doi:10.1093/scan/nst110 SCAN (2013) 1of 8 The suggestible …€¦ · autosuggestion successfully devalued snacks. This was indicated by participants decision-making, their self-report

The suggestible brain posthypnotic effects on

value-based decision-making

Vera U Ludwig1234 Christine Stelzel1234 Harald Krutiak15 Amadeus Magrabi1246 Rosa Steimke1234

Lena M Paschke1234 Norbert Kathmann23 and Henrik Walter1241Department of Psychiatry amp Psychotherapy Division of Mind and Brain Research Charite Universitatsmedizin Berlin 10117 Berlin 2Berlin

School of Mind and Brain Humboldt-Universitat zu Berlin 10117 Berlin 3Department of Psychology Humboldt-Universitat zu Berlin 12489

Berlin 4Berlin Center for Advanced Neuroimaging 10119 Berlin 5Fortbildungszentrum OST der Deutschen Gesellschaft fur Hypnose und

Hypnotherapie eV 10777 Berlin and 6Institute of Cognitive Science Universitat Osnabruck 49069 Osnabruck Germany

Hypnosis can affect perception motor function and memory However so far no study using neuroimaging has investigated whether hypnosis can

influence reward processing and decision-making Here we assessed whether posthypnotic suggestions can diminish the attractiveness of unhealthy

food and whether this is more effective than diminishing attractiveness by ones own effort via autosuggestion In total 16 participants were hypnotized

and 16 others were instructed to associate a color cue (blue or green) with disgust regarding specific snacks (sweet or salty) Afterwards participants

bid for snack items shown on an either blue or green background during functional magnetic resonance imaging measurement Both hypnosis and

autosuggestion successfully devalued snacks This was indicated by participants decision-making their self-report and by decreased blood oxygen level-

dependent signal in the ventromedial prefrontal cortex (vmPFC) a region known to represent value Different vmPFC subregions coded for cue and snack

type The cue had significantly stronger effects on vmPFC after hypnosis than after autosuggestion indicating that hypnosis was more effective in

genuinely reducing value Supporting previous findings the precuneus was involved in the hypnotic effects by encoding whether a snack was sweet or

salty during hypnotic cue presentation Our results demonstrate that posthypnotic suggestions can influence valuation and decision-making

Keywords hypnosis precuneus self-control value-based decision-making ventromedial prefrontal cortex

INTRODUCTION

Hypnosis is a state of altered attention and heightened suggestibility

which is typically induced by verbal instructions During hypnosis sug-

gestions can be given to participants and these may either take effect

immediately or after the hypnotic state In the latter case they are

termed lsquoposthypnoticrsquo suggestions (Raz et al 2002 2005 Wheatley

and Haidt 2005 Iani et al 2006 2009) Hypnotic suggestions can

lead to strong and genuine effects in susceptible individuals such as

paralysis (Halligan et al 2000 Cojan et al 2009) experiencing own

movements as externally caused (Blakemore et al 2003) seeing letters

in colors (Cohen Kadosh et al 2009) sensory pain without an affective

component (Rainville et al 1997) visual illusions (Kosslyn et al 2000)

or auditory hallucinations (Szechtman et al 1998) Hypnotic sugges-

tions can also affect moral judgments and moral behavior (Wheatley

and Haidt 2005 Brune et al 2012) So far however no study using

neuroimaging has investigated whether hypnosis can also influence

reward processing and value-based decision-making This is a crucial

question given the wide use of hypnosis to treat maladaptive decision-

making such as in nicotine addiction or obesity (Kirsch et al 1995

Allison and Faith 1996 Carmody et al 2008 Barnes et al 2010)

It is well established that the subjective value people place on

decision options is represented in the ventromedial prefrontal cortex

(vmPFC) which includes the rostral anterior cingulate cortex (rACC)

and the medial orbitofrontal cortex (mOFC Kable and Glimcher

2007 Hare et al 2008 Lebreton et al 2009 Basten et al 2010

Peters and Buchel 2010 Plassmann et al 2010 Grabenhorst and

Rolls 2011 Brosch et al 2012) For example the greater the activity

in vmPFC the more people are willing to pay for an item (Plassmann

et al 2007 Chib et al 2009 Janowski et al submitted for publica-

tion) or the more they desire to consume it (Hare et al 2009 Litt

et al 2011) Some studies have shown that value signals in vmPFC can

be modulated by self-control or attention (Hare et al 2009 Hollmann

et al 2011) or by mindsets (Bhanji and Beer 2012 for studies on

modulating pleasantness of tasting or smelling rewards see de

Araujo et al 2005 Grabenhorst and Rolls 2008 Grabenhorst et al

2008 Plassmann et al 2008) For example when participants focus

their attention on health aspects of food items vmPFC responds more

strongly to the healthiness of the food and participants also make

healthier decisions (Hare et al 2011) Moreover when participants

focus on the (negative) long-term rather than the (positive) short-term

consequences of consuming food or cigarettes vmPFC responds less

strongly to pictures showing food or cigarettes (Kober et al 2010)

However overall evidence regarding experimental manipulations of

vmPFC value signals during decision-making has been scarce

Here we investigated whether posthypnotic suggestions can

influence the value people place on unhealthy food during decision-

making as indicated by behavior self-report and vmPFC activation

We further asked whether hypnosis can achieve stronger effects than

self-controlled down-regulation of the attractiveness of food termed

here lsquoautosuggestionrsquo (Baudouin 2003 Coue 2009) Autosuggestion

refers to the process of implementing a mental change in oneself (eg

by repeating suggestions to oneself and by engaging in goal-directed

imagery) It is a novel approach to use an autosuggestion (or self-

control) group as a comparison group for hypnosis Previous studies

have typically used control participants who were either instructed to

lsquosimulatersquo hypnotic behavior (Cojan et al 2009) or who received the

same suggestions as the hypnotized group without a hypnotic

Received 12 November 2012 Revised 10 March 2013 Accepted 17 July 2013

We thank Antonio Rangel for stimulating discussions on study design and data analysis We thank Sven Reichelt

for taking the pictures for the stimulus set and Hilke Plassmann for advice regarding the creation of the stimuli We

are grateful to Walter Bongartz for providing materials for the German HGSHSA and to Dar Meshi for proof-reading

and commenting on the manuscript We thank Dominik Bach Bjorn Schott and Susanne Erk for discussions and

Torsten Wustenberg for providing the MATLAB tool for the creation of the vmPFC ROI

This study was funded by the VW-Foundation (II84 051 HW) and the German National Academic Foundation

(to VUL)

Correspondence should be addressed to Vera U Ludwig Department of Psychiatry and Psychotherapy

Division of Mind and Brain Research Charite Universitatsmedizin Berlin Chariteplatz 1 10117 Berlin Germany

E-mail VeraLudwighu-berlinde

doi101093scannst110 SCAN (2013) 1of 8

The Author (2013) Published by Oxford University Press For Permissions please email journalspermissionsoupcom

Social Cognitive and Affective Neuroscience Advance Access published August 21 2013 at C

haritAtildecopy

on August 22 2013

httpscanoxfordjournalsorgD

ownloaded from

induction (Iani et al 2006) Another approach is to compare hypnotic

effects between highly suggestible and less suggestible participants

(Raz et al 2002) Here we compared hypnosis to autosuggestion

because it is clinically and practically relevant to determine if hypnosis

is more effective than attempts to implement a mental change by

oneself

We further assessed whether the hypnotic manipulation of value-

based decision-making involves the precuneus Previous findings indi-

cated that the precuneus is important for hypnotic effects In a study

by Cojan et al (2009) participants were given hypnotic suggestions for

left-hand paralysis When they were instructed to move their left

handwhich they were unable to dothere was precuneus activation

and precuneus showed enhanced functional connectivity with primary

motor cortex The authors related their findings to studies showing

that the precuneus is involved in mental imagery and self-related pro-

cessing (Lou et al 2004 Cavanna and Trimble 2006) They proposed

that during hypnotic effects behavior is guided by increased self-moni-

toring processes and by internal representations produced by imagery

and by the hypnotic suggestions

We hypothesized that hypnosis would be able to change decision-

making about unhealthy snacks behaviorally and that this would be

reflected in diminished value signals in vmPFC during those decisions

We further predicted that hypnosis would lead to stronger effects than

autosuggestion Finally we hypothesized that the precuneus would be

functionally involved in the hypnotic effects by encoding relevant

information about the content of the suggestions

METHODS

Participants

We tested 32 participants (18 female mean agefrac14 2494 years

sdfrac14 370) 16 in a hypnosis group and 16 in an autosuggestion

group Inclusion criteria were right-handedness normal or

corrected-to-normal vision no history of eating disorders or other

psychiatric or neurological disorders no medication which may influ-

ence brain activation no current diet liking of both sweet and salty

snacks and upper medium to high hypnotic suggestibility (pre-

screened using the Harvard Group Scale of Hypnotic Susceptibility

Form A HGSHSA required score 7ndash12 Shor and Orne 1962)

