Half-Blind Tasting: A Deception-Free Method for Sizing Placebo and Nocebo Responses to Price and Packaging Attributes

2019 ◽  
Vol 14 (3) ◽  
pp. 321-331 ◽  
Author(s):  
Robin S. Goldstein
Keyword(s):  
Prospect Theory ◽  
Placebo Response ◽  
Sensory Experience ◽  
Controlled Experiment ◽  
Consumer Experience ◽  
Placebo Effects ◽  
Preliminary Results ◽  
Nocebo Effects ◽  
Jel Classifications

AbstractInformation conveyed on the price tag or label of a consumable packaged good is widely thought to change the consumer's sensory experience of consuming the good. Can the positive “placebo” effects of high prices and negative “nocebo” effects of low prices on consumer experience be isolated and observed in a controlled experiment without using deception? In a pilot wine experiment using a method I call “half-blind tasting,” I observe that the nocebo response to a $5 price tag is stronger than the placebo response to a $50 price tag. To interpret these preliminary results, I borrow some insights from prospect theory. (JEL Classifications: C91, D81, L66, M31, Q11)

Learned Placebo Effects in the Immune System

2014 ◽  
Vol 222 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Sabine Vits ◽  
Manfred Schedlowski
Keyword(s):  
Nervous System ◽  
Immune System ◽  
Associative Learning ◽  
Placebo Response ◽  
Immunosuppressive Drug ◽  
Immune Functions ◽  
Placebo Effects ◽  
New Therapeutic Approaches ◽  
Biological Variables ◽  
Experimental Approaches

Associative learning processes are one of the major neuropsychological mechanisms steering the placebo response in different physiological systems and end organ functions. Learned placebo effects on immune functions are based on the bidirectional communication between the central nervous system (CNS) and the peripheral immune system. Based on this “hardware,” experimental evidence in animals and humans showed that humoral and cellular immune functions can be affected by behavioral conditioning processes. We will first highlight and summarize data documenting the variety of experimental approaches conditioning protocols employed, affecting different immunological functions by associative learning. Taking a well-established paradigm employing a conditioned taste aversion model in rats with the immunosuppressive drug cyclosporine A (CsA) as an unconditioned stimulus (US) as an example, we will then summarize the efferent and afferent communication pathways as well as central processes activated during a learned immunosuppression. In addition, the potential clinical relevance of learned placebo effects on the outcome of immune-related diseases has been demonstrated in a number of different clinical conditions in rodents. More importantly, the learned immunosuppression is not restricted to experimental animals but can be also induced in humans. These data so far show that (i) behavioral conditioned immunosuppression is not limited to a single event but can be reproduced over time, (ii) immunosuppression cannot be induced by mere expectation, (iii) psychological and biological variables can be identified as predictors for this learned immunosuppression. Together with experimental approaches employing a placebo-controlled dose reduction these data provide a basis for new therapeutic approaches to the treatment of diseases where a suppression of immune functions is required via modulation of nervous system-immune system communication by learned placebo effects.

Hidden Assumptions and the Placebo Effect

2009 ◽  
Vol 27 (2) ◽  
pp. 68-69 ◽  
Author(s):  
Anthony Campbell
Keyword(s):  
Placebo Effect ◽  
Folk Psychology ◽  
Placebo Response ◽  
Placebo Effects ◽  
Cartesian Dualism ◽  
Reading Research ◽  
Philosophical Assumption ◽  
Acupuncture Effects ◽  
The Brain

Whether, or how far, acupuncture effects can be explained as due to the placebo response is clearly an important issue, but there is an underlying philosophical assumption implicit in much of the debate, which is often ignored. Much of the argument is cast in terms which suggest that there is an immaterial mind hovering above the brain and giving rise to spurious effects. This model derives from Cartesian dualism which would probably be rejected by nearly all those involved, but it is characteristic of “folk psychology” and seems to have an unconscious influence on much of the terminology that is used. The majority of philosophers today reject dualism and this is also the dominant trend in science. Placebo effects, on this view, must be brain effects. It is important for modern acupuncture practitioners to keep this in mind when reading research on the placebo question.

