Publications

Featured Publications

Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • Marital status and survival in cancer patients: A systematic review and meta-analysis. Cancer medicine Krajc, K., Mirosevic, S., Sajovic, J., Klemenc Ketis, Z., Spiegel, D., Drevensek, G., Drevensek, M. 2022

    Abstract

    BACKGROUND: In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival.METHODS: The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT).RESULTS: Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p<0.001), thus confirming results from the previous meta-analysis.CONCLUSIONS: Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.

    View details for DOI 10.1002/cam4.5003

    View details for PubMedID 35789072

  • Effects of hypnosis versus enhanced standard of care on postoperative opioid use after total knee arthroplasty: the HYPNO-TKA randomized clinical trial. Regional anesthesia and pain medicine Markovits, J., Blaha, O., Zhao, E., Spiegel, D. 2022

    Abstract

    BACKGROUND: Hypnosis decreases perioperative pain and has opioid-sparing potential but has not been rigorously studied in knee arthroplasty. This trial investigates the impact of perioperative hypnosis on inpatient opioid use following total knee arthroplasty.METHODS: This prospective randomized controlled trial was conducted at a single academic medical center. The hypnosis arm underwent a scripted 10min hypnosis session prior to surgery and had access to the recorded script. The control arm received hypnosis education only. The primary outcome was opioid use in milligram oral morphine equivalents per 24 hours during hospital admission. A secondary analysis was performed for patients taking opioids preoperatively.RESULTS: 64 primary knee arthroplasty patients were randomized 1:1 to hypnosis (n=31) versus control (n=33) and included in the intent-to-treat analysis. The mean (SD) postoperative opioid use in oral morphine equivalents per 24 hours was 70.5 (48.4) in the hypnosis versus 90.7 (74.4) in the control arm, a difference that was not statistically significant (difference -20.1; 95% CI -51.8 to 11.4; p=0.20). In the subgroup analysis of the opioid-experienced patients, there was a 54% daily reduction in opioid use in the hypnosis group (82.4 (56.2) vs 179.1 (74.5) difference of -96.7; 95% CI -164.4 to -29.0; p=<0.01), equivalent to sparing 65mg of oxycodone per day.CONCLUSION: Perioperative hypnosis significantly reduced inpatient opioid use among opioid-experienced patients only. A larger study examining these findings is warranted.TRIAL REGISTRATION NUMBER: NCT03308071.

    View details for DOI 10.1136/rapm-2022-103493

    View details for PubMedID 35715013

  • 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

  • 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

  • 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

  • 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

Journal Articles

Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • Development of a Web-Based Decision Aid and Planning Tool for Family Building After Cancer (Roadmap to Parenthood): Usability Testing. JMIR cancer Benedict, C., Dauber-Decker, K. L., Ford, J. S., King, D., Spiegel, D., Schapira, L., Simon, P., Diefenbach, M. 2022; 8 (2): e33304

    Abstract

    Owing to gonadotoxic cancer treatments, young adult female survivors often report uncertainty about their fertility, reproductive potential, and family-building options after treatment. Roadmap to Parenthood is a web-based decision aid and planning tool for family building after cancer.As part of a patient-centered development process, this study evaluated the usability of the decision aid website to inform design modifications and improve user experience.In total, 2 rounds of usability testing were conducted with the target population of young adult female cancer survivors. During the testing sessions, participants viewed the website twice; first, as a think-aloud exercise, and second, while a researcher interrupted at key points to obtain user feedback. Quantitative and qualitative data were collected to assess website usability. Quantitative measures included the System Usability Scale, WebQual, and eHealth Impact Questionnaire. An exit interview with open-ended questions gathered feedback on likes and dislikes and suggestions for improvement.Participants (N=10) were young adult women, with average age of 30.9 (SD 4.51) years, and average time since treatment was 4.44 (SD 3.56) years. Website usability scores improved on the System Usability Scale from "acceptable" in round 1 to "excellent" in round 2 after making design changes based on user feedback (scores of 68 and 89.4, respectively). WebQual scores showed similar improvement from round 1 to round 2 of testing (mean 5.6 to 6.25; range 1-7). On the eHealth Impact Questionnaire, the information and presentation of the website was perceived as comprehensive, easy to understand, and trustworthy. Participants also reported improved confidence to discuss and manage fertility and family-building issues and felt encouraged to play a more active role in managing their fertility. In all, 3 usability themes were identified from the qualitative feedback: ease of use, visibility and navigation, and informational content and usefulness. Overall feedback was positive, and participants reported intentions to use the decision aid website in the future. In total, 10% (1/10) of the participants reported negative emotions when learning about infertility risks and potential family-building challenges.Website usability improved after design changes were made in response to user feedback. Young adult female survivors reported positive views about the website and indicated that the decision aid would be useful in decision-making about family building after cancer. Future studies will include further design modifications to consider the emotional experiences of users and any additional navigational features or content to optimize the ease of use and support provided by the tool.