Participants of the two groups were matched in terms of age sex

and hypnotic suggestibility (Supplementary Table S1) Participants

received monetary compensation for participation and gave written

informed consent The study was approved by the local ethics

committee

Procedure

Participants arrived at the laboratory hungry as they had been asked to

not eat for 4 h before the experiment (Figure 1A) The 16 participants

of the hypnosis group were then hypnotized in a one-to-one setting by

a professional hypnotist (HK) During hypnosis participants were

suggested to open their eyes and to look at a color on a monitor

(blue or green counterbalanced across subjects) They were suggested

that this color would be associated with a strong feeling of disgust

regarding either sweet or salty snacks (counterbalanced across sub-

jects) This is a posthypnotic suggestion as it is activated when the

posthypnotic color cue is encountered lsquoafterrsquo hypnosis in a normal

state Note that hypnosis did not involve induction of amnesia par-

ticipants were therefore aware of what had been suggested to them We

refer to those snacks (ie sweet or salty) that were associated with

disgust as lsquotarget snacksrsquo and to the others as lsquonon-target snacksrsquo

The 16 other participants were instructedwithout hypnosisto asso-

ciate the color cue (bluegreen) with disgust regarding either sweet or

salty snacks They were given as much time as the hypnotized subjects

to make the association by themselves and they were also sitting in

front of the monitor with the color while engaging in the autosugges-

tion Participants were free to use their own strategy to make this

association which we inquired about after the experiment

(Supplementary Table S2)

After the intervention we assessed participantsrsquo decision-making

and brain activation using functional magnetic resonance imaging

(fMRI) during an auction on unhealthy snacks (Figure 1B) Note

that participants in the hypnosis group were in a normal state

during scanning as hypnosis was finished beforehand After scanning

participants completed a questionnaire about their experience The

procedures are described in more detail in the Supplementary Data

Task

The auction was a variant of a BeckerndashDeGrootndashMarshak method

(Becker et al 1964 Plassmann et al 2007) and took 35min

Participants saw pictures of sweet and salty snack items (eg chocolate

bars chips) and could bid between 0E and 250E for each of them

(in 050E steps) Snacks were shown on an either blue or green back-

ground That is during two out of the four runs of the auction snacks

were shown on the color cue associated with disgust (cueON-runs)

and during the two other runs snacks were shown on the neutral color

(cueOFF-runs) There were hence four trial types targets-cueON

non-targets-cueON targets-cueOFF and non-targets-cueOFF

(Figure 1C) Runs were separated by math problems for distraction

Our stimulus set comprised 50 high-resolution pictures of appetitive

snack items (25 sweet and 25 salty) that were highly familiar in

Germany For each run 40ndash43 stimuli were randomly selected for

presentation out of the stimulus set Approximately half of the

snacks in each run were target snacks and half were non-target

Fig 1 Methods (A) Procedure hungry participants were either hypnotized or they used autosug-gestion in order to feel disgust regarding either sweet or salty snacks upon seeing either a blue or agreen color cue Afterwards they carried out an auction on sweet and salty snacks shown on aneither blue or green background in the fMRI scanner They could buy a real snack at the auction(B) Experimental auction (C) Overview of the trial types Note that in this figure example stimulihave been modified so that the brands of the snacks are not recognizable

2 of 8 SCAN (2013) VULudwig et al

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snacks (ie half were sweet and half were salty) presented randomly

No stimulus was shown more than once during one run

The auction was set up such that participants would treat each de-

cision as a real decision and as the only one that counts

(see Supplementary Data) To incentivize honest responses partici-

pants could buy a real snack on the auction If participants did not

buy a snack they had to stay hungry for another half hour after leaving

the scanner

Postexperimental questionnaire

The postexperimental questionnaire differed partly between groups

The following questions were overlapping (translated from German)

lsquoHow much disgust did you experience for salty snacks on blue back-

groundrsquo (the same question reoccurred three more times with sweet

on blue salty on green and salty on blue) lsquoTo what degree did you feel

physical disgustrsquo lsquoHow automatic vs self-controlled did the disgust

appear to you in case that you felt disgustrsquo lsquoPlease be honest

during the experiment did you sometimes just pretend to feel disgustrsquo

and lsquoDid you often consciously think about the meaning of the color

cue during the experiment and consciouslyvoluntarily recalled the as-

sociation with disgustrsquo Answers were given on Likert-scales from 1ndash7

Some open response questions about participantsrsquo experiences were

also included (eg regarding the strategies that participants in the

autosuggestion group used)

Analysis of behavior and self-report

Mixed analysis of variances (ANOVAs) were used to analyze bids

mean reaction times (RTs) for bids and postexperimental disgust rat-

ings ANOVAs included the within-subject factors snack type (target

non-targets) and cue (cueONcueOFF) and the between-subject factor

group (hypnosisautosuggestion) Prior to the analysis bids were log-

transformed in order to meet the assumption of normality

(see Supplementary Data for more information) To compare the

two groups regarding the remaining self-report questions we used

independent t-tests where data were normally distributed and non-

parametric MannndashWhitney tests where data were not normal For

ANOVAs 2 is reported as a measure of effect size It represents the

proportion of variance in the dependent variable explained by an

effect Effect sizes r for t-tests and MannndashWhitney tests were calculated

following Rosenthal (1991) interpretation of r 010 small 030

medium and 050 large (Cohen 1988)

fMRI data acquisition and preprocessing

Data were collected using a 3T Siemens Tim Trio MRI scanner with a

12-channel head coil For each run 185 functional images including 33

axial slices were acquired in descending order using a T2-sensitive

one-shot gradient-echo echo-planar imaging (EPI) sequence The fol-

lowing parameters were used repetition timefrac14 2 s echo timefrac14 25ms

field of viewfrac14 24 cm matrix sizefrac14 64 64 voxel sizefrac14 3 3 3mm

and inter-slice gapfrac14 075mm Functional images were realigned and

unwarped based on fieldmaps slice-time-corrected spatially normal-

ized to the standard Montreal National Institute (MNI) EPI template

and smoothed using an isotropic 8mm full-width half-maximum

Gaussian kernel (see also Supplementary Data) Coordinates reported

in this article are MNI-coordinates

fMRI data analysis

We calculated general linear models on the single-subject level In a

first model we modeled target trials non-target trials and missed trials

as box-car functions of 3 s convolved with the hemodynamic response

function Depending on the run the target and non-target regressors

encoded lsquotargets-cueONrsquo and lsquonon-targets-cueONrsquo or lsquotargets-cueOFFrsquo

and lsquonon-targets-cueOFFrsquo Motion parameters were included as regres-

sors of no interest High-pass temporal filtering (128 s) was applied

A second model was set up in the same way as the first model but it

included the parametric modulator bid size This served to identify

regions correlating with bids Relevant contrasts were calculated on the

first level for each subject separately On the second level we used one-

sample t-tests for determining the effects for all subjects together and

independent t-tests for the group comparisons We restricted our main

analyses to voxels within our regions of interest (ROIs) in vmPFC and

precuneus (Supplementary Figure S1) We corrected the results using

family-wise error (FWE) correction at Plt 005 within ROIs using

small-volume correction For completeness we also report other rele-

vant effects within ROIs at a liberal threshold of Plt 0001 uncorrected

Moreover we conducted exploratory whole-brain analyses at

Plt 0001 uncorrected

Regions of interest

For the two areas of interestvmPFC and precuneuswe created a

priori ROIs (see Supplementary Data) These regions served to spa-

tially restrict the main analyses and for small-volume alpha error ad-

justment For vmPFC we created a probabilistic ROI that takes into

account the coordinates of several previous studies on valuation

(Supplementary Figure S1A and Supplementary Table S5) For precu-

neus we used the peak coordinate from Cojan et al (2009) with a

15mm sphere around it (Supplementary Figure S1B)

RESULTS

Bids

Bids per condition are shown in Figure 2A For all subjects together

there was a main effect of snack type F(130)frac14 16095 Plt 0001

2frac14 029 as participants bid less for target snacks than for non-

target snacks There was also a main effect of cue F(130)frac14 17686

Plt 0001 2frac14 002 as participants bid less for snacks during cueON-

runs than during cueOFF-runs Finally there was an interaction of

cue snack type F(130)frac14 22953 Plt0001 2frac14 004 as the differ-

ence between bids for target snacks and non-target snacks was bigger

during cueON-runs than during cueOFF-runs Furthermore there

were no interactions of group snack type group cue or group -

snack type cue (all P-values gt050) and also no main effect of

group (Pfrac14 016) Hence the effects for bids did not differ between

groups

Pairwise comparisons for all subjects together further showed that

bids for targets-cueON were lower than those for each of the other

three conditions (all P-values lt 0001 all P-values reported here are

Bonferroni-corrected) There was no difference between non-targets-

cueON and non-targets-cueOFF (Pgt050) Unexpectedly bids for tar-

gets-cueOFF were also lower than bids for non-targets-cueON

(Plt005) and tended to be lower than those for non-targets-

cueOFF (Plt010) In sum both hypnosis and autosuggestion success-

fully devalued target snacks during cue presentation as measured by

bidding behavior

RTs for bid responses (Table 1) did not differ between groups or

conditions (P-values gt 010 for all main effects and interactions)

