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Dennis OConnor

The Quantification of Placebo Effects Within a General Model of Health Care Outcomes - 1 views

www.ncbi.nlm.nih.gov/...PMC3162378

placebo research positivity

shared by Dennis OConnor on 04 Jul 20 - No Cached
  • It is proposed that the integration of a scientific model of placebo effects within a general model of health care outcomes could finally end the placebo debate and help to integrate these powerful effects into the health care system.
  • Positive expectancy is recognized as a central component of placebo phenomena by all placebo theorists
  • The proposed model emphasizes that the search for a placebo personality factor must be combined with the measurement of situational expectancy.
  • ...47 more annotations...
  • an individual who has negative expectations regarding treatment effectiveness would likely produce a stronger than average “nocebo” effec
  • placebo-prone personality
  • Absorption
  • receptivity to sensory experiences and a propensity for sustained, focused attention.
  • Absorption has a genetic basis and is higher in women compared to men
  • Absorption can go in either a positive or negative direction, depending on the situation,
  • Subjects were randomly
  • outcome measures
  • based on three scales
  • includes scales measuring fatigue, pain, and spasticity
  • Judgment that the placebo was the active device resulted in a positive score with a magnitude of the confidence rating.
  • if judgment was that the placebo was the placebo device, the confidence rating of the placebo was a negative score, with the magnitude of the rating.
  • scored in the upper quintile on improved quality of life, as measured by the 3 QLI (an average of three symptom scales measuring pain, fatigue, and spasticity) after receiving treatment with a sham device.
  • placebo responders
  • Placebo responders scored higher on Absorptio
  • Placebo responders gave higher confidence ratings that the placebo was the active device
  • This study provides support for a two-factor model of placebo responding.
  • importance of positive expectancy
  • both cognitive and emotional factors mediate these effects
  • Positive beliefs or confidence in the treatment coupled with a desire to feel better activate processes that result in positive outcomes.
  • positive expectancy is an essential factor
  • disease-specific pathways that are activated by positive expectancies have helped to transform this “soft” psychologic factor into a “hard” physiologic factor with physically measurable effects.
  • While the shift from negative to positive affect may be the hallmark of placebo responding, negative affect alone is not sufficient and can play a role in people who worsen as well (nocebo effects).
  • Numerous research studies have reliably shown that Absorption is modestly (yet very consistently) correlated with hypnotizability.
  • Hypnotizability is often associated with “suggestibility,” with perhaps the sense of a weak-willed character or unbridled fantasy-proneness, the “unreality factor” that has plagued placebo theory for decades.
  • enlightening to view these individual differences as a natural endowment in self-regulation skills: a potential innate strength rather than a simple weakness with a natural ability for self-directed healing in response to health challenges.
  • Decades of research have reliably demonstrated that individuals scoring high in Absorption can skillfully modulate an impressive array of physiologic processes in laboratory settings.
  • The literature suggests that the mind–body control of high Absorption scorers is similar to the self-regulation skills that many are seeking to develop with meditation, mindfulness, yoga, and qigong.
  • The regular practice of mind–body control and the cultivation of positive attitudes may enhance regulation at higher levels, improving the regularity of circadian and other rhythms,
  • points to the role of both expectation and conditioning, with conditioning playing a greater role in certain pathways such as immune modulation.
  • somatic vulnerability of high Absorption individuals who suffer from negative biases in perception.
  • nocebo phenomena described by these researchers are important for our model as they directly illustrate the power of a negative interaction of the two factors.
  • Many physicians admit to prescribing placebos to contribute to patient wellness, even though this “dark secret” is not condoned and is considered to be ethically questionable.
  • High Absorption individuals may benefit from encouragement to utilize their innate self-regulation skills toward maximum therapeutic effect.
  • ersons with average Absorption scores can be encouraged to become more skilled at self-regulation through mind–body therapies
  • The model does not specifically address the many factors that contribute to confidence in the treatment, such as cost, pill color, pill size, or confidence-enhancing paraphernalia.
  • The role of provider and patient interaction are also not specifically addressed.
  • he model also does not directly address the role of stress reduction
  • The strength of placebo responding in domains such as pain and depression clearly indicate the importance of the shift from a negative to a positive state.
  • the unresolved issue of why some people respond to placebos whereas others do not
  • asic two-factor model can be further tested with the basic measurement tools of expectancy and Absorption,
  • Conclusions
  • the recognition that positive expectancy and expert self-regulation skills significantly contribute to health outcomes can help to integrate these powerful effects into the health care system
  • The “positive psychology” movement is shifting attention to the power of positive expectation
  • undermining nature of negative expectancy and pessimistic language, especially in vulnerable populations such as those with pain and depression
  • Practitioners of the art of health care have always recognized the importance of motivated and empowered patients and the power of a kind word and a ray of hope.
  • This is the time to quantify these factors, integrating art and science, and finally solving (and forgiving Descartes for) the mind–body problem.
  • Dennis OConnor on 04 Jul 20
     
    "The topic of placebo effects is distinguished by decades of keen scientific interest1-4 coupled with a general skepticism regarding the ultimate significance of these phenomena. The importance of psychologic factors in mediating these effects may contribute to the attitude that placebo effects are not as substantial as a therapeutic effect produced by a drug. Complementary and alternative therapies have sometimes been dismissed as "mere placebos." However, recent studies have provided compelling evidence that placebo effects are physiologically measurable with condition-specific pathways.5"
  • Dennis OConnor on 04 Jul 20
     
    Dr. Jake Fleming recently suggested these potent keywords: quantifiable placebo The keywords led to this article. I find it affirming and empowering.
Dennis OConnor

