Octarine
The Eighth Colour
- Joined
- Oct 14, 2007
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- 1,351
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- Enneagram
- 10w
- Instinctual Variant
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Psychology is currently dominated by the biopsychosocial ideology and one of the assumptions is that behaviour and cognitions can both cause and relieve somatic symptoms. One of the implications is the hypothesis of the placebo effect - that conditioning can cause biological responses that relieve symptoms. The problem with this model is that the majority of the evidence is subjective in nature. There certainly is a moderate subjective effect after conditioning, that depends on the nature of the conditioning. The problem is that little if any evidence has been shown demonstrating actual biological responses that are well understood enough to explain the relief of symptoms. The subjective response may simply be due to various response biases. The effect has also been questioned due to longer term results where the effect usually reverts to the mean.
The idea of a biological placebo response is controversial as it impacts the validity of the so-called placebo controlled pharmaceutical trials. The argument is that the placebo effect can have a beneficial effect and therefore this comparison reduces the effect size of the treatment. Proposed alternatives include the open treatment results compared to hidden treatment, where the timing of the treatment varies - patients don't actually know when they will receive the actual treatment.
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD003974/pdf_fs.html
Do you think their conclusions are reasonable?
Does this change your view on the placebo effect?
If the outcome effect (the effect that is called the placebo effect by some) is due to biases in subjective reporting, what do you think these specific biases are?
Do you think that the traditional 'randomised placebo controlled study' is still a valid method?
The idea of a biological placebo response is controversial as it impacts the validity of the so-called placebo controlled pharmaceutical trials. The argument is that the placebo effect can have a beneficial effect and therefore this comparison reduces the effect size of the treatment. Proposed alternatives include the open treatment results compared to hidden treatment, where the timing of the treatment varies - patients don't actually know when they will receive the actual treatment.
Plain Language Summary said:Placebo interventions for all clinical conditions
Placebo interventions are often claimed to substantially improve many clinical conditions. However,most reports on effects of placebos
are based on unreliable studies that have not randomised patients to placebo or no treatment.
We studied the effect of placebo treatments by reviewing 202 trials comparing placebo treatment with no treatment covering 60
healthcare problems. In general, placebo treatments produced no major health benefits, although on average they had a modest effect
on outcomes reported by patients, such as pain. However, the effect on pain varied from large to non-existent, even in well-conducted
trials. Variations in the effect of placebo was partly explained by variations in how trials were conducted, the type of placebo used, and
whether patients were informed that the trial involved placebo.
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD003974/pdf_fs.html
Do you think their conclusions are reasonable?
Does this change your view on the placebo effect?
If the outcome effect (the effect that is called the placebo effect by some) is due to biases in subjective reporting, what do you think these specific biases are?
Do you think that the traditional 'randomised placebo controlled study' is still a valid method?