Self-report

Results concerning the postexperimental questionnaires are shown in

Figure 2B and C (disgust ratings and other questions respectively) For

disgust ratings there was a main effect of snack type F(130)frac14 17177

Plt 0001 2frac14 018 of cue F(130)frac14 48661 Plt 0001 2frac14 020 and

an interaction of cue snack type F(130)frac14 23236 Plt 0001

2frac14 008 There were no interactions of group cue group snack

Posthypnotic effects on decision-making SCAN (2013) 3 of 8

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type or group cue snack type (all P-values gt015) However there

was a main effect of group as the hypnosis group reported higher

average disgust than the autosuggestion group F(130)frac14 1076

Pfrac14 0003 2frac14 026 As predicted t-tests for all participants together

showed that reported disgust was higher for targets-cueON than for

each of the other conditions (all P-values lt0001 Bonferroni-

corrected) The remaining three conditions did not differ from each

other (all corrected P-values gt040)

Thus disgust ratings per condition indicated that both interventions

were equally successful in devaluing target snacks experientially

However participants in the hypnosis group reported their disgust

to be more bodily t(30)frac14 2250 Pfrac14 003 rfrac14 038 and less self-

controlled (ie more automatic) than participants in the autosugges-

tion group Ufrac14 22500 Plt0001 rfrac14070 (two values were missing

here) Moreover participants in the autosuggestion group reported

merely having pretended to feel disgust to a stronger degree than par-

ticipants in the hypnosis group t(20033)frac142499 Pfrac14 002 rfrac14 049

(degrees of freedom adjusted due to unequal variances) In terms of

recalling the suggestion or instruction during the experiment the

groups did not differ Ufrac14 91500 Pfrac14 016 rfrac14025

Correlation between vmPFC activation and bids independent

of condition

In the fMRI analysis we first tested whether vmPFC correlated with

subjective value as shown by previous studies Thus we determined

whether any voxels within our vmPFC ROI (Supplementary Figure

S1A) correlated with bids independent of condition in all 32 partici-

pants As expected rACC and parts of mOFC correlated with bids at

Plt 005 corrected (Figure 3)

Effects on vmPFC

Our next goal was to corroborate our behavioral findings across the

four conditions with corresponding activation patterns in vmPFC We

tested for the effects of cue (OFFgtON) of snack type (non-tar-

get gt target) and for the interaction of cue snack type (stronger

effect for non-targets gt targets during cueON-runs than during

cueOFF-runs) within our vmPFC ROI (Supplementary Figure S1A)

Diminished attractiveness of snacks should be reflected in diminished

Fig 2 Behavior and self-report (A) Bids (B) Postexperimental disgust ratings (C) Postexperimentally reported degree of physicality of disgust experience of self-control (as opposed to automaticity) regardingthe feeling of disgust pretending of disgust and conscious recall of suggestioninstruction during the experiment Ninety-five percent confidence interval (CI) of the mean are shown adjusted for within-subjectdesigns where appropriate Loftus and Masson (1994) T target snacks (sweet or salty) NT non-target snacks CueON cue color shown in the background CueOFF neutral background color ME Main effectIE Interaction effect Plt 0001 Plt 001 Plt 005 ns not significant

Table 1 Mean RTs per condition in seconds

Hypnosis (nfrac14 16) Autosuggestion (nfrac14 16)

Cue Snack type Mean (sd) Mean (sd)CueON Targets 1434 (0247) 1457 (0229)

Non-targets 1475 (0216) 1440 (0150)CueOFF Targets 1476 (0192) 1409 (0198)

Non-targets 1442 (0203) 1381 (0205)

sd standard deviation


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blood oxygen level-dependent (BOLD) signal in vmPFC We initially

analyzed the fMRI data for all subjects together and then assessed

group differences

Indeed for all these contrasts we found BOLD signal changes in

vmPFC (Figure 4) The effects of cue and snack type were both sig-

nificant at Plt005 corrected while the interaction of cue snack type

was significant at Plt0001 uncorrected Interestingly activations for

the three effects were found in distinct but partly overlapping regions

of vmPFC Note that it is not problematic that the cue snack type

interaction was non-significant after correction This interaction might

also be encoded by the pattern of activation across the two vmPFC

subregions showing effects for cue and snack type Thus there does not

necessarily need to be a subregion representing the interaction as such

The effects of cue snack type and of their interaction (Figure 4)

overlapped with the region that correlated with bids lsquowithinrsquo the four

conditions (Figure 3) This indicates that hypnosis and autosuggestion

indeed altered lsquovaluationrsquo of food stimuli Hence when analyzing all

subjects together the results of the fMRI analysis corroborated the

behavioral results as vmPFC was responsive to the experimental ma-

nipulations in the expected directions

When comparing the two groups we further found that the effect of

the cue on rACC (a subregion of the vmPFC ROI) was stronger in the

hypnosis group than in the autosuggestion group at Plt005 cor-

rected (Figure 5A) The effect of snack type and the interaction of

cue snack type in contrast did not differ significantly between

groups within the vmPFC ROI

Effects on the precuneus

If the precuneus was functionally involved in the effects of hypnosis or

autosuggestion we would expect finding an effect of cue snack type or

of their interaction in this region As above we first tested for these

three effects in all subjects together (nfrac14 32) in all voxels of the pre-

cuneus ROI (Supplementary Figure S1B) There was no effect of cue or

snack type but there was an interaction of cue snack type at Plt005

corrected (peak 6 55 52 tfrac14 425)

The cue snack type interaction in the precuneus was stronger in

the hypnosis group than in the autosuggestion group at Plt005

corrected Figure 5B shows mean -values of the interaction voxels

per condition The pattern shows that the group cue snack type

interaction arises because only in the hypnosis group precuneus dif-

ferentiated between targetsnon-targets during cueON-runs but not

during cueOFF-runs This indicates that the precuneus was indeed

functionally involved in the effects of the hypnotic suggestions because

it encoded relevant information concerning the hypnotic suggestions

Finally we also found stronger activation of the precuneus for all trials

(against baseline) for the hypnosis group compared with the autosug-

gestion group at Plt005 corrected (peak 0 61 34 tfrac14 389)

Whole-brain analysis

Our exploratory whole-brain analyses revealed effects of snack type

and of the interaction of cue snack type on several regions outside

of our ROIs when all participants were analyzed together Among

other findings the right anterior insula was more active for target

snacks than for non-target snacks An interaction of cue snack type

was for example found in the fusiform gyrus the posterior cingulate

cortex and the parahippocampal gyrus (Supplementary Table S3 shows

the complete results) The analyses further showed that group differ-

ences between hypnosis and autosuggestion were largely specific to

vmPFC and precuneus (Supplementary Table S4)

DISCUSSION

In this study participants were either given posthypnotic suggestions

or they used autosuggestion to associate a color cue (blue or green)

with the feeling of disgust regarding particular unhealthy snacks (either

sweet or salty) Both hypnosis and autosuggestion successfully

diminished the attractiveness of snacks in suggestible participants as

indicated by behavior self-report and vmPFC activation Participants

who underwent hypnosis reported the effects to be more physical

automatic and genuine (not simulated) compared with participants

who used autosuggestion Moreover while the behavioral effects of

hypnosis and autosuggestion were equally strong the color cue had

significantly stronger effects on vmPFC activation (specifically rACC)

in the hypnosis group compared with the autosuggestion group

As both groups behaved indistinguishably during the experiment

the neural differences between groups cannot be attributed to partici-

pantsrsquo behavior (Egner et al 2005) The finding that vmPFC correlates

with subjective value or attractiveness is one of the most established

findings in neuroeconomics (Plassmann et al 2007 2010 Kable and

Glimcher 2007 Hare et al 2008 2009 2011 Chib et al 2009 Basten

Fig 4 Effect of the cue (yellow) of snack type (cyan) and of the interaction of cue snack type(red) in vmPFC for participants of both groups analyzed together (nfrac14 32 peaks within ROI for cue6 35 2 tfrac14 401 snack type 6 26 17 tfrac14 429 cue snack type 0 32 2 tfrac14 363)Results are masked by the vmPFC ROI For visualization activations are shown at Plt 0005 kfrac14 10beta-plots visualize the results (mean beta 1 se) and were constructed in a way that ensuresindependency from the main analysis (see Supplementary Data) T target snacks (sweet or salty) NTnon-target snacks CueON cue color shown in the background CueOFF neutral background color

Fig 3 Correlation with bids independent of condition for participants of both groups analyzedtogether (nfrac14 32 peak 6 35 2 tfrac14 509) Results are masked by the a priori defined vmPFCROI (Supplementary Figure S1A) For visualization purpose activations are shown at Plt 0005kfrac14 10 The beta-plot visualizes the results (mean beta 1 se) The plot was constructed usinga procedure that ensures independency from the main analysis (see Supplementary Data Litt et al2011)


