0521 - Placebo Effect and the Locus of Healing - EG

Question 1

Define placebo

Answer 1

an inert substance or therapy, which when applied to a person, results in improvement in illness.
Involves a positive expectation to a positive effect.

Question 2

Define nocebo

Answer 2

opposite of placebo, an inert substance or therapy, which when applied to a person, results in deterioration or cause of illness.
Involves negative expectations to a negative effect.

Question 3

What are some explanation for the placebo effect?

Answer 3

• The natural course of illness
• undetected active substance in “placebo”
• expectation / conditioning
• regression to the mean (illness symptoms fluctuating in intensity)
• divine intervention

Question 4

Placebo analgesia appears to occur through:

Answer 4

expectation (endogenous opioids) and through conditioning, which activates opioid and non-opioid subsystems and social learning.

Question 5

Expectation aids the placebo affect in Parkinsons’ by

Answer 5

motor improvements, increased dopamine release noted on PET

Question 6

The nocebo effect appears to work through:

Answer 6

expectation, which heightens anxiety, and through conditioning.

Question 7

Why do people succumb to a voodoo death?

Answer 7

because they believe they will die.
“belief held so firmly be all members of the tribe and the individual”…“in terror he refuses both food and drink” Walter Cannon

Question 8

What phrases may result in nocebo effects?

Answer 8

“This is really going to hurt” (through expectation)
“There is a problem on your test”
“Hopefully this drug won’t give you any side effects” (particularly listing the side-effects and causing concern over the medication)
“This surgery can have the following complications”

Question 9

How may a Doctor’s behaviour itself offer a placebo effect?

Answer 9

Through patient expectation there will be improvement from the trust relationship with the Dr.