analysis of Autonomic Dysregulation PSYCHOSOMATIC MEDICINE Giese-Davis, J., Wilhelm, F. H., Tamagawa, R., Palesh, O., Neri, E., Taylor, C. B., Kraemer, H. C., Spiegel, D. 2015; 77 (4): 346-355

    Abstract

    High levels of high-frequency heart rate variability (HF-HRV), related to parasympathetic-nervous-system functioning, have been associated with longer survival in patients with myocardial infarction and acute trauma and in patients undergoing palliative care. From animal studies linking higher vagal activity with better immune system functioning and reduced metastases, we hypothesized that higher HF-HRV would predict longer survival in patients with metastatic or recurrent breast cancer (MRBC).Eighty-seven patients with MRBC participated in a laboratory task including a 5-minute resting baseline electrocardiogram. HF-HRV was computed as the natural logarithm of the summed power spectral density of R-R intervals (0.15-0.50 Hz). In this secondary analysis of a study testing whether diurnal cortisol slope predicted survival, we tested the association between resting baseline HF-HRV on survival using Cox proportional hazards models.A total of 50 patients died during a median follow-up of 7.99 years. Higher baseline HF-HRV predicted significantly longer survival, with a hazard ratio of 0.75 (95% confidence interval = 0.60-0.92, p = .006). Visceral metastasis status and baseline heart rate were related to both HF-HRV and survival. However, a combination of HF-HRV and heart rate further improved survival prediction, with a hazard ratio of 0.64 (95% confidence interval = 0.48-0.85, p = .002).Vagal activity of patients with MRBC strongly predicted their survival, extending the known predictive window of HF-HRV in cancer beyond palliative care. Vagal activity can be altered by behavioral, pharmacological, and surgical interventions and may be a promising target for extending life expectancy in patients with metastasizing cancer.

    View details for DOI 10.1097/PSY.0000000000000167

    View details for Web of Science ID 000354553000001

    View details for PubMedID 25886831

Journal Articles

Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • Hypnotic predictors of agency: Responsiveness to specific suggestions in hypnosis is associated with involuntariness in fibromyalgia. Consciousness and cognition Faerman, A., Stimpson, K. H., Bishop, J. H., Neri, E., Phillips, A., Gulser, M., Amin, H., Nejad, R., Fotros, A., Williams, N. R., Spiegel, D. 2021; 96: 103221

    Abstract

    Hypnosis is associated with alterations in the sense of agency which can play a role in its utilization as a nonpharmacological option for pain management. The goal of the current study was to examine the relationships between responsiveness to suggestions in hypnosis and alterations of the sense of agency among patients with fibromyalgia. Ninety-eight participants with fibromyalgia underwent two hypnotizability assessments followed by the Sense of Agency Rating Scale. Clinical pain measures were also collected. Involuntariness was predicted by responsiveness to control, ideomotor, and dissociation suggestions. Effortlessness was predicted by responsiveness to control and ideomotor suggestions, and age. Hypnotizability was associated with main clinical pain outcomes, but agency alterations were not. Results suggest a shared mechanism between responsiveness to specific suggestions and the sense of agency in hypnosis. We discuss theoretical and clinical implications for pain management and the need for further research.

    View details for DOI 10.1016/j.concog.2021.103221

    View details for PubMedID 34695719

  • Impact of assessment frequency of patient-reported outcomes: an observational study using an eHealth platform in cancer patients. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer Innominato, P. F., Komarzynski, S., Dallmann, R., Wreglesworth, N. I., Bouchahda, M., Karaboue, A., Ulusakarya, A., Subbe, C. P., Spiegel, D., Levi, F. A. 2021

    Abstract

    BACKGROUND AND AIM: The evaluation of patient-reported outcomes (PRO) in cancer has proven relevant positive clinical impact on patients' communication with healthcare professionals, decision-making for management, well-being, and overall survival. However, the optimal frequency of PRO assessment has yet to be defined. Based on the assumption that more frequent sampling would enhance accuracy, we aimed at identifying the optimal sampling frequency that does not miss clinically relevant insight.METHODS: We used pilot data from 31 advanced cancer patients who completed once daily the 19-item MD Anderson Symptom Inventory at home. The resulting dataset allowed us to compare different PRO assessment frequencies to daily sampling, i.e., alternate days (q2d), every third day (q3d), or once a week (q1w). We evaluated the sampling frequencies for two main outcomes: average symptom intensity and identification of severe symptoms.RESULTS: The majority of the differences between corresponding averages of daily data and those for q2d, q3d, and q1w datasets were close to 0, yet the extremes exceeded 5. Clinically meaningful differences, i.e.,>1, were observed in 0.76% of patient items for q2d, in 2.72% for q3d, and in 11.93% for q1w. Moreover, median values of missed instances of a severe symptom (i.e.,>6) were 14.6% for q2d, 27.8% for q3d, and 55.6% for q1w.CONCLUSIONS: Our analysis suggests that in patients receiving chemotherapy for advanced cancer, increasing the density of PRO collection enhances the accuracy of PRO assessment to a clinically meaningful extent. This is valid for both computations of averages symptom burden and for the recognition of episodes of severe symptom intensity.