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et al 2010 Peters and Buchel 2010 Grabenhorst and Rolls 2011 Litt

et al 2011 Janowski et al in press) Therefore a possible explanation

for the group difference is that hypnosis induced more genuine

decreases of the perceived attractiveness of snacks This interpretation

should however be treated with caution because it cannot be

excluded that vmPFC activation can be reduced when the value of

an object has not truly changed (eg when participants think of some-

thing negative while looking at pictures or due to other unrelated

processes) However the interpretation is supported by the finding

that only participants in the autosuggestion group reported sometimes

having pretended to feel disgust Moreover we could show that BOLD

signal in the exact same region which was affected more by hypnosis

than autosuggestion correlated with bids independent of condition

within the current study Notably only the effect of the color cue on

vmPFC (and not of snack type or the interaction of cue snack type)

was stronger after hypnosis compared with autosuggestion A possible

explanation for this is that the color cue was especially important for

the hypnotic effects This could be due to the fact that the salient color

cue can be processed quickly and automatically whereas it takes more

cognitive processing to categorize snacks as sweet or salty

Regarding the mechanisms of hypnotic effects we additionally

found evidence for involvement of the precuneus in line with previous

findings (Cojan et al 2009) There was higher precuneus activation for

all trials against baseline after hypnosis compared with autosuggestion

More importantly there was a three-way interaction of cue snack

type group This arose because only in the hypnosis group the

precuneus differentiated between sweet and salty snacks during

cueON-runs Thus in this group the precuneus activated less for the

devalued target snacks than for non-target snacks but only when the

posthypnotic cue was shown Precuneus hence encoded specific

information regarding the suggestions

Two points should be kept in mind with respect to our results

particularly those concerning group differences First all our conclu-

sions apply to lsquofreersquo autosuggestion rather than highly structured or

trained autosuggestion That is participants in the autosuggestion

group chose and used their own mental strategies In contrast partici-

pants in the hypnosis group received a relatively standardized struc-

tured intervention This was done to approximate a real-life situation

in the autosuggestion group in which people attempt to reduce their

craving for food completely by their own effort Importantly the ef-

fectiveness of autosuggestion might increase when participants receive

specific instructions or training concerning the use of autosuggestion

Second we selected participants based on their responsiveness to hyp-

nosis We assumed that participants who respond well to hypnosis are

also good at using autosuggestion For example highly hypnotizable as

compared to low hypnotizable participants respond better to autogenic

training (involving autosuggestion Schultz and Luthe 1959) and to

cognitive self-hypnosis in the treatment of headaches (ter Kuile et al

1994) Moreover suggestible participants respond very well to sugges-

tions given outside hypnosis (Kirsch and Braffman 2001 Raz et al

2006 McGeown et al 2012) Nevertheless it cannot be excluded that

autosuggestion would have had even stronger effects in participants

specifically selected to be good at using autosuggestion

The finding that not only hypnosis but also free autosuggestion

could influence decision-making is remarkable On the postexperimen-

tal questionnaire participants reported their strategies for autosugges-

tion they typically imagined disgusting objects and told themselves

repeatedly that the snacks were disgusting (Supplementary Table S2)

There is little explicit empirical work on autosuggestion in the neuroi-

maging literature Exceptions are studies on autogenic training

(Schlamann et al 2010 Naglatzki et al 2012) and the placebo effect

(Wager et al 2004 Raz 2007 Eippert et al 2009) which involves

unconscious autosuggestion or belief that a treatment will help Our

results show that conscious autosuggestion as a tool to influence cog-

nition or behavior is a promising field for future neuroscientific

research

Interestingly Coue (2009) proposed that suggestion lsquodoes not and

cannot exist except on the sine qua non condition of transforming itself

into autosuggestion in the subjectrsquo Thus also the effects in our hyp-

nosis group might (partly) be due to autosuggestion as participants

might have used their cognitive resources to support the suggested

effects It is likely very difficult to disentangle autosuggestive from

heterosuggestive components of hypnosis One possibility for this

would be comparing hetero-hypnosis with self-hypnosis with the

exact same suggestions for both However self-hypnosis requires train-

ing and is usually taught through hetero-hypnosis (Sacerdote 1981)

Another possibility would be to induce posthypnotic amnesia so that

participants would be unaware of what has been suggested to them

(Mendelsohn et al 2008) However only few subjects are susceptible

to posthypnotic amnesia and it is difficult to ascertain that partici-

pants are truly amnesic

Finally our results may have implications beyond the area of hyp-

nosis This experiment can be conceived of as an experiment about

valuation of multi-attribute objects The food pictures in this study

had two salient features that varied namely type of taste (sweet or

salty) and background color (blue or green) Hypnosis and autosug-

gestion systematically changed the value of the levels of these features

Thus for each subject one type of taste and one background color

was associated with a negative value (eg saltyfrac14 disgusting and

greenfrac14 disgusting) When participants assigned values to stimuli

they had to perceive and evaluate both stimulus features and integrate

them to an overall value (together with other variables von

Winterfeldt and Fischer 1975) We found that different vmPFC sub-

regions tracked the value of different stimulus attributes (Figure 4)

Fig 5 Group differences (A) There was a stronger effect of the cue on vmPFC activation in thehypnosis group (peak 3 32 4 tfrac14 473) (B) There was also a stronger interaction effect ofcue snack type on the precuneus in the hypnosis group (peak 9 58 46 tfrac14 400) Results aremasked by the vmPFC ROI in panel A and by the precuneus ROI in panel B (Supplementary Figure S1gives a depiction of the ROIs) For visualization activations are shown at Plt 0005 kfrac14 10 beta-plots visualize the results (mean beta 1 se) and were constructed in a way that ensuresindependency from the main analysis (see Supplementary Data) T target snacks (sweet or salty)NT non-target snacks CueON cue color shown in the background CueOFF neutral background color


at CharitAtilde

copy on A


Dow

nloaded from

While rACC was most responsive to the (value of the) cue more

ventral parts of rACC and mOFC tracked the value of the type of

taste (sweetnesssaltiness) Thus our resultsgained by using hypnosis

as a toolindicate that the values of different features of objects are

represented in different vmPFC subregions This demonstrates that

hypnosis and autosuggestion can be useful for studying the neural

basis of decision-making (Raz and Shapiro 2002 Oakley and

Halligan 2009 Raz 2011)

In sum our results show that posthypnotic suggestions andto a

lesser extentfree autosuggestion can influence decision-making and

valuation on the behavioral phenomenological and on the neural level

Thus these methods might be useful for studying the neural basis of

decision-making and they may be useful for helping people make

better decisions in real life

SUPPLEMENTARY DATA

Supplementary data are available at SCAN online

REFERENCES

Allison DB Faith MS (1996) Hypnosis as an adjunct to cognitive-behavioral psycho-

therapy for obesity a meta-analytic reappraisal Journal of Consulting and Clinical

Psychology 64(3) 513ndash6

Barnes J Dong C McRobbie H Walker N Mehta M Stead L (2010) Hypnotherapy

for smoking cessation Cochrane Database of Systematic Reviews (10) 1ndash34

Basten U Biele G Heekeren HR Fiebach CJ (2010) How the brain integrates costs

and benefits during decision making Proceedings of the National Academy of Sciences

USA 107(50) 21767ndash72

Baudouin C (2003) Suggestion and Autosuggestion Whitefish Montana Kessinger

Publishing

Becker G DeGroot M Marschak J (1964) Measuring utility by a single-response

sequential method Behavioral Science 9 226ndash32

Bhanji JP Beer JS (2012) Taking a different perspective Mindset influences neural

regions that represent value and choice Social Cognitive and Affective Neuroscience 7(7)

782ndash93

Blakemore SJ Oakley DA Frith CD (2003) Delusions of alien control in the normal

brain Neuropsychologia 41(8) 1058ndash67

Brosch T Coppin G Schwartz S Sander D (2012) The importance of actions and the

worth of an object dissociable neural systems representing core value and economic

value Social Cognitive and Affective Neuroscience 7(5) 497ndash505

Brune M Tas C Wischniewski J Welpinghus A Heinisch C Newen A (2012)

Hypnotic ingroupndashoutgroup suggestion influences economic decision-making in an

Ultimatum Game Consciousness and Cognition 21(2) 939ndash46

Carmody TP Duncan C Simon JA et al (2008) Hypnosis for smoking cessation a

randomized trial Nicotine amp Tobacco Research 10(5) 811ndash8

Cavanna AE Trimble MR (2006) The precuneus a review of its functional anatomy

and behavioural correlates Brain 129(3) 564ndash83

Chib VS Rangel A Shimojo S OrsquoDoherty JP (2009) Evidence for a common rep-

resentation of decision values for dissimilar goods in human ventromedial prefrontal

cortex Journal of Neuroscience 29(39) 12315ndash20

Cohen J (1988) Statistical Power Analysis for the Behavioral Sciences 2nd edn New York

Academic Press

Cohen KR Henik A Catena A Walsh V Fuentes LJ (2009) Induced cross-modal

synaesthetic experience without abnormal neuronal connections Psychological Science