Placebo and nocebo effects in randomized double-blind clinical trials for fatigue in advanced cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9640-9640
Author(s):  
M. de la Cruz ◽  
D. Hui ◽  
H. A. Parsons ◽  
P. Lynn ◽  
C. Parker ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Randomized Clinical Trials ◽  
Placebo Response ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Edmonton Symptom Assessment Scale ◽  
Nocebo Effects

9640 Background: We have previously reported significant placebo response in randomized controlled treatment trials for cancer related fatigue (CRF). We conducted a retrospective study to determine the frequency and predictors of response to placebo and nocebo effect in patients with CRF. Methods: We reviewed patients that received placebo in two previous randomized clinical trials conducted by our group and determined the proportion of patients who demonstrated clinical response to fatigue using an increase (ΔFACIT-F score) > 7 from baseline to day 8, and those with nocebo response as those who reported side effects. Baseline patient characteristics and symptoms recorded from the Edmonton Symptom Assessment Scale (ESAS) were analyzed to determine their association with placebo and nocebo effects. Results: A total of 105 advanced cancer patients received placebo. 59 (56%) patients responded to placebo (median Δ FACIT-F score of 22). Worse baseline anxiety and well-being subscale score (univariate) and well-being (multivariate, MR) were significantly associated with placebo response. Common side effects reported were insomnia (79%), anorexia (53%), nausea (38%) and restlessness (34%). MR analysis showed that worse baseline (ESAS) sleep, appetite, nausea, and restless are associated with increased reporting of these side effects ( Table ). Conclusions: Nearly half of advanced cancer patients enrolled in the fatigue trials responded to placebo. Worse physical well-being score was associated with placebo response. Patients experiencing specific symptoms at baseline were more likely to report these as side effects of the medication. These findings should be considered in fatigue clinical trial design. [Table: see text] No significant financial relationships to disclose.

scholarly journals What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care

2021 ◽  
Vol 12 ◽  
Author(s):  
Hailey E. Yetman ◽  
Nevada Cox ◽  
Shelley R. Adler ◽  
Kathryn T. Hall ◽  
Valerie E. Stone
Keyword(s):  
Clinical Setting ◽  
Clinical Care ◽  
Quality Care ◽  
Clinical Encounter ◽  
Medical Mistrust ◽  
Placebo Effects ◽  
Beneficial Effects ◽  
Unequal Treatment ◽  
Black Patients ◽  
Nocebo Effects

A placebo effect is a positive clinical response to non-specific elements of treatment with a sham or inert replica of a drug, device, or surgical intervention. There is considerable evidence that placebo effects are driven by expectation of benefit from the intervention. Expectation is shaped by a patient’s past experience, observations of the experience of others, and written, verbal, or non-verbal information communicated during treatment. Not surprisingly, expectation in the clinical setting is strongly influenced by the attitude, affect, and communication style of the healthcare provider. While positive expectations can produce beneficial effects, negative information and experiences can lead to negative expectations, and consequently negative or nocebo effects. Key components identified and studied in the placebo and nocebo literature intersect with factors identified as barriers to quality care in the clinical setting for Black patients and other patients of color, including poor patient-clinician communication, medical mistrust, and perceived discrimination. Thus, in the context of discrimination and bias, the absence of placebo and presence of nocebo-generating influences in clinical settings could potentially reinforce racial and ethnic inequities in clinical outcomes and care. Healthcare inequities have consequences that ripple through the medical system, strengthening adverse short- and long-term outcomes. Here, we examine the potential for the presence of nocebo effects and absence of placebo effects to play a role in contributing to negative outcomes related to unequal treatment in the clinical encounter.

Online Shopping Experience

2004 ◽  
pp. 15-44 ◽  
Author(s):  
Yi M. Guo
Keyword(s):  
Influencing Factors ◽  
Web Sites ◽  
Online Shopping ◽  
Individual Characteristics ◽  
Consumer Experience ◽  
Preliminary Results ◽  
Factors Influencing ◽  
Shopping Experience ◽  
Research Questions ◽  
Online Consumer