    View details for DOI 10.1007/s00520-021-06262-1

    View details for PubMedID 33963910

  • The Hypnotic Induction Profile (HIP) in Clinical Practice and Research. The International journal of clinical and experimental hypnosis Alexander, J. E., Stimpson, K. H., Kittle, J., Spiegel, D. 2021; 69 (1): 72–82

    Abstract

    The Hypnotic Induction Profile (HIP) was developed as a brief, yet thorough, assessment of a person's level of trait hypnotizability and their potential to experience a hypnotic state. The HIP quantitatively and qualitatively measures hynotizability by evaluating biological and sensorimotor experiences designed to assess 3 fundamental observable and measurable components of hypnosis: absorption, dissociation, and suggestibility through a guided assessment that takes 5 to 10minutes. From conception, the HIP has been utilized in clinical settings to assess appropriateness for the use of hypnosis in treatment planning and research protocols to stratify research participants. The brevity, accessibility, and reliability of the HIP have allowed it to adapt, not only across settings but through media platforms as technology and remote delivery become increasingly incorporated in the field of hypnosis.

    View details for DOI 10.1080/00207144.2021.1836646

    View details for PubMedID 33513067

  • Posthypnotic Amnesia in Hypnotizability Assessment: Validation of a New Scoring System for the Hypnotic Induction Profile. The International journal of clinical and experimental hypnosis Faerman, A., Spiegel, D. 2021; 69 (1): 83–93

    Abstract

    The Hypnotic Induction Profile (HIP) is a standardized assessment of hypnotizability featuring a validated 0-10 scoring system, that does not factor in posthypnotic amnesia. Using confirmatory factor analyses (CFA), we compared the 10-point scoring system with a new 12-point system that includes the posthypnotic amnesia item in independent samples of individuals with fibromyalgia (n =98) and healthy adults (n =97). Additionally, we explored associations of the two scoring systems with measures of hypnotic phenomena. CFA results indicate that the 12-point scoring system is a good fit for the 1-factor model of hypnotizability. Posthypnotic amnesia loaded highly on the model in the fibromyalgia sample, and moderately on the model in healthy adults. Furthermore, the 12-point scoring system correlated significantly with measures of hypnotic phenomena. We conclude that the 12-point scoring system is psychometrically equivalent yet conceptually more comprehensive than the 10-point scoring system.

    View details for DOI 10.1080/00207144.2021.1834860

    View details for PubMedID 33513058

  • Hypnosis: The Most Effective Treatment You Have Yet to Prescribe. The American journal of medicine Kittle, J., Spiegel, D. 2020

    View details for DOI 10.1016/j.amjmed.2020.10.010

    View details for PubMedID 33171103

  • Identification With the Aggressor and Inward and Outward Aggression in Abuse Survivors. Journal of interpersonal violence Lahav, Y., Allende, S., Talmon, A., Ginzburg, K., Spiegel, D. 2020: 886260520938516

    Abstract

    Childhood abuse survivors may display both inward and outward aggression manifested in self-injurious behavior (SIB) and violent acts toward others. Scrutinizing the literature reveals that the relational dynamics between victims and their perpetrators might be involved in these phenomena. Yet, research on this subject matter has been sparse. Filling this gap, this study investigated the contribution of the singular bonds between victims and their perpetrators, known as identification with the aggressor, in explaining survivors' aggression. The study was conducted among 306 Israeli college/university students who reported a history of childhood abuse. Results revealed that levels of adopting the perpetrator's experience, identifying with the perpetrator's aggression, and replacing one's agency with that of the perpetrator were significantly associated with survivors' inward and outward aggression. Moreover, profile type-that is, having high versus low levels of identification with the aggressor-was implicated in participants' SIBs, urge to harm others, and violent acts toward others, above and beyond the effects of gender and posttraumatic stress disorder (PTSD) symptoms. The present findings suggest that identification with the aggressor might make survivors prone to the re-enactment of past abusive dynamics, which, in turn, could eventuate in aggression toward themselves and others.