20(2) 258ndash65

Cojan Y Waber L Schwartz S Rossier L Forster A Vuilleumier P (2009) The brain

under self-control modulation of inhibitory and monitoring cortical networks during

hypnotic paralysis Neuron 62(6) 862ndash75

Coue E (2009) Self Mastery Through Conscious Autosuggestion Fairford UK Echo Lib

de Araujo IE Rolls ET Velazco MI Margot C Cayeux I (2005) Cognitive modu-

lation of olfactory processing Neuron 46(4) 671ndash9

Egner T Jamieson G Gruzelier J (2005) Hypnosis decouples cognitive control from

conflict monitoring processes of the frontal lobe NeuroImage 27(4) 969ndash78

Eippert F Bingel U Schoell ED et al (2009) Activation of the opioidergic descending

pain control system underlies placebo analgesia Neuron 63(4) 533ndash43

Grabenhorst F Rolls ET (2008) Selective attention to affective value alters how the brain

processes taste stimuli European Journal of Neuroscience 27(3) 723ndash9

Grabenhorst F Rolls ET (2011) Value pleasure and choice in the ventral prefrontal

cortex Trends in Cognitive Sciences 15(2) 56ndash67

Grabenhorst F Rolls ET Bilderbeck A (2008) How cognition modulates affective

responses to taste and flavor top-down influences on the orbitofrontal and pregenual

cingulate cortices Cerebral Cortex 18(7) 1549ndash59

Halligan PW Athwal BS Oakley DA Frackowiak RS (2000) Imaging hypnotic

paralysis implications for conversion hysteria Lancet 355(9208) 986ndash7

Hare TA Camerer CF Rangel A (2009) Self-control in decision-making involves

modulation of the vmPFC valuation system Science 324(5927) 646ndash8

Hare TA Malmaud J Rangel A (2011) Focusing attention on the health aspects of

foods changes value signals in vmPFC and improves dietary choice Journal of

Neuroscience 31(30) 11077ndash87

Hare TA OrsquoDoherty J Camerer CF Schultz W Rangel A (2008) Dissociating the

role of the orbitofrontal cortex and the striatum in the computation of goal values and

prediction errors Journal of Neuroscience 28(22) 5623ndash30

Hollmann M Hellrung L Pleger B et al (2011) Neural correlates of the volitional

regulation of the desire for food International Journal of Obesity 36 648ndash55

Iani C Ricci F Baroni G Rubichi S (2009) Attention control and susceptibility to

hypnosis Consciousness and Cognition 18(4) 856ndash63

Iani C Ricci F Gherri E Rubichi S (2006) Hypnotic suggestion modulates cognitive

conflict Psychological Science 17(8) 721ndash7

Janowski V Camerer C Rangel A (2013) Empathic choice involves vmPFC value

signals that are modulated by social processing implemented in IPL Social Cognitive

and Affective Neuroscience 8(2) 201ndash8 doi 101093scannsr086

Kable JW Glimcher PW (2007) The neural correlates of subjective value during inter-

temporal choice Nature Neuroscience 10(12) 1625ndash33

Kirsch I Braffman W (2001) Imaginative suggestibility and hypnotizability Current

Directions in Psychological Science 10(2) 57ndash61

Kirsch I Montgomery G Sapirstein G (1995) Hypnosis as an adjunct to cognitive-

behavioral psychotherapy a meta-analysis Journal of Consulting and Clinical Psychology

63(2) 214ndash20

Kober H Mende-Siedlecki P Kross EF et al (2010) Prefrontalndashstriatal pathway

underlies cognitive regulation of craving Proceedings of the National Academy of

Sciences USA 107(33) 14811ndash6

Kosslyn SM Thompson WL Costantini-Ferrando MF Alpert NM Spiegel D

(2000) Hypnotic visual illusion alters color processing in the brain American Journal

of Psychiatry 157(8) 1279ndash84

Lebreton M Jorge S Michel V Thirion B Pessiglione M (2009) An automatic

valuation system in the human brain evidence from functional neuroimaging

Neuron 64(3) 431ndash9

Litt A Plassmann H Shiv B Rangel A (2011) Dissociating valuation and saliency

signals during decision-making Cerebral Cortex 21(1) 95ndash102

Loftus GR Masson MEJ (1994) Using confidence intervals in within-subject designs

Psychonomic Bulletin amp Review 1(4) 476ndash90

Lou HC Luber B Crupain M et al (2004) Parietal cortex and representation

of the mental self Proceedings of the National Academy of Sciences USA 101(17)

6827ndash32

McGeown WJ Venneri A Kirsch I et al (2012) Suggested visual hallucination with-

out hypnosis enhances activity in visual areas of the brain Consciousness and Cognition

21(1) 100ndash16

Mendelsohn A Chalamish Y Solomonovich A Dudai Y (2008) Mesmerizing mem-

ories Brain substrates of episodic memory suppression in posthypnotic amnesia


Naglatzki RP Schlamann M Gasser T et al (2012) Cerebral somatic pain modulation

during autogenic training in fMRI European Journal of Pain 16(9) 1293ndash301

Oakley DA Halligan PW (2009) Hypnotic suggestion and cognitive neuroscience

Trends in Cognitive Sciences 13(6) 264ndash70

Peters J Buchel C (2010) Neural representations of subjective reward value Behavioural

Brain Research 213(2) 135ndash41

Plassmann H OrsquoDoherty J Rangel A (2007) Orbitofrontal cortex encodes

willingness to pay in everyday economic transactions Journal of Neuroscience 27(37)

9984ndash8

Plassmann H OrsquoDoherty J Shiv B Rangel A (2008) Marketing actions can modulate

neural representations of experienced pleasantness Proceedings of the National Academy

of Sciences USA 105(3) 1050ndash4

Plassmann H OrsquoDoherty JP Rangel A (2010) Appetitive and aversive goal values are

encoded in the medial orbitofrontal cortex at the time of decision making Journal of


Rainville P Duncan GH Price DD Carrier B Bushnell MC (1997) Pain affect

encoded in human anterior cingulate but not somatosensory cortex Science 277(5328)

968ndash71

Raz A (2007) Hypnobo perspectives on hypnosis and placebo American Journal of

Clinical Hypnosis 50(1) 29ndash36

Raz A (2011) Hypnosis a twilight zone of the top-down variety Trends in Cognitive

Sciences 15(12) 555ndash7

Raz A Fan J Posner MI (2005) Hypnotic suggestion reduces conflict in the human

brain Proceedings of the National Academy of Sciences USA 102(28) 9978ndash83

Raz A Kirsch I Pollard J Nitkin-Kaner Y (2006) Suggestion reduces the Stroop effect

Psychological Science 17(2) 91ndash5

Raz A Shapiro T (2002) Hypnosis and neuroscience a cross talk between clinical and

cognitive research Archives of General Psychiatry 59(1) 85ndash90


at CharitAtilde

copy on A


Dow

nloaded from

Raz A Shapiro T Fan J Posner MI (2002) Hypnotic suggestion and the modulation

of Stroop interference Archives of General Psychiatry 59(12) 1155ndash61

Rosenthal R (1991) Meta-analytic Procedures for Social Research revised edn Newbury

Park CA Sage

Sacerdote P (1981) Teaching self-hypnosis to adults International Journal of Clinical and

Experimental Hypnosis 29(3) 282ndash99

Schlamann M Naglatzki R Greiff Ad Forsting M Gizewski ER (2010) Autogenic

training alters cerebral activation patterns in fMRI International Journal of Clinical and


Schultz IH Luthe W (1959) Autogenic training a psychophysiologic approach in

psychotherapy New York Georg amp Stratton

Shor RE Orne EC (1962) The Harvard Group Scale of Hypnotic Susceptibility Form A

Palo Alto CA USA Consulting Psychologists Press

Szechtman H Woody E Bowers KS Nahmias C (1998) Where the imaginal appears

real a positron emission tomography study of auditory hallucinations Proceedings of the

National Academy of Sciences USA 95(4) 1956ndash60

ter Kuile MM Spinhoven P Linssen ACG Zitman FG Van Dyck R

Rooijmans HGM (1994) Autogenic training and cognitive self-hypnosis for the treat-

ment of recurrent headaches in three different subject groups Pain 58(3) 331ndash40

von Winterfeldt D Fischer GW (1975) Multi-attribute utility theory models and as-

sessment procedures In Wendt D Vlek CAJ editors Utility Probability and

Human Decision Making Dordrecht the Netherlands Reidel pp 47ndash86

Wager TD Rilling JK Smith EE et al (2004) Placebo-induced changes in FMRI in

the anticipation and experience of pain Science 303(5661) 1162ndash7

Wheatley T Haidt J (2005) Hypnotic disgust makes moral judgments more severe



at CharitAtilde

copy on A


Dow

nloaded from

Supplementary Material Ludwig et al

1

SUPPLEMENTARY MATERIAL

Vera U Ludwig1234 Christine Stelzel1234 Harald Krutiak15 Amadeus Magrabi1246

Rosa Steimke1234 Lena M Paschke 1234 Norbert Kathmann23 and Henrik Walter124

The suggestible brain

posthypnotic effects on value-based decision-making

1Division of Mind and Brain Research Department of Psychiatry amp Psychotherapy Chariteacute

Universitaumltsmedizin Berlin Berlin Germany 2Berlin School of Mind and Brain Humboldt-

Universitaumlt zu Berlin Berlin Germany 3Department of Psychology Humboldt-Universitaumlt zu

Berlin Berlin Germany 4Berlin Center for Advanced Neuroimaging Berlin Germany

5Fortbildungszentrum OST der Deutschen Gesellschaft fuumlr Hypnose und Hypnotherapie eV

Berlin Germany 6Institute of Cognitive Science Universitaumlt Osnabruumlck Osnabruumlck

Germany


2

SUPPLEMENTARY RESULTS

Supplementary Table 1 Comparison of the two groups

Hypnosis Autosuggestion Comparison

Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15

Hypnotic suggestibility

(HGSHS possible

range 1-12 included in

this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85

Desire to eat target

snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15

Desire to eat nontarget

snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80

Note Mean (standard deviation) ns not significant Data about participantsrsquo hunger and

their desire to eat snacks were obtained by a pre-experimental questionnaire


3

Supplementary Table 2 Descriptions of the strategies used by participants in the

autosuggestion group

Subject number

(autosuggestion group)