In this chapter, a model of online shopping experience is proposed to unify previous works of online consumer experience. Online shopping experience (OSE) is the interaction between shoppers and commercial web sites. It consists of physical, cognitive, and affective activities, and in-progress responses. Factors influencing shopping experience include individual characteristics of shoppers, characteristics of stores and commercial web sites, characteristics of products and shopping task, and other contextual factors. The outcomes of shopping experience have been studied in many ways. Based on this model, series of research questions can be asked to examine relationships between components of shopping experience and influencing factors, and between shopping experience and shopping outcomes. Preliminary results of a study are reported to illustrate the usefulness of the concept of online shopping experience.

scholarly journals Why we need more research into the placebo response in psychiatry

2020 ◽  
Vol 50 (14) ◽  
pp. 2317-2323
Author(s):  
Nathan T.M. Huneke ◽  
Nic van der Wee ◽  
Matthew Garner ◽  
David S. Baldwin
Keyword(s):  
Current Knowledge ◽  
Biological Effects ◽  
Placebo Response ◽  
Placebo Effects ◽  
Biological Mechanisms ◽  
Research Directions ◽  
Treatment Development ◽  
Novel Treatment ◽  
New Treatments ◽  
Review Current

AbstractPlacebos are not inert, but exert measurable biological effects. The placebo response in psychiatric illness is important and clinically relevant, but remains poorly understood. In this paper, we review current knowledge about the placebo response in psychiatric medicine and identify research directions for the future. We argue that more research is needed into the placebo response in psychiatric medicine for three broad reasons. First, awareness of factors that cause placebo response, for whom, and when, within clinical trials will allow us to better evidence efficacy of new treatments. Second, by understanding how placebo mechanisms operate in the clinic, we can take advantage of these to optimise the effects of current treatments. Finally, exploring the biological mechanisms of placebo effects might reveal tractable targets for novel treatment development.

scholarly journals Behavioural conditioning as the mediator of placebo responses in the immune system

2011 ◽  
Vol 366 (1572) ◽  
pp. 1799-1807 ◽  
Author(s):  
Sabine Vits ◽  
Elvir Cesko ◽  
Paul Enck ◽  
Uwe Hillen ◽  
Dirk Schadendorf ◽  
...  
Keyword(s):  
Immune System ◽  
Placebo Response ◽  
Clinical Settings ◽  
Immune Functions ◽  
Placebo Effects ◽  
Allograft Survival ◽  
Physiological Mechanisms ◽  
Potential Clinical Benefit ◽  
Efferent Pathways ◽  
The Brain

Current placebo research postulates that conditioning processes are one of the major mechanisms of the placebo response. Behaviourally conditioned changes in peripheral immune functions have been demonstrated in experimental animals, healthy subjects and patients. The physiological mechanisms responsible for this ‘learned immune response’ are not yet fully understood, but some relevant afferent and efferent pathways in the communication between the brain and the peripheral immune system have been identified. In addition, possible benefits and applicability in clinical settings have been demonstrated where behaviourally conditioned immunosuppression attenuated the exacerbation of autoimmune diseases, prolonged allograft survival and affected allergic responses. Here, we summarize data describing the mechanisms and the potential clinical benefit of behaviourally conditioned immune functions, with particular focus on learned placebo effects on allergic reactions.

scholarly journals The Nocebo Effect and Pediatric Concussion

2021 ◽  
pp. 1-7
Author(s):  
Michael W. Kirkwood ◽  
David R. Howell ◽  
Brian L. Brooks ◽  
Julie C. Wilson ◽  
William P. Meehan III
Keyword(s):  
Pediatric Patients ◽  
Clinical Medicine ◽  
Evidence Based ◽  
Placebo Effects ◽  
Nocebo Effect ◽  
Pediatric Concussion ◽  
Nocebo Effects ◽  
Clinical Interactions ◽  
Negative Expectations

While placebo effects are well recognized within clinical medicine, “nocebo effects” have received much less attention. Nocebo effects are problems caused by negative expectations derived from information or treatment provided during a clinical interaction. In this review, we examine how nocebo effects may arise following pediatric concussion and how they may worsen symptoms or prolong recovery. We offer several suggestions to prevent, lessen, or eliminate such effects. We provide recommendations for clinicians in the following areas: terminology selection, explicit and implicit messaging to patients, evidence-based recommendations, and awareness of potential biases during clinical interactions. Clinicians should consider the empirically grounded suggestions when approaching the care of pediatric patients with concussion.

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