Re: [Vo]:Placebo effect getting stronger
Its not that complicated. Jed suggested the appropriate control for placebo: No treatment at all. On Fri, Apr 19, 2013 at 10:20 PM, John Berry berry.joh...@gmail.com wrote: This is obviously a complex issue. But I think that strong belief as with hypnosis and other suggestions can't be discounted (faith healers). There are people who have apparently died from being made to think they they were having blood drain from their bodies. And if someone goes into surgery with a death wish of a negative expectation the Nocebo effect is apparently very dangerous. At the extreme ends of mind body relationship, there are people that insist that those with multiple personality disorder/disassociative personality disorder can gain and lose medical conditions such as diabetes and eye colour can change between the personalities. Blisters have apparently been raised by pencils that hypnotized subjects have been told is hot. So let's say that the mind body connection is complex, but that a sugar pill will not always deliver a powerful mind body effect, which is not to say it can't if there is not enough belief. I also recall an experiment very poorly recounted: rats being effected by a 'ritual' where if a chemical was omitted the expected results still occurred. I don't recall the details but essentially this was somewhere between a placebo effect on a mouse/rat a Pavlovian response. John On Sat, Apr 20, 2013 at 3:05 PM, Jed Rothwell jedrothw...@gmail.comwrote: If the studies I read are correct, this indicates the disease they are trying to cure with this particular drug usually goes away on its own. The placebo effect is not getting stronger. They happen to be treating a disease in a group of people where nature usually does a better job than medical science does. There are several diseases and syndromes that used to be treated aggressively but nowadays are often left alone because they usually go away after a while, or they cause no serious harm. Then there are diseases where some doctors recommend treatment and others do not, such as childhood hemangioma. - Jed
Re: [Vo]:Placebo effect getting stronger
James brings up important points with respect to hypnosis and the mind/body relationship. No treatment controls have been performed in many studies--most often through the use of wait list controls. In other words, one group is on a waiting list to begin the treatment, and this is compared to the putative active treatment and placebo groups. There can be little doubt in the reality of the placebo effect to bring real physiological changes. What is debatable is the extent of these changes, and the conditions that can be affected. Warts--caused by the HPV virus have long been successfully treated utilizing hypnosis. Hypnosis has also shown benefit to other conditions such as migraine headaches, psoriasis, and intestinal conditions. The placebo effect is not magic, but works by physiological mechanisms. It is of particular importance in studying medication for psychological disorders as one's expectancies can have a profound impact on one's recovery. Proper control conditions for examining the placebo effect are slightly more complicated than using a no-treatment control. One actually needs a placebo medication that may produce some noticeable side effects because of the research showing that patients are often able to identify if they are in the placebo or active medication groups based on the presence of absence of side effects. This degree of control is rarely performed in studies, but wait-list controls are not infrequent in psychopharmacology. Most medical conditions have a psychological aspect to them -- if nothing else in a person's perception of their condition. If you are studying a pain medication, it is important to have a properly designed placebo control condition as pain perception occurs in the mind and is affected by many psychological factors. To get more of a grasp on this area, it's useful to study psychoneuroimmunology, which is a complex and fascinating field looking at the interaction psychology, hormone systems, and the immune system. There is a substantial amount of research linking chronic stress to the development of many physical conditions. And James is also correct with the nocebo affect being attributed to phenomena known as voodoo death. On a less dramatic issue is that negative expectancies can lead to lack of benefit in a number of treatments--particularly in psychopharmacology. Best regards, Jack On Sat, Apr 20, 2013 at 10:44 AM, James Bowery jabow...@gmail.com wrote: Its not that complicated. Jed suggested the appropriate control for placebo: No treatment at all. On Fri, Apr 19, 2013 at 10:20 PM, John Berry berry.joh...