Reported strategy

Subject 1 Imagined disgust-inducing images

Subject 2 Repeatedly told myself bdquoSalty is disgustingldquo

Subject 3 Try to imagine that I have to eat a lot of sweet snack

Subject 4 Imagined sweet snacks and looked at the color

Subject 5 Imagined disgusting green objects that touch snacks

Subject 6 Partly auto-suggestion partly conscious reduction of the price

Subject 7 Green color fit with disgust

Subject 8 Imagined to be so stuffed from sweet snacks that one feels sick

Subject 9 None

Subject 10 Imagined overeating on sweet snacks

Subject 11 Told myself into ldquowhen I see green I find sweet disgustingrdquo

Subject 12 Thought about unpleasant experiencetaste from the past

Subject 13 Remembered the rule

Subject 14 Told myself that green and salty snacks are disgusting and do not

taste well because they are bitter

Subject 15 Thought about salty snacks which I do not like that much

Subject 16 Imagined overeating

Note Descriptions were translated from German by author VUL


4

Supplementary Table 3 Whole-brain analysis including all participants (n = 32)

Region side BA

MNI-

coordinates k T

Effect of the cue (cueOFF gt cueON)

ventromedial prefrontal cortex

(rostral anterior cingulate cortex) LR 2432 -6 35 -2 22 401

caudal anterior cingulate cortex LR 24 0 29 16 13 371

Effect of the cue reversed (cueON gt cueOFF)

(no regions)

Effect of snack type (nontarget snacks gt target snacks)

putamen lateral globus pallidus

posterior insula L 13 -27 -13 -2 395 635dagger

postcentral gyrus transverse temporal

gyrus L 40 -60 -16 16 incl 488

thalamus L -12 -22 7 incl 469

precentral gyrus postcentral gyrus

inferior parietal lobule middle frontal

gyrus superior frontal gyrus medial

frontal gyrus

L 1-6

40 -33 -22 61 917 559

ventromedial prefrontal cortex (medial

frontal gyrus gyrus rectus subcallosal

gyrus)

R 1125 9 26 -17 33 485

cuneus precuneus posterior cingulate

cortex L -18 -55 19 47 471

superior frontal gyrus middle frontal

gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417


(rostral anterior cingulate cortex) L 2432 -6 29 -5 3 352

Effect of snack type reversed (target snacks gt nontarget snacks)

(corpus callosum ventricle) LR 3 -16 25 26 431

anterior insula inferior frontal gyrus R 47 42 26 -5 12 417


5

Continuation of Supplementary Table 3

Region side BA

MNI-

coordinates k T

Interaction of cue x snack type (stronger effect for nontarget snacks gt target snacks during

cueON-runs than during cueOFF-runs)

middle frontal gyrus R 11 21 35 -14 20 508

inferior parietal lobule postcentral gyrus L 240 -42 -31 43 213 500

inferior parietal lobule R 40 42 -43 46 34 433

precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423

precentral gyrus inferior frontal gyrus L 69 -54 2 40 25 411

inferior frontal sulcus R 46 42 29 16 10 406


gyrus L 6 -24 -7 70 22 399

posterior cingulate cortex

parahippocampal gyrus lingual gyrus R

1819

2930 15 -46 -2 41 396

inferior frontal gyrus R 9 63 11 28 13 393

superior parietal lobule L 7 -18 -64 58 20 388

postcentral gyrus L 40 -54 -22 25 17 384


(rostral anterior cingulate cortex) L 24 0 32 -2 2 363

Interaction of cue x snack type reversed (weaker effect for nontarget snacks gt target snacks

during cueON-runs than during cueOFF-runs)

middle temporal gyrus L -48 -31 -8 13 411

Note voxels within these clusters are significant at p lt 05 FWE-corrected within ROIs

daggersignificant a p lt 05 FWE-corrected for the whole brain For completeness table also shows

all other activations at p lt 001 with cluster sizes ge 10 (except within ROIs where also

smaller clusters are reported) Labels were assigned according to the anatomical labels

provided by xjview 8 For large cluster (k gt 100) only labels for regions including at least 10

voxels of the cluster are reported Note that several activations are motor-related because

participants indicated lower bids (0-1euro) by using their left hand and higher bids (150euro -

250euro) by using their right hand incl included in previous cluster LR leftright BA

Brodmann areas k cluster size in voxel T t-value of the peak voxel


6

Supplementary Table 4 Whole-brain analysis concerning differences between the hypnosis

group (n = 16) and the autosuggestion group (n = 16)

Region Side BA

MNI-

coordinates k T

HYPNOSIS gt AUTOSUGGESTION

Cue (cueOFF gt cueON)


(rostral anterior cingulate cortex) LR 24 3 32 4 20 473

Snack type (nontarget snacks gt target snacks)

precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400

angular gyrus inferior parietal lobule

superior parietal lobule R 740 39 -61 37 25 398

AUTOSUGGESTION gt HYPNOSIS


(white matter) -33 -10 31 10 447


hypothalamus LR 3 2 -8 14 401



(no regions)

Note voxels within these clusters are significant at p lt 05 FWE-corrected within ROIs For

completeness table also shows all other activations at p lt 001 with cluster sizes ge 10

(except within ROIs where also smaller clusters are reported) Labels were assigned

according to the anatomical labels provided by xjview 8 LR leftright BA Brodmann areas

k cluster size in voxel T t-value of the peak voxel


7

SUPPLEMENTARY METHODS

Overall procedure

On average 16 weeks (range 1 day ndash 22 days) before the experiment participants of the

hypnosis group took part in a group meeting with the hypnotist to ensure they would be

comfortable with the hypnotic procedure on the test day On this meeting the hypnotist led

the group into a relaxing and pleasurable hypnotic trance

On the test day participants were asked to not eat or drink anything except water for 4 hours

before coming to the laboratory After participants arrived they completed a pre-experimental

questionnaire asking what and when they had eaten that day how hungry they were and

how strongly they currently desired to eat sweet and salty snacks (see Supplementary Table

1 for results) The experimental task was then explained to participants and they were

trained Afterwards all participants were seated in front of a monitor displaying a color either

blue or green

Further procedure for the hypnosis group Participants closed their eyes Trance induction

involved arm catalepsy (rigidity of an arm which was put upright with the elbow on the arm

rest of the chair) and pleasant suggestions for relaxation and positive imagery The hypnotist

then led participants into a state of disgust by suggesting a vivid experience of an item that

participants had reported to consider disgusting prior to hypnosis (eg rotten yogurt)

Participants were then asked to open their eyes and to look at the color on the monitor It

was suggested that an association would form between the color and the feeling of disgust

regarding either sweet or salty snacks This association was suggested to last only for this

one day of experimental testing One participant did not open his eyes In this case the

hypnotist described and named the color Participants were told that their arm which still

stood upright with the elbow on the arm rest would slowly move down towards the arm rest

as the association between the color and disgust regarding certain snacks strengthened It

was further suggested that once the association was formed the arm would touch the arm


8

rest and the eyes would close again The participant who kept his eyes closed also moved

his arm downwards which is why he was included in the analysis Participants took on

average 3 min and 6 sec (SD = 1 min and 26 sec) until the arm touched the chair The

hypnotist ended with pleasant suggestions and reoriented participants back to the outside

world

The usefulness of including suggested movements in hypnotic procedures has for example

been discussed by Milton Erickson (see Havens 1996 pp 98-102 Rossi 1980) It is

relatively easy for a hypnotist to induce movements in participants by using suggestion To

the participant however the experience of a seemingly involuntary movement is fascinating

and unusual Therefore the experience of an involuntary movement increases participantsrsquo

interest participation and focus on the hypnotic procedure Furthermore it strengthens

participantsrsquo expectations that other hypnotic suggestions will also be effective In the

procedure used in the current study the participant experiences that his or her arm is moving

down by itself without that she consciously wants it to move (following the suggestions of the

hypnotist) The fact that the arm is moving down (seemingly by itself) serves as evidence to

the participant that there is indeed ldquosomething happeningrdquo at an unconscious level and that

the hypnotic suggestions work This in turn strengthens the effects of the disgust-related

suggestions which are given at the same time as the suggestions for movement

Note that our procedure was not completely standardized Even though the overall procedure

was always the same we allowed a degree of flexibility in the exact wording of suggestions

and the time participants took for making the disgust-association Our reasoning was that

part of the effectiveness of hypnosis comes from the individually-tailored interaction of the

hypnotist and the hypnotized person the hypnotist is paying attention to the hypnotized

individual and is reacting accordingly


9

Further procedure for the autosuggestion group The experimenter told participants in the

autosuggestion group that this study was about peoplersquos ability to control their emotions

They were given the instruction to associate the color on the screen with disgust regarding

either sweet or salty snacks They were given as much time to look at the screen and to

make the association as participants in the hypnosis group That is the time given for looking

at the screen for each subject in the autosuggestion group was equal to the time of a

matched subject in the hypnosis group Participants were free to use their own

autosuggestive strategies during this time (see Supplementary Table 2 for the strategies that

participants reported to have used)

