An analysis of the placebo phenomenon

Liberman, Robert Paul

doi:10.1016/0021-9681(62)90048-6

Cited by 71 publications

(17 citation statements)

References 31 publications

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“…Initial, largely inconclusive studies attempted to discover a psychological profile of placebo responders in clinical trials (Lasagna et al, 1954;Liberman, 1962). More recently, and in the context of placebo analgesia, trait optimism and trait anxiety were found to be positive and negative, reproducible predictors (Geers et al, 2010;Morton et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Personality Trait Predictors of Placebo Analgesia and Neurobiological Correlates

Peciña

Azhar

Love

et al. 2012

Neuropsychopharmacol

166

107

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Personality traits have been shown to interact with environmental cues to modulate biological responses including treatment responses, and potentially having a role in the formation of placebo effects. Here, we assessed psychological traits in 50 healthy controls as to their capacity to predict placebo analgesic effects, placebo-induced activation of m-opioid neurotransmission and changes in cortisol plasma levels during a sustained experimental pain challenge (hypertonic saline infused in the masseter muscle) with and without placebo administration. Statistical analyses showed that an aggregate of scores from Ego-Resiliency, NEO Altruism, NEO Straightforwardness (positive predictors) and NEO Angry Hostility (negative predictor) scales accounted for 25% of the variance in placebo analgesic responses. Molecular imaging showed that subjects scoring above the median in a composite of those trait measures also presented greater placebo-induced activation of m-opioid neurotransmission in the subgenual and dorsal anterior cingulate cortex (ACC), orbitofrontal cortex, insula, nucleus accumbens, amygdala and periaqueductal gray (PAG). Endogenous opioid release in the dorsal ACC and PAG was positively correlated with placebo-induced reductions in pain ratings. Significant reductions in cortisol levels were observed during placebo administration and were positively correlated with decreases in pain ratings, m-opioid system activation in the dorsal ACC and PAG, and as a trend, negatively with NEO Angry Hostility scores. Our results show that personality traits explain a substantial proportion of the variance in placebo analgesic responses and are further associated with activations in endogenous opioid neurotransmission, and as a trend cortisol plasma levels. This initial data, if replicated in larger sample, suggest that simple trait measures easily deployable in the field could be utilized to reduce variability in clinical trials, but may also point to measures of individual resiliency in the face of aversive stimuli such as persistent pain and potentially other stressors.

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Section: Introductionmentioning

confidence: 99%

Personality Trait Predictors of Placebo Analgesia and Neurobiological Correlates

Peciña

Azhar

Love

et al. 2012

Neuropsychopharmacol

166

107

View full text Add to dashboard Cite

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“…Some of these difficulties are noted in the reports of trials discussed here, particularly centred around the issue of side effects and their implications for double-blinding [see the discussions in Durelli et al, 17, and Knobler et al,24], With the use of more powerful pharmaco logical agents, the usual placebo-generated side effects can be uniformly different than those for the treatment group, and the latter may in any case require obvious managerial strategies. Such a difference is likely to be noticeable to the physician even if it is not to the patient, and this then may substantially disturb the effectiveness of placebo control [41,50,51,57], Both Brown et al [9] and Weiner and Ellison [10] note the implications of this point.…”

Section: Reporting On 23 Clinical Trials In Msmentioning

confidence: 99%

Analysing the Structure of 23 Clinical Trials in Multiple Sclerosis

Robinson¹

1987

Neuroepidemiology

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At present many trials appear to be using subjective data, but using these data in an unsystematic and inappropriate way. In this context it is not surprising that subjective measures have a generally low status amongst investigators in clinical trials in MS. A more careful approach to such subjective measures would enable trials to take into account a significantly wider range of features. Controlled trials can then act as an important psychosocial as well as biomedical laboratory in the understanding of MS.

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“…He reported that sympathetic, experienced nursing in single rooms was a major calming influence. Similarly, in studies of the placebo response in the treatment of pain, Lieberman [1962] reported that with pathological pain in a hospital setting and in the presence of a doctor a better response is obtained than in experimental pain in laboratory volun teers.…”

Section: The Patient and His Environmentmentioning

confidence: 99%

Factors Complicating the Effectiveness of Drugs

Davison¹

1974

Geront clin

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An analysis of the placebo phenomenon

Cited by 71 publications

References 31 publications

Personality Trait Predictors of Placebo Analgesia and Neurobiological Correlates

Personality Trait Predictors of Placebo Analgesia and Neurobiological Correlates

Analysing the Structure of 23 Clinical Trials in Multiple Sclerosis

Factors Complicating the Effectiveness of Drugs

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