The neuroscience of placebo effects: connecting context, learning and health - 0 views

www.ncbi.nlm.nih.gov/...PMC6013051

placebo

shared by Dennis OConnor on 23 Oct 19 - No Cached
  • Dennis OConnor on 23 Oct 19
     
    "Abstract Placebo effects are beneficial effects that are attributable to the brain-mind responses to the context in which a treatment is delivered rather than to the specific actions of the drug. They are mediated by diverse processes - including learning, expectations and social cognition - and can influence various clinical and physiological outcomes related to health. Emerging neuroscience evidence implicates multiple brain systems and neurochemical mediators, including opioids and dopamine. We present an empirical review of the brain systems that are involved in placebo effects, focusing on placebo analgesia, and a conceptual framework linking these findings to the mind-brain processes that mediate them. This framework suggests that the neuropsychological processes that mediate placebo effects may be crucial for a wide array of therapeutic approaches, including many drugs."
Dennis OConnor

Ted J. Kaptchuk | Selected Articles - 0 views

tedkaptchuk.com/selected-publications

placebo

shared by Dennis OConnor on 23 Oct 19 - No Cached
  • Dennis OConnor on 23 Oct 19
     
    "PLACEBO STUDIES"
  • Dennis OConnor on 23 Oct 19
     
    Keyword: Placebo
Dennis OConnor

Ted J. Kaptchuk | Publications - 0 views

tedkaptchuk.com/bibliography

placebo

shared by Dennis OConnor on 23 Oct 19 - No Cached
  • Dennis OConnor on 23 Oct 19
     
    "PUBLICATIONS" Ted J. Kaptchuk is Professor of Medicine and Professor of Global Health and Social Medicine at Harvard Medical School and Director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston, Massachusetts
  • Dennis OConnor on 23 Oct 19
     
    Keyword: Placebo
Dennis OConnor

Norman Doidge: Placebo Possibilities - YouTube - 0 views

www.youtube.com/watch

placebo Doidge

shared by Dennis OConnor on 23 Oct 19 - No Cached
  • Dennis OConnor on 23 Oct 19
     
    Interview with Dr. Norman Doige, part of a series of interviews on Brain Plasticity, Healing and "The Brain That Changes Itself".
  • Dennis OConnor on 23 Oct 19
     
    Dr. Michael Kurisu D.O. recommended Doidge's book, "The Brain That Changes Itself" to me several years ago. Reading the rich and detailed case studies in his book opened me to so many intriguing ideas. In particular, his explanations of how the placebo effect relates to neuroplasticity.
Dennis OConnor

The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? - 0 views

www.ncbi.nlm.nih.gov/...PMC3118090

research N-of-One

shared by Dennis OConnor on 26 Jan 19 - No Cached
  • Dennis OConnor on 26 Jan 19
     
    "N-of-1 or single subject clinical trials consider an individual patient as the sole unit of observation in a study investigating the efficacy or side-effect profiles of different interventions. The ultimate goal of an n-of-1 trial is to determine the optimal or best intervention for an individual patient using objective data-driven criteria. Such trials can leverage study design and statistical techniques associated with standard population-based clinical trials, including randomization, washout and crossover periods, as well as placebo controls. Despite their obvious appeal and wide use in educational settings, n-of-1 trials have been used sparingly in medical and general clinical settings. We briefly review the history, motivation and design of n-of-1 trials and emphasize the great utility of modern wireless medical monitoring devices in their execution. We ultimately argue that n-of-1 trials demand serious attention among the health research and clinical care communities given the contemporary focus on individualized medicine. Keywords: clinical equipoise, early-phase trials, individualized medicine, n-of-1, remote phenotyping, single patient trial, treatment repositioning, wireless health"
Dennis OConnor

Like Mind, Like Body Podcast - Curable Health - 0 views

www.curablehealth.com/podcast

placebo podcast

shared by Dennis OConnor on 23 Oct 19 - No Cached
  • Dennis OConnor on 23 Oct 19
     
    "Can our thoughts and feelings really miraculously heal, or slowly destroy our physical health and well being? Join us as we interview top researchers, best-selling authors, and field experts about the astonishing ways the mind can affect the body. Powered by Curable, an online program that uses mindbody techniques to relieve chronic pain."
  • Dennis OConnor on 23 Oct 19
     
    Keyword: Placebo
Dennis OConnor

Doctors' Expectations Make Pain Treatments More Effective, Research Finds : Shots - Hea... - 0 views

www.npr.org/...-can-catch-it-from-your-doctor

placebo

shared by Dennis OConnor on 23 Oct 19 - No Cached
  • Dennis OConnor on 23 Oct 19
     
    "If there's one thing you do want to catch from a trip to your doctor, it's her optimism. A new study, published Monday in the journal Nature Human Behavior, finds that patients can pick up on subtle facial cues from doctors that reveal the doctor's belief in how effective a treatment will be. And that can have a real impact on the patient's treatment outcome."
Dennis OConnor

The Power of the Process: Creating Positive Outcomes with David Rakel, MD | The Institu... - 0 views

www.ifm.org/...sitive-outcomes-david-rakel-md

empathy compassion

shared by Dennis OConnor on 07 Jan 20 - No Cached
  • Dennis OConnor on 07 Jan 20
     
    "In this podcast, IFM's Director of Medical Education, Dan Lukaczer, ND, interviews researcher, educator, and clinician David Rakel, MD, on the power of empathy, compassion, the placebo effect, and the patient story. In particular, they explore how empathy and sympathy can lead to burnout, while compassion can be restorative." shared by Vicky Newman
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