Task

For the auction participants received 250euro in addition to their normal participation fee After

the experiment one trial was randomly chosen For this trial the computer bid against the

participant by producing a random bid between 0 and 250euro If this bid exceeded the bid of

the participant the participant did not receive a snack and kept the 250euro If the bid was

smaller or equal to the participantrsquos bid the participant bought the item for the price that the

computer had bid and kept the rest of the 250euro If participants did not buy a snack they had

to stay hungry for another half hour after leaving the scanner That is the auction was set up

such that participants would treat each decision as a real decision and as the only one that

counts

For half of the subjects the first and the third run of the auction were cueONndashruns and the

second and the fourth were cueOFFndashruns and for the other half of subjects the opposite

order applied Runs lasted about 6 minutes each and were separated by periods of

mathematical problem solving to distract participants from possible general feelings of

disgust induced in CueON-runs At the beginning of each cueON-run subjects were

reminded once about the suggestion or instruction by the following text shown on the screen

(in German) ldquoRecall the meaning of the color in the backgroundrdquo Participants bid by using a


10

6-button response device (3 buttons with the left hand 3 buttons with the right hand bids

from left to right 0 050 1 150 2 and 250)

Stimuli

Stimuli were selected based on three criteria assessed in a survey (i) highly familiar in

Germany (ii) spanning the range from neutral to highly liked for most people and (iii)

perceived as typically sweet or typically salty The background colors in RGB (red green

blue) were [0 100 0] for green and [52 30 255] for blue


Data were checked for normality using Kolmogorov-Smirnoff tests and visual inspection Bids

in some conditions were not normally distributed Bids were therefore log-transformed in

order to meet the assumption of normality using the formula lg10(x+1) (Field 2005) Disgust

ratings and questionnaire data on automaticity and conscious recall were also non-normal

but could not be normalized using standard transformations For automaticity and conscious

recall we used the non-parametric Mann-Whitney test to compare groups (Mann and

Whitney 1947) For disgust ratings we used an ANOVA despite non-normality This was

done to allow the calculation of interactions and because ANOVA is relatively robust against

violations of normality To make sure this was justified we also analyzed these data using

non-parametric methods which yielded the same statistical conclusions as the parametric

analysis reported in the main text

fMRI data acquisition

To minimize motion artifacts participantsrsquo heads were fixated with cushions Stimuli were

presented via projection onto a mirror (tilted by 45deg) fixated on top of the head coil

Presentationreg software (Version 149 wwwneurobscom) was used to control stimulus

presentation To optimize functional sensitivity in vmPFC slices were acquired in an oblique

orientation of 30deg (maximum depending on subject) to the anterior commissure-posterior


11

commissure line (Deichmann et al 2003) fMRI data were analyzed using SPM8 (Wellcome

Department of Imaging Neuroscience London UK httpwwwfilionuclacukspm) The first

three volumes of each run were discarded to allow for magnetic saturation effects Moreover

a quality check was conducted on the preprocessed data using the Artifact Detection

Toolbox (ART) Due to detected artifacts for four subjects 1 out of the 4 functional runs were

excluded from the analysis and for one subject 2 runs were excluded

fMRI data analysis

To allow creation of the beta-plot in Figure 3 another first-level GLM was calculated in

addition to those described in the main text It included regressors for all six types of bids for

targets and nontargets separately (0euro 050euro 1euro 150euro 2euro 250euro) as well as missed trials

and motion parameters This GLM was solely used for creation of the figure

ROIs

For our two areas of interest vmPFC and precuneus we created a priori ROIs For the

precuneus we used the peak coordinate from Cojan (2009) [9 -63 45] with a 15 mm sphere

around it For vmPFC we created a probabilistic ROI that takes into account the coordinates

of several previous studies on valuation For this purpose we took the peak coordinates in

rACC andor mOFC from fMRI publications which investigated the brain correlates of the

subjective value for food items (Chib et al 2009 Hare et al 2009 Hare et al 2011 Litt et

al 2011 Plassmann et al 2007 Plassmann et al 2010) We then created the ROI by the

following three steps (Schubert et al 2008) (1) We estimated the probability that a voxel at

a given position showed neural activity regarding the corresponding literature by calculating a

3D normal (Gaussian) distribution G(x y z) as follows (Turkeltaub et al 2002)


13

Supplementary Table 5 MNI-Coordinates used to create probabilistic ROI in vmPFC

x y Z Reference

4 30 -18 Plassmann2007 - conjunction-mOFC


3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC

3 30 12 Chib2009 - food only - Experiment 1

-3 42 -6 Chib2009 - conjunction - Experiment 1


-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC

Construction of beta-plots

All plots showing beta values in Figures 3 4 and 5 were created using a procedure that

ensures independency from the main analysis (Litt et al 2011) These plots were used for

visualization only For all one-sample t-tests (Figures 3 and 4) the beta plots were created

by carrying out the following steps for each subject i

1 We calculated one-tailed t-tests for the respective contrast of interest for all subjects

except for subject i (n = 31 Figure 3 parametric modulator for the correlation with bids

Figure 4 cueOFF gt cueON nontarget gt target interaction of cue x target)

2 The coordinate of the peak t-value of this t-test was determined within our vmPFC ROI

3 The mean beta values for subject i for the conditions of interest were extracted within a

3mm sphere around this peak

This procedure resulted in beta values for all conditions of interest for each subject which

allowed creation of the plots Note that for the beta plot in Figure 3 (betas per bid size) beta


14

values were only taken into account if there were more than 5 trials for the parametric

regressor for the particular run and subject

For the independent t-tests between groups (Figure 5) we carried out the same procedure

as described above except that we excluded one subject per group (two subjects in total)

from each independent t-test That is for each subject ihyp from the hypnosis group and

subject iaut from the autosuggestion group we carried out the following steps

1 We calculated two-sample t-tests for the respective contrast of interest for all subjects

except for subject ihyp and iaut (n = 15 vs n = 15 16 analyses in total Figure 5A analysis for

cueOFF gt cueON Figure 5B interaction of cue x target)


(Figure 5A) or precuneus ROI (Figure 5B)

3 The mean beta values for the conditions of interest were extracted within a 3mm sphere

around this peak for subject ihyp and subject iaut separately


15

REFERENCES

Chib VS Rangel A Shimojo S ODoherty JP (2009) Evidence for a common

representation of decision values for dissimilar goods in human ventromedial prefrontal

cortex Journal of Neuroscience 29(39) 12315-12320

Cojan Y Waber L Schwartz S Rossier L Forster A Vuilleumier P (2009)

The brain under self-control modulation of inhibitory and monitoring cortical networks during

hypnotic paralysis Neuron 62(6) 862-875

Deichmann R Gottfried JA Hutton C Turner R (2003) Optimized EPI for fMRI

studies of the orbitofrontal cortex NeuroImage 19(2) 430-441

Field A (2005) Discovering Statistics Using SPSS 2nd edn London Sage

Publications Ltd


modulation of the vmPFC valuation system Science 324(5927) 646-648

Hare TA Malmaud J Rangel A (2011) Focusing attention on the health aspects

of foods changes value signals in vmPFC and improves dietary choice Journal of

Neuroscience 31(30) 11077-11087

Havens RA ed (1996) The Wisdom of Milton H Erickson Hypnosis and

Hypnotherapy Volume 1 (New York Irvington Publishers Inc)

Litt A Plassmann H Shiv B Rangel A (2011) Dissociating valuation and

saliency signals during decision-making Cerebral Cortex 21(1) 95-102

Mann HB Whitney DR (1947) On a test of whether one of two random variables

is stochastically larger than the other Annals of Mathematical Statistics 18 50-60

Plassmann H ODoherty J Rangel A (2007) Orbitofrontal cortex encodes


9984-9988

Plassmann H ODoherty JP Rangel A (2010) Appetitive and aversive goal

values are encoded in the medial orbitofrontal cortex at the time of decision making Journal

of Neuroscience 30(32) 10799-10808

induction (Iani et al 2006) Another approach is to compare hypnotic

effects between highly suggestible and less suggestible participants

(Raz et al 2002) Here we compared hypnosis to autosuggestion

because it is clinically and practically relevant to determine if hypnosis

is more effective than attempts to implement a mental change by

oneself

We further assessed whether the hypnotic manipulation of value-

based decision-making involves the precuneus Previous findings indi-

cated that the precuneus is important for hypnotic effects In a study

by Cojan et al (2009) participants were given hypnotic suggestions for

left-hand paralysis When they were instructed to move their left

handwhich they were unable to dothere was precuneus activation

and precuneus showed enhanced functional connectivity with primary

motor cortex The authors related their findings to studies showing

that the precuneus is involved in mental imagery and self-related pro-

cessing (Lou et al 2004 Cavanna and Trimble 2006) They proposed

that during hypnotic effects behavior is guided by increased self-moni-

toring processes and by internal representations produced by imagery

and by the hypnotic suggestions

We hypothesized that hypnosis would be able to change decision-

making about unhealthy snacks behaviorally and that this would be

reflected in diminished value signals in vmPFC during those decisions

We further predicted that hypnosis would lead to stronger effects than

autosuggestion Finally we hypothesized that the precuneus would be

functionally involved in the hypnotic effects by encoding relevant

information about the content of the suggestions

METHODS

Participants

We tested 32 participants (18 female mean agefrac14 2494 years

sdfrac14 370) 16 in a hypnosis group and 16 in an autosuggestion

group Inclusion criteria were right-handedness normal or

corrected-to-normal vision no history of eating disorders or other

psychiatric or neurological disorders no medication which may influ-

ence brain activation no current diet liking of both sweet and salty

snacks and upper medium to high hypnotic suggestibility (pre-

screened using the Harvard Group Scale of Hypnotic Susceptibility

Form A HGSHSA required score 7ndash12 Shor and Orne 1962)