    View details for DOI 10.1177/0886260520938516

    View details for PubMedID 32659159

  • Inviting Scientific Discourse on Traumatic Dissociation: Progress Made and Obstacles to Further Resolution PSYCHOLOGICAL INJURY & LAW Dalenberg, C. J., Brand, B. L., Loewenstein, R. J., Frewen, P. A., Spiegel, D. 2020
  • Evening salivary cortisol as a single stress marker in women with metastatic breast cancer. Psychoneuroendocrinology Allende, S. n., Medina, J. L., Spiegel, D. n., Zeitzer, J. M. 2020; 115: 104648

    Abstract

    Flattened diurnal salivary cortisol patterns predict shorter subsequent survival with breast, lung, and renal cell carcinomas. The underlying cause of this flattened slope is undetermined, though it has been hypothesized to be secondary to a deficit in the amplitude of the circadian clock. To gain greater insight into the portions of the diurnal salivary curve that are associated with cancer survival, we examined (1) which points in the diurnal curve are predictive of the slope of the curve and (2) whether elevated evening cortisol levels alone are associated with reduced HPA-axis feedback inhibition (i.e., decreased sensitivity to the dexamethasone suppression test).We examined study hypotheses on adult women with advanced breast cancer (age = 54.3 ± 9.58 years; n = 99) using non-parametric Wilcoxon's rank-sum tests, Spearman correlation coefficients and an accuracy formula based on a confusion matrix. Cortisol was sampled five times per day for three consecutive days, with dexamethasone administered late on the second day.Salivary cortisol concentrations did not vary between those with flat and steep slopes during the morning (p's > .05), but did vary in the evening (p's < 0.05). Furthermore, the concentration of the 2100h alone was 86% accurate in discriminating between individuals classified as having "flat" or "steep" slopes. Dexamethasone suppression was only associated with diurnal salivary cortisol slope (p = .0042).Evening cortisol levels are a sensitive indicator flattened diurnal cortisol slope, suggesting evening cortisol may also be a useful predictor of breast cancer survival. Future research should focus on determining the causes of abnormally increased evening cortisol.

    View details for DOI 10.1016/j.psyneuen.2020.104648

    View details for PubMedID 32171899

  • Brain and Physiological Markers of Autonomic Function Are Associated With Treatment-Related Improvements in Self-Reported Autonomic Dysfunction in Veterans With Gulf War Illness: An Exploratory Pilot Study. Global advances in health and medicine Mathersul, D. C., Eising, C. M., DeSouza, D. D., Spiegel, D., Bayley, P. J. 2020; 9: 2164956120922812

    Abstract

    Background: Gulf War Illness (GWI) is a poorly understood condition characterized by a constellation of mood, cognitive, and physical symptoms. A growing body of evidence demonstrates autonomic nervous system (ANS) dysfunction. Few published treatment studies exist for GWI.Method: We recently completed a randomized controlled trial comparing a 10-week group yoga intervention to 10-week group cognitive behavioral therapy (CBT) for veterans with GWI. Here, we present exploratory data on ANS biomarkers of treatment response from a small pilot exploratory neurophysiological add-on study (n=13) within that larger study.Results: Findings suggest that veterans with GWI receiving either yoga or CBT for pain improved following treatment and that changes in biological ANS-especially for the yoga group-moved in the direction of healthy profiles: lower heart rate, higher square root of the mean squared differences between successive R-R intervals (RMSSD), greater parasympathetic activation/dominance (increased high-frequency heart rate variability [HF-HRV], decreased low-frequency/high-frequency [LF/HF] ratio), reduced right amygdala volume, and stronger amygdala-default mode/amygdala-salience network connectivity, both immediately posttreatment and at 6-month follow-up. Biological mechanisms of CBT appeared to underlie improvements in more psychologically loaded symptoms such as self-reported fatigue and energy. Higher tonic arousal and/or more sympathetic dominance (higher skin conductance, lower RMSSD, lower HF-HRV, higher LF/HF ratio) pretreatment predicted greater treatment-related improvements in self-reported ANS for both the yoga and CBT group.Conclusion: These exploratory pilot data provide preliminary support for the suggestion that treatment (yoga, CBT) is associated with improvements in both biological and self-reported ANS dysfunctions in GWI. The major limitation for these findings is the small sample size. Larger and more controlled studies are needed to replicate these findings and directly compare biomarkers of yoga versus CBT.