@gmail.comwrote: This is obviously a complex issue. But I think that strong belief as with hypnosis and other suggestions can't be discounted (faith healers). There are people who have apparently died from being made to think they they were having blood drain from their bodies. And if someone goes into surgery with a death wish of a negative expectation the Nocebo effect is apparently very dangerous. At the extreme ends of mind body relationship, there are people that insist that those with multiple personality disorder/disassociative personality disorder can gain and lose medical conditions such as diabetes and eye colour can change between the personalities. Blisters have apparently been raised by pencils that hypnotized subjects have been told is hot. So let's say that the mind body connection is complex, but that a sugar pill will not always deliver a powerful mind body effect, which is not to say it can't if there is not enough belief. I also recall an experiment very poorly recounted: rats being effected by a 'ritual' where if a chemical was omitted the expected results still occurred. I don't recall the details but essentially this was somewhere between a placebo effect on a mouse/rat a Pavlovian response. John On Sat, Apr 20, 2013 at 3:05 PM, Jed Rothwell jedrothw...@gmail.comwrote: If the studies I read are correct, this indicates the disease they are trying to cure with this particular drug usually goes away on its own. The placebo effect is not getting stronger. They happen to be treating a disease in a group of people where nature usually does a better job than medical science does. There are several diseases and syndromes that used to be treated aggressively but nowadays are often left alone because they usually go away after a while, or they cause no serious harm. Then there are diseases where some doctors recommend treatment and others do not, such as childhood hemangioma. - Jed
Re: [Vo]:Placebo effect getting stronger
Actually, it does say that: One estimated that the so-called effect size (a measure of statistical significance) in placebo groups had nearly doubled over that time. On Sat, Apr 20, 2013 at 1:18 PM, John Berry berry.joh...@gmail.com wrote: I said that the placebo effect had about doubled in effectiveness over what it had been. Someone asked for the source. I am sure a better search of google will turn up more info on that, but here is an article about it getting more effective without (I think) mentioning a doubling: http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all John
Re: [Vo]:Placebo effect getting stronger
If the studies I read are correct, this indicates the disease they are trying to cure with this particular drug usually goes away on its own. The placebo effect is not getting stronger. They happen to be treating a disease in a group of people where nature usually does a better job than medical science does. There are several diseases and syndromes that used to be treated aggressively but nowadays are often left alone because they usually go away after a while, or they cause no serious harm. Then there are diseases where some doctors recommend treatment and others do not, such as childhood hemangioma. - Jed
Re: [Vo]:Placebo effect getting stronger
This is obviously a complex issue. But I think that strong belief as with hypnosis and other suggestions can't be discounted (faith healers). There are people who have apparently died from being made to think they they were having blood drain from their bodies. And if someone goes into surgery with a death wish of a negative expectation the Nocebo effect is apparently very dangerous. At the extreme ends of mind body relationship, there are people that insist that those with multiple personality disorder/disassociative personality disorder can gain and lose medical conditions such as diabetes and eye colour can change between the personalities. Blisters have apparently been raised by pencils that hypnotized subjects have been told is hot. So let's say that the mind body connection is complex, but that a sugar pill will not always deliver a powerful mind body effect, which is not to say it can't if there is not enough belief. I also recall an experiment very poorly recounted: rats being effected by a 'ritual' where if a chemical was omitted the expected results still occurred. I don't recall the details but essentially this was somewhere between a placebo effect on a mouse/rat a Pavlovian response. John On Sat, Apr 20, 2013 at 3:05 PM, Jed Rothwell jedrothw...@gmail.com wrote: If the studies I read are correct, this indicates the disease they are trying to cure with this particular drug usually goes away on its own. The placebo effect is not getting stronger. They happen to be treating a disease in a group of people where nature usually does a better job than medical science does. There are several diseases and syndromes that used to be treated aggressively but nowadays are often left alone because they usually go away after a while, or they cause no serious harm. Then there are diseases where some doctors recommend treatment and others do not, such as childhood hemangioma. - Jed
Re: [Vo]:Placebo effect getting stronger
I suppose an alternative hypothesis would be that these particular diseases are psychosomatic. - Jed
