Skip to main content
SpringerLink
Log in

Placebo expectations and the detection of somatic information

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

In a laboratory study we examined the hypothesis that placebo expectations enhance the initial identification of placebo-relevant sensations over placebo-irrelevant sensations. Participants (N = 102) were randomly assigned to one of three expectation groups. In the first group, participants ingested a placebo capsule and were told it was caffeine (deceptive expectation). In a second group, participants ingested a placebo capsule and were told it may be caffeine or it may be a placebo (double-blind expectation). Participants in the third group were given no expectation. All participants then tallied the placebo-relevant and placebo-irrelevant sensations they experienced during a 7-min period. Participants in the deceptive expectation group identified more placebo-relevant sensations than placebo-irrelevant sensations. No-expectation participants identified more placebo-irrelevant sensations than placebo-relevant sensations. Participants given the double-blind expectation identified an equal amount of placebo-relevant and irrelevant sensations. The amount of both placebo-relevant and placebo-irrelevant sensations detected mediated the relationship between the expectation manipulation and subsequent symptom reports. These data support the position that expectations cause placebo responding, in part, by altering how one identifies bodily sensations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Anderson, D. B., & Pennebaker, J. W. (1980). Pain and pleasure: Alternative interpretations for identical stimulation. European Journal of Social Psychology, 10, 207–212.

    Article  Google Scholar 

  • Benedetti, F., Mayberg, H. S., Wager, T. D., Stohler, C. S., & Zubieta, J. (2005). Neurobiological mechanisms of the placebo effect. Journal of Neuroscience, 25, 10390–10402.

    Article  PubMed  CAS  Google Scholar 

  • Brody, H., & Brody, D. (2000). The placebo response. New York, NY: HarperCollins Publishers.

    Google Scholar 

  • Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An integrative and conceptual model. Psychological Bulletin, 130, 793–812.

    Article  PubMed  Google Scholar 

  • Caspi, O., & Bootzin, R. R. (2002). Evaluating how placebos produce change: Logical and causal traps and understanding cognitive explanatory mechanisms. Evaluative and Health Professions, 25, 436–464.

    Article  Google Scholar 

  • Chaput de Saintonge, D. M., & Herxheimer, A. (1994). Harnessing placebo effects in health care. Lancet, 334, 995–998.

    Article  Google Scholar 

  • De la Fuente-Fernandez, R., Ruth, T. J., Sossi, V., Schulzer, M., Calne, D. B., & Stoessl, A. J. (2001). Expectation and dopamine release: Mechanism of the placebo effect in Parkinson’s disease. Science, 293, 1164–1166.

    Article  PubMed  Google Scholar 

  • Dinnerstein, A. J., & Halm, J. (1970). Modification of placebo effects by means of drugs: Effects of aspirin and placebos on self-rated moods. Journal of Abnormal Psychology, 75, 308–314.

    Article  PubMed  CAS  Google Scholar 

  • Ernst, E., & Resch, K. L. (1995). Concept of true and perceived placebo effects. Journal of Behavioral Medicine, 311, 551–563.

    CAS  Google Scholar 

  • Fillmore, M., & Vogel-Sprott, M. (1992). Expected effect of caffeine on motor performance predicts the type of response to placebo. Psychopharmacology, 106, 209–214.

    Article  PubMed  CAS  Google Scholar 

  • Geers, A. L., Helfer, S. G., Kosbab, K., & Weiland, P. E. (2006). Expectations and placebo response: A laboratory investigation into the role of somatic focus. Journal of Behavioral Medicine, 29, 171–178.

    Article  PubMed  Google Scholar 

  • Geers, A. L., Weiland, P. E., Kosbab, K., Landry, S. J., & Helfer, S. G. (2005). Goal activation, expectations, and the placebo effect. Journal of Personality and Social Psychology, 89, 143–159.

    Article  PubMed  Google Scholar 

  • Hammersley, R., Finnigan, F., & Millar, K. (1998). Verbal expectancies and performance after alcohol. Addictive Behavior, 23, 489–496.

    Article  CAS  Google Scholar 

  • Harrington, A. (1997). The placebo effect: An interdisciplinary exploration. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Hirt, E. R., Lynn, S. J., Payne, D. G., Kracknow, E., & McCrea, S. M. (1999). Expectancies and memory: Inferring the past from what must have been. In I. Kirsch (Ed.), How expectancies shape experience (pp. 93–124). Washington DC: American Psychological Association.