    View details for DOI 10.2196/33304

    View details for PubMedID 35639461

  • The longitudinal effects of chronotype on chemotherapy-induced nausea and vomiting in patients with breast cancer receiving neoadjuvant chemotherapy. Journal of psychosomatic research Jung, S., Son, K., Jung, S., Moon, J. Y., Oh, G. H., Yeom, C., Lee, K., Kim, W., Jung, D., Kim, T., Im, S., Lee, K., Spiegel, D., Hahm, B. 2022; 157: 110804

    Abstract

    OBJECTIVE: The object of this longitudinal cohort study was to investigate whether chronotype affects the incidence of chemotherapy-induced nausea and vomiting (CINV) among patients with breast cancer.METHODS: The study included a total of 203 breast cancer patients who received neoadjuvant chemotherapy using a regimen of doxorubicin and cyclophosphamide with high emetogenicity. Patients received four cycles of chemotherapy in approximately three months. Patients completed questionnaires including the Munich Chronotype Questionnaire (MCTQ) before the first chemotherapy and the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) after each of the four chemotherapy sessions. To confirm the effect of chronotype on CINV during the four cycles, we performed statistical analyses using a generalized estimating equation (GEE).RESULTS: CINV occurred in 108 (53.2%), 112 (55.2%), 102 (50.3%), and 62 (30.5%) patients during four cycles of treatment. In the GEE approach, late and early chronotypes (vs. intermediate chronotype) were associated with an increased risk of CINV (late chronotype: odds ratio [OR], 2.06; 95% confidence interval [CI], 1.41-2.99; p<0.001, early chronotype: OR, 1.84; CI, 1.25-2.73; p=0.002), which remained significant even after adjusting for age, BMI, antiemetic treatment, history of nausea and vomiting, anxiety, and sleep quality.CONCLUSION: Chronotype affected CINV across the four cycles of neoadjuvant chemotherapy in patients with breast cancer, suggesting the need to consider chronotype in predicting and managing CINV.

    View details for DOI 10.1016/j.jpsychores.2022.110804

    View details for PubMedID 35381494

  • Morning Chronotype Decreases the Risk of Chemotherapy-Induced Peripheral Neuropathy in Women With Breast Cancer. Journal of Korean medical science Son, K., Jung, D., Lee, K., Yeom, C., Oh, G. H., Kim, T., Im, S., Lee, K., Spiegel, D., Hahm, B. 2022; 37 (5): e34

    Abstract

    BACKGROUND: The purpose of this longitudinal prospective cohort study was to investigate the role of chronotype in the incidence of chemotherapy-induced peripheral neuropathy (CIPN) among women with breast cancer.METHODS: We recruited women with breast cancer awaiting adjuvant chemotherapy, including four cycles of docetaxel. Participants reported peripheral neuropathy symptoms of numbness/tingling at the baseline, and at 4weeks after completion of chemotherapy. Candidate psychiatric factors associated with CIPN were assessed at the baseline, using the Composite Scale of Morningness, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale. To examine the association between chronotype and CIPN, we built logistic regression models, adjusting for demographic, clinical, and other psychiatric variables.RESULTS: Among 48 participants, 29 participants developed CIPN. The morning chronotype was inversely associated with CIPN (odds ratio, 0.06; confidence interval, 0.01-0.74; P = 0.028) after adjusting for age, BMI, education, type of operation, alcohol use, smoking, sleep quality, depression, and anxiety.CONCLUSION: Our results suggest that the morning chronotype is a protective factor against the development of CIPN in patients with breast cancer who were treated with docetaxel.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01887925.

    View details for DOI 10.3346/jkms.2022.37.e34

    View details for PubMedID 35132840

  • 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

  • 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

  • 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

  • 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

Conference Proceedings

Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • CARDIOVASCULAR COREGULATION TO A SERIES OF ACUTE INTERPERSONAL STRESSORS: INNOVATIVE METHODOLOGICAL APPROACH TO STUDYING REGULATION TO A CHRONIC ILLNESS IN THE FAMILY Moulder, R., Tsai, T. C., Hurwitz, B., Spiegel, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2022: A38
  • Altered Neurochemical Ratio in the Prefrontal Cortex is Associated With Pain in Fibromyalgia Syndrome Bishop, J., Faerman, A., Geoly, A., Maron-Katz, A., Sacchet, M., Spiegel, D., Williams, N. SPRINGERNATURE. 2021: 163
  • 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
  • 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
  • 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
  • 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