Hypnosis, Placebos, and Systematic Research Bias in Biological Psychiatry (original) (raw)
Related papers
Placebo Response Correlates With Hypnotic Suggestibility
Placebo response shares phenomenology and likely overlaps with substrates of cognition and personality. However, inconsistent findings abound regarding the potential link between suggestibility and responding to placebos. Here we directly probe whether suggestibility of the hypnotic type influences placebo response. Fifty healthy undergraduates underwent a standard measure of hypnotic suggestibility — the Harvard Group Scale of Hypnotic Susceptibility. These participants later ingested a placebo capsule in one of two similar conditions: (a) relaxation, wherein we identified the capsule as a strong dose of an herbal sedative, or (b) control, wherein we identified the capsule as inert. We indexed placebo response via changes in heart rate, blood pressure, and self-report measures of relaxation and drowsiness. We hypothesized that placebo response and hypnotic suggestibility would correlate positively in the relaxation condition. Hypnotic suggestibility correlated with subjective but not physiological response to ingesting the placebo sedative capsule. Here we report preliminary findings demonstrating a correlation between hypnotic suggestibility and subjective placebo response.
Science, Pseudoscience and Politics
Journal of Neurotherapy, 2002
In an elaboration on the contribution by Raz (current issue), placebo response is further reviewed in relation to psychotropic drug research. Many therapists are unaware that placebo controlled research documents that antidepressant and anxiolytic drugs on average are only mildly more effective than a placebo. Systematic biases in research design are noted that could account for the small differences. These factors, and turf and financial motivations associated with the rise of "biological psychiatry," are discussed because they impact the practice of clinical hypnosis and psychotherapy. Although placebo research is fascinating and expectancy is certainly an important factor in hypnotic response, thus far, there is little research to support the strong involvement of placebo response as part of hypnotic responsiveness.
Rethinking placebo in psychiatry: how and why placebo effects occur
Advances in Psychiatric Treatment, 2013
SummaryThis article outlines proximate (physical and mental) and ultimate mechanisms of placebo effects. Interpersonal processes contributing to placebo effects are reviewed and illustrated through research into the process of psychotherapy. Evolutionary theories of how and why the capacity for placebo effects might have evolved are described. The components of treatment and placebo effects are defined. It is concluded that maximising therapeutic placebo effects is effective and a valid clinical goal.
Rethinking placebo in psychiatry: the range of placebo effects
Advances in Psychiatric Treatment, 2013
SummaryThis article, the first of two on placebo effects, provides a broad overview of placebo in the field of medicine. A brief conceptual history is followed by some basic facts about placebos. Problems of definition are identified. Additive and non-additive models of treatment effects, and problems of measurement of placebo effects are described. The role of placebo in the pharmacotherapy of depression and complementary and alternative medicine is discussed. The ‘efficacy paradox’ (that placebo treatments can have larger effects than ‘evidence-based treatments’) is introduced. Finally, ethical issues are discussed.
Placebo Effects in Psychotherapy: A Framework
Frontiers in Psychiatry, 2019
The issue of placebo response and the extent of its effect on psychotherapy is complex for two specific reasons: i) Current standards for drug trials, e.g., true placebo interventions, double-blinding, cannot be applied to most psychotherapy techniques, and ii) some of the "nonspecific effects" in drug therapy have very specific effects in psychotherapy, such as the frequency and intensity of patient-therapist interaction. In addition, different psychotherapy approaches share many such specific effects (the "dodo bird verdict") and lack specificity with respect to therapy outcome. Here, we discuss the placebo effect in psychotherapy under four aspects: a) nonspecific factors shared with drug therapy (context factors); b) nonspecific factors shared among all psychotherapy traditions (common factors); c) specific placebo-controlled options with different psychotherapy modalities; and d) nonspecific control options for the specific placebo effect in psychotherapy. The resulting framework proposes that the exploration and enumeration of context factors, common factors, and specific factors contributes to the placebo effects in psychotherapy.
Journal of Clinical Psychology, 2005
The logic of the randomized double-blind placebo control group design is presented, and problems with using the design in psychotherapy are discussed. Placebo effects are estimated by examining clinical trials in medicine and psychotherapy. In medicine, a recent meta-analysis of clinical trials with treatment, placebo, and no treatment arms was conducted , and it was concluded that placebos have small or no effects. A re-analysis of those studies, presented here, shows that when disorders are amenable to placebos and the design is adequate to detect the effects, the placebo effect is robust and approaches the treatment effect. For psychological disorders, particularly depression, it has been shown that pill placebos are nearly as effective as active medications whereas psychotherapies are more effective than psychological placebos. However, it is shown that when properly designed, psychological placebos are as effective as accepted psychotherapies.
A brief history of placebos and clinical trials in psychiatry
Canadian journal of psychiatry. Revue canadienne de psychiatrie
The history of placebos in psychiatry can be understood only in the context of randomized controlled trials (RCTs). Placebo treatments are as old as medicine itself, and are particularly effective in dealing with psychosomatic symptoms. In psychiatry, placebos have mainly been featured in clinical drug trials. The earliest controlled trial in psychiatry (not involving drugs) occurred in 1922, followed by the first crossover studies during the 1930s. Meanwhile the concept of randomization was developed during the interwar years by British statistician Ronald A Fisher, and introduced in 3 trials of tuberculosis drugs between 1947 and 1951. These classic studies established the RCT as the gold standard in pharmaceutical trials, and its status was cemented during the mid-1950s. Nevertheless, while the placebo became established as a standard measure of drug action, placebo treatments became stigmatized as unethical. This is unfortunate, as they constitute one of the most powerful therap...