    Chapter  Google Scholar 

  • Hróbjartsson, A., & Gotzsche, P. C. (2001). Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. New England Journal of Medicine, 344, 1594–1601.

    Article  PubMed  Google Scholar 

  • Hróbjartsson, A., & Gotzsche, P. C. (2004). Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no-treatment. Journal of International Medicine, 256, 91–100.

    Google Scholar 

  • Hyland, M. E., & Whalley, B. (2008). Motivational concordance: An important mechanism in self-help therapeutic rituals involving inert (placebo) substances. Journal of Psychosomatic Research, 65, 405–413.

    Article  PubMed  Google Scholar 

  • Hyland, M. E., Whalley, B., & Geraghy, A. W. A. (2007). Dispositional predictors of placebo responding: A motivational interpretation of flower essence and gratitude therapy. Journal of Psychosomatic Research, 62, 331–340.

    Article  PubMed  Google Scholar 

  • Jospe, M. (1978). The placebo effect in healing. Lexington, MA: Lexington books.

    Google Scholar 

  • Keinle, G. S., & Keine, H. (1997). The powerful placebo: Fact or fiction? Journal of Clinical Epidemiology, 50, 1311–1318.

    Article  Google Scholar 

  • Keltner, J. R., Furst, A., Fan, C., et al. (2006). Isolating the modulatory effect of expectation on pain transmission: A functional magnetic resonance imaging study. Journal of Neuroscience, 26, 4437–4443.

    Article  PubMed  CAS  Google Scholar 

  • Kenny, D. A., Kashy, D. A., & Bolger, N. (1998). Data analysis in social psychology. In D. Gilbert, S. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (Vol. 1, pp. 233–265). Boston, MA: McGraw-Hill.

    Google Scholar 

  • Kirsch, I. (1999). How expectancies shape experience. Washington DC: American Psychological Association.

    Book  Google Scholar 

  • Kirsch, I., & Rosadino, M. J. (1993). Do double-blind studies with informed consent yield externally valid results? An empirical test. Psychopharmacology, 110, 437–442.

    Article  PubMed  CAS  Google Scholar 

  • Kirsch, I., & Sapirstein, G. (1998). Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Preventative Treatment, 1. Retrieved from http://journals.apa.org/prevention/volume1/pre0010002a.html.

  • Kirsch, I., & Weixel, L. J. (1988). Double-blind versus deceptive administration of a placebo. Behavioral Neuroscience, 102, 319–323.

    Article  PubMed  CAS  Google Scholar 

  • Koyama, T., McHaffie, J. G., Laurienti, P. J., & Coghill, R. C. (2005). The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Science, 102, 12950–12955.

    Article  CAS  Google Scholar 

  • Lorenz, J., Hauck, M., Paur, R. C., et al. (2005). Cortical correlates of false expectations during pain intensity judgments—a possible manifestation of placebo/nocebo cognitions. Brain, Behavior, and Immunity, 19, 283–295.

    Article  PubMed  Google Scholar 

  • Lundh, L. (1987). Placebo, belief, and health: A cognitive-emotional model. Scandinavian Journal of Psychology, 28, 28–143.

    Article  Google Scholar 

  • Madsen, M. V., Gotzsche, P. C., & Hróbjartsson, A. (2009). Acupuncture treatment for pain: Systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. British Medicinal Journal, 338, a3115.

  • McDonald, D., Mazzuca, S., & McCabe, G. P. (1983). How much of the placebo “effect” is really statistical regression? Statistics in Medicine, 2, 417–427.

    PubMed  CAS  Google Scholar 

  • Meissner, K., Distel, H., & Mitzdorf, U. (2007). Evidence for placebo effects on physical but not biochemical outcome parameters: A review of clinical trials. BMC Medicine, 5, 3.

    Article  PubMed  Google Scholar 

  • Mondaini, N., Gontero, P., Giubilei, G., et al. (2007). Finasteride 5 mg and sexual side effects: How many of these are related to a nocebo phenomenon? Journal of Sexual Medicine, 4, 1708–1712.

