0521 - Placebo Effect and the Locus of Healing - EG Flashcards
Define placebo
an inert substance or therapy, which when applied to a person, results in improvement in illness.Involves a positive expectation to a positive effect.
Define nocebo
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.
What are some explanation for the placebo effect?
- The natural course of illness- undetected active substance in “placebo”- expectation / conditioning- regression to the mean (illness symptoms fluctuating in intensity)- divine intervention
Placebo analgesia appears to occur through:
expectation (endogenous opioids) and through conditioning, which activates opioid and non-opioid subsystems and social learning.
Expectation aids the placebo affect in Parkinsons’ by
motor improvements, increased dopamine release noted on PET
The nocebo effect appears to work through:
expectation, which heightens anxiety, and through conditioning.
Why do people succumb to a voodoo death?
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
What phrases may result in nocebo effects?
“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”
How may a Doctor’s behaviour itself offer a placebo effect?
Through patient expectation there will be improvement from the trust relationship with the Dr.