    View details for DOI 10.1177/2164956120922812

    View details for PubMedID 32426178

  • Wrangling with p-values versus effect sizes to improve medical decision-making: A tutorial. The International journal of eating disorders Kraemer, H. C., Neri, E. n., Spiegel, D. n. 2020

    Abstract

    The most pervasive and damaging myth in clinical research is that the smaller the p-value, the stronger the hypothesis. In reality, the p-value primarily reflects the quality of research design decisions. The most common proposal to avoid misleading conclusions from clinical research requires the appropriate use of effect sizes, but which effect size, used when and how, is an open question. A solution is proposed for perhaps the most common problem in clinical research, the comparison between two populations, for example, comparison of two treatments in a randomized clinical trial or comparison of high risk versus low risk individuals in an epidemiological study: the success rate difference or equivalently the number needed to treat/take (NNT).

    View details for DOI 10.1002/eat.23216

    View details for PubMedID 31922284

Conference Proceedings

Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • FEASIBILITY OF HYPNOSIS AS ADJUNCTIVE TREATMENT FOR SUBJECTIVE SLEEP DISTURBANCE: A PILOT STUDY AND PROOF OF CONCEPT Zhao, E., Faerman, A., Spiegel, D. OXFORD UNIV PRESS INC. 2021: A140-A141
  • DO RESEARCH PARTICIPANTS DIFFER BY RECRUITMENT SOURCE?OBSERVATIONS FROM A STUDY OF NEWLY-DIAGNOSED BREAST CANCER PATIENTS Agrawal, A., Benedict, C., Nouriani, B., Medina, J., Kurian, A. W., Spiegel, D. OXFORD UNIV PRESS INC. 2020: S75
  • PROTEOMIC BIOMARKERS OF CIRCADIAN TIME Ambati, A., Lin, L., Zitting, K., Duffy, J. F., Zeitzer, J., Spiegel, D., Czeisler, C. A., Mignot, E. OXFORD UNIV PRESS INC. 2019
  • MATURITY OF DEFENSES, DIURNAL CORTISOL PROFILES, AND DEPRESSIVE SYMPTOMS IN WOMEN WITH PRIMARY BREAST CANCER Rouleau, C., Dutta, N., Li, Y., Sephton, S. E., Tomfohr-Madsen, L., Golant, M., Kronenwetter, C., Spiegel, D., Giese-Davis, J. LIPPINCOTT WILLIAMS & WILKINS. 2018: A31
  • Meta-Analysis of Psychosocial Treatment Effects on Cancer Survival and Sources of Heterogeneity Spiegel, D., Krizanec, S., Kraemer, H., Jo, B., Ershadi, M., Neri, E., Nouriani, B., Aasly, L. NATURE PUBLISHING GROUP. 2017: S331
  • Modulation of the Neural Circuitry Underlying Trait Hypnotizability With Spaced Continuous Theta-Burst Stimulation Williams, N., Sudheimer, K., Stimpson, K., Duvio, D., Chung, C., DeSouza, D., Jo, B., Williams, L., Yeomans, D., Spiegel, D. NATURE PUBLISHING GROUP. 2017: S508–S509
  • Objective sleep duration (SD) and overall survival (OS) in patients (pts) with metastatic colorectal cancer (MCC). Spiegel, D., Levi, F., Bjarnason, G. A., Ulusakarya, A., Palesh, O., Innominato, P. F. AMER SOC CLINICAL ONCOLOGY. 2016
  • Aberrant Nocturnal Cortisol as a Vulnerability Trait for More Rapid Progression of Advanced Breast Cancer Zeitzer, J., Nouriani, B., Rissling, M., Sledge, G., Palesh, O., Jo, B., Neri, E., Spiegel, D. NATURE PUBLISHING GROUP. 2015: S194–S195
  • Symptoms associated with circadian rest-activity rhythm disruption in 237 patients with metastatic colorectal cancer. Innominato, P. F., Palesh, O., Bjarnason, G. A., Ulusakarya, A., Spiegel, D., Levi, F. AMER SOC CLINICAL ONCOLOGY. 2015
  • Tranceformation: hypnosis in brain and body Spiegel, D. KARGER. 2015: 67