    Article  PubMed  Google Scholar 

  • Nash, J. M., Holroyd, K. A., Rokicki, L. A., Kvaal, S., & Penzien, D. B. (2002). The influence of placebo awareness on stimulant drug response in a double-blind trial. Psychopharmacology, 161, 213–221.

    Article  PubMed  CAS  Google Scholar 

  • Pennebaker, J. W., & Skelton, J. A. (1981). Selective monitoring of physical sensations. Journal of Personality and Social Psychology, 41, 213–223.

    Article  PubMed  CAS  Google Scholar 

  • Peters, D. (2001). Understanding the placebo effect in complementary medicine. London, UK: Harcourt Publishing.

    Google Scholar 

  • Petrovic, P., Kalso, E., Petersson, K. H., & Ingvar, M. (2002). Placebo and opioid analgesia: Imaging a shared neuronal network. Science, 295, 1737–1740.

    Article  PubMed  CAS  Google Scholar 

  • Pollo, A., Amanzio, M., Arslanian, A., Casadio, C., Maggi, G., & Benedetti, F. (2001). Response expectancies in placebo analgesia and their clinical relevance. Pain, 93, 77–84.

    Article  PubMed  CAS  Google Scholar 

  • Price, D. D., Finniss, D. G., & Benedetti, F. (2008). A comprehensive review of the placebo effect: Recent advances and current thought. Annual Review of Psychology, 59, 565–590.

    Article  PubMed  Google Scholar 

  • Price, D. D., Milling, L. S., Kirsch, I., Duff, A., Montgomery, G. H., & Nicholls, S. S. (1999). An analysis of factors that contribute to the magnitude of placebo analgesia in an experimental paradigm. Pain, 83, 147–156.

    Article  PubMed  CAS  Google Scholar 

  • Rief, W., Hofmann, S. G., & Nestoriuc, Y. (2008). The power of expectation—understanding the placebo and nocebo phenomenon. Social and Personality Psychology Compass, 2, 1–14.

    Article  Google Scholar 

  • Rief, W., Nestoriuc, Y., Weiss, S., Welzel, E., Barsky, A. J., & Hofmann, S. G. (2009). Meta-analysis of the placebo response in antidepressant trials. Journal of Affective Disorders, 118, 1–8.

    Article  PubMed  CAS  Google Scholar 

  • Ross, M., & Olson, J. M. (1981). An expectancy-attribution model of the effects of placebos. Psychological Review, 88, 408–437.

    Article  PubMed  CAS  Google Scholar 

  • Sauro, M. D., & Greenberg, R. P. (2005). Endogenous opiates and the placebo effect: A meta-analytic review. Journal of Psychosomatic Research, 58, 115–120.

    Article  PubMed  Google Scholar 

  • Shapiro, A. K., & Shapiro, E. (1997). The powerful placebo effect. Baltimore, MA: John Hopkins University Press.

    Google Scholar 

  • Smith, E. E. (2007). Expectancy and the perception of aversive events. In Y. Shoda, D. Cervone, & G. Downey (Eds.), Person in context (pp. 148–168). New York, NY: Guilford Publications.

    Google Scholar 

  • Stewart-Williams, S., & Podd, J. (2004). The placebo effect: Dissolving the expectancy versus conditioning debate. Psychological Bulletin, 130, 324–340.

    Article  PubMed  Google Scholar 

  • Vase, L., Riley, J. L., & Price, D. D. (2002). A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia. Pain, 99, 443–452.

    Article  PubMed  Google Scholar 

  • Wager, T. D., Rilling, J. K., Smith, E. E., et al. (2004). Placebo-induced changes in FMRI in the anticipation and experience of pain. Science, 303, 1162–1167.

    Article  PubMed  CAS  Google Scholar 

  • Walach, H., Schmidt, S., Dirhold, T., & Nosch, S. (2002). The effects of a caffeine placebo and suggestion on blood pressure, heart rate, well-being, and cognitive performance. International Journal of Psychophysiology, 43, 247–260.

    Article  PubMed  Google Scholar 

  • Zubieta, J. K., Yau, W. Y., Scott, D. J., & Stohler, C. S. (2006). Belief or need? Accounting for individual variations in the neurochemistry of the placebo effect. Brain, Behavior, and, Immunology, 20, 15–26.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Toledo, Toledo, OH, 43606-3390, USA

    Andrew