Participants of the two groups were matched in terms of age sex

and hypnotic suggestibility (Supplementary Table S1) Participants

received monetary compensation for participation and gave written

informed consent The study was approved by the local ethics

committee

Procedure

Participants arrived at the laboratory hungry as they had been asked to

not eat for 4 h before the experiment (Figure 1A) The 16 participants

of the hypnosis group were then hypnotized in a one-to-one setting by

a professional hypnotist (HK) During hypnosis participants were

suggested to open their eyes and to look at a color on a monitor

(blue or green counterbalanced across subjects) They were suggested

that this color would be associated with a strong feeling of disgust

regarding either sweet or salty snacks (counterbalanced across sub-

jects) This is a posthypnotic suggestion as it is activated when the

posthypnotic color cue is encountered lsquoafterrsquo hypnosis in a normal

state Note that hypnosis did not involve induction of amnesia par-

ticipants were therefore aware of what had been suggested to them We

refer to those snacks (ie sweet or salty) that were associated with

disgust as lsquotarget snacksrsquo and to the others as lsquonon-target snacksrsquo

The 16 other participants were instructedwithout hypnosisto asso-

ciate the color cue (bluegreen) with disgust regarding either sweet or

salty snacks They were given as much time as the hypnotized subjects

to make the association by themselves and they were also sitting in

front of the monitor with the color while engaging in the autosugges-

tion Participants were free to use their own strategy to make this

association which we inquired about after the experiment

(Supplementary Table S2)

After the intervention we assessed participantsrsquo decision-making

and brain activation using functional magnetic resonance imaging

(fMRI) during an auction on unhealthy snacks (Figure 1B) Note

that participants in the hypnosis group were in a normal state

during scanning as hypnosis was finished beforehand After scanning

participants completed a questionnaire about their experience The

procedures are described in more detail in the Supplementary Data

Task

The auction was a variant of a BeckerndashDeGrootndashMarshak method

(Becker et al 1964 Plassmann et al 2007) and took 35min

Participants saw pictures of sweet and salty snack items (eg chocolate

bars chips) and could bid between 0E and 250E for each of them

(in 050E steps) Snacks were shown on an either blue or green back-

ground That is during two out of the four runs of the auction snacks

were shown on the color cue associated with disgust (cueON-runs)

and during the two other runs snacks were shown on the neutral color

(cueOFF-runs) There were hence four trial types targets-cueON

non-targets-cueON targets-cueOFF and non-targets-cueOFF

(Figure 1C) Runs were separated by math problems for distraction

Our stimulus set comprised 50 high-resolution pictures of appetitive

snack items (25 sweet and 25 salty) that were highly familiar in

Germany For each run 40ndash43 stimuli were randomly selected for

presentation out of the stimulus set Approximately half of the

snacks in each run were target snacks and half were non-target

Fig 1 Methods (A) Procedure hungry participants were either hypnotized or they used autosug-gestion in order to feel disgust regarding either sweet or salty snacks upon seeing either a blue or agreen color cue Afterwards they carried out an auction on sweet and salty snacks shown on aneither blue or green background in the fMRI scanner They could buy a real snack at the auction(B) Experimental auction (C) Overview of the trial types Note that in this figure example stimulihave been modified so that the brands of the snacks are not recognizable


at CharitAtilde

copy on A


Dow

nloaded from








the scanner













































fMRI data analysis





















Regions of interest









RESULTS

Bids













groups










bidding behavior



Self-report








at CharitAtilde

copy on A


Dow

nloaded from






















of condition







Effects on vmPFC













Non-targets 1442 (0203) 1381 (0205)



at CharitAtilde

copy on A


Dow

nloaded from



group differences























































DISCUSSION






















at CharitAtilde

copy on A


Dow

nloaded from


































































research































at CharitAtilde

copy on A


Dow

nloaded from















SUPPLEMENTARY DATA


REFERENCES








USA 107(50) 21767ndash72


Publishing





782ndash93

















Academic Press



20(2) 258ndash65











































63(2) 214ndash20
















6827ndash32



21(1) 100ndash16












9984ndash8









968ndash71












at CharitAtilde

copy on A


Dow

nloaded from




Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988











the scanner













































fMRI data analysis





















Regions of interest









RESULTS

Bids













groups










bidding behavior



Self-report








at CharitAtilde

copy on A


Dow

nloaded from






















of condition







Effects on vmPFC













Non-targets 1442 (0203) 1381 (0205)



at CharitAtilde

copy on A


Dow

nloaded from



group differences























































DISCUSSION






















at CharitAtilde

copy on A


Dow

nloaded from


































































research































at CharitAtilde

copy on A


Dow

nloaded from















SUPPLEMENTARY DATA


REFERENCES








USA 107(50) 21767ndash72


Publishing





782ndash93

















Academic Press



20(2) 258ndash65











































63(2) 214ndash20
















6827ndash32



21(1) 100ndash16












9984ndash8









968ndash71












at CharitAtilde

copy on A


Dow

nloaded from




Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988

























of condition







Effects on vmPFC













Non-targets 1442 (0203) 1381 (0205)



at CharitAtilde

copy on A


Dow

nloaded from



group differences























































DISCUSSION






















at CharitAtilde

copy on A


Dow

nloaded from


































































research































at CharitAtilde

copy on A


Dow

nloaded from















SUPPLEMENTARY DATA


REFERENCES








USA 107(50) 21767ndash72


Publishing





782ndash93

















Academic Press



20(2) 258ndash65











































63(2) 214ndash20
















6827ndash32



21(1) 100ndash16












9984ndash8









968ndash71












at CharitAtilde

copy on A


Dow

nloaded from




Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988






group differences























































DISCUSSION






















at CharitAtilde

copy on A


Dow

nloaded from


































































research































at CharitAtilde

copy on A


Dow

nloaded from















SUPPLEMENTARY DATA


REFERENCES








USA 107(50) 21767ndash72


Publishing





782ndash93

















Academic Press



20(2) 258ndash65











































63(2) 214ndash20
















6827ndash32



21(1) 100ndash16












9984ndash8









968ndash71












at CharitAtilde

copy on A


Dow

nloaded from




Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





































































research































at CharitAtilde

copy on A


Dow

nloaded from















SUPPLEMENTARY DATA


REFERENCES








USA 107(50) 21767ndash72


Publishing





782ndash93

















Academic Press



20(2) 258ndash65











































63(2) 214ndash20
















6827ndash32



21(1) 100ndash16












9984ndash8









968ndash71












at CharitAtilde

copy on A


Dow

nloaded from




Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988


















SUPPLEMENTARY DATA


REFERENCES








USA 107(50) 21767ndash72


Publishing





782ndash93

















Academic Press



20(2) 258ndash65











































63(2) 214ndash20
















6827ndash32



21(1) 100ndash16












9984ndash8









968ndash71












at CharitAtilde

copy on A


Dow

nloaded from




Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988







Park CA Sage
























at CharitAtilde

copy on A


Dow

nloaded from


1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





1












Germany


2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





2




Sex 7 male

9 female

7 male

9 female

ns

Age 2313 (340) 2494 (370)

t(30) = -1443

p gt 15


(HGSHS possible


this study 7-12)

900 (151) 888 (145)

t(30) = 239

p gt 80

Hunger before the

experiment (1-7)

513 (96) 506 (106)

t(30) = 175

p gt 85


snacks before the

experiment (1-7)

431 (125) 356 (175)

t(30) = 1395

p gt 15


snacks before the

experiment (1-7)

438 (167) 425 (124)

t(30) = 241

p gt 80




3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





3



Subject number


Reported strategy









Subject 9 None











4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





4


Region side BA

MNI-

coordinates k T






(no regions)





gyrus L 40 -60 -16 16 incl 488





frontal gyrus

L 1-6

40 -33 -22 61 917 559



gyrus)

R 1125 9 26 -17 33 485


cortex L -18 -55 19 47 471


gyrus R 68 30 26 61 43 441

cerebellum R 24 -46 -29 77 434

cerebellum R 15 -61 -50 20 417







5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





5


Region side BA

MNI-

coordinates k T






precuneus LR 7 6 -55 52 73 425

fusiform gyrus R 37 39 -49 -17 25 423




gyrus L 6 -24 -7 70 22 399



1819

2930 15 -46 -2 41 396



















6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





6



Region Side BA

MNI-

coordinates k T






precuneus R 7 3 -64 49 1 339



precuneus R 7 9 -58 46 8 400





(white matter) -33 -10 31 10 447





(no regions)







7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





7


Overall procedure











blue or green















8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





8





world





















9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





9










Task









counts









10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





10



Stimuli
























11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





11







fMRI data analysis





ROIs












13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





13


x y Z Reference



3 36 -12 Hare2009 - mOFC

3 51 3 Hare2009 - ACC




-9 50 4 Hare2011 - vmPFC

-6 24 -21 Litt2011 - mOFC

0 39 3 Litt2011 - rACC















14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





14















15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988





15

REFERENCES










Publications Ltd





Neuroscience 31(30) 11077-11087









9984-9988




Documents

doi:10.1093/scan/nst110 SCAN (2013) 1of 8 The suggestible …€¦ · autosuggestion successfully devalued snacks. This was indicated by participants decision-making, their self-report