Placebo

Question 1

What is a placebo?

Answer 1

A pharmacologically inert substance without specific biological activity for what is being treated, which is given to a patient and might give them benefit.

Question 2

Non-interactive theories of placebo effectiveness?

Answer 2

1) Patient characteristics
- Emotional dependence, extraversion, neurosis, high suggestibility.
- No personal characteristics have predicted how a person will respond.
2) Treatment characteristics
- The ore serious the treatment, the greater the placebo effect. Surgery> Injection> Pills.
3) HCP characteristics
- The greater the enthusiasm, warmth, empathy and greater the professional status of the HCP, the greater the placebo effect.

Question 3

Issues with non-interactive theories?

Answer 3

Ignores interactions between the three factors. Assumes each can be measured independently.

Question 4

Interactive theories of placebo effectiveness?

Answer 4

1) Experimenter bias
- HCPs expectations about the treatment can cause a greater placebo effect.
2) Reporting error
- Misattribute spontaneous improvements in symptoms to treatment.
- Confabulations
3) Learning theories
- Classical conditioning. UCS (treatment) paired with NS(white coat) turns NS into CS. CS (White coat) and placebo can cause CR (recovery or improvement).
4) Anxiety reduction
- Receiving any treatment relaxes patients as they feel in control thus closes pain gate and reduces pain.

Question 5

Physiological theories of placebo effects?

Answer 5

They can activate opiate release to decrease pain.

They can cause withdrawal, dependance and tolerance.

Question 6

What is a Nocebo?

Answer 6

When patients told about side-effects, more likely to report the side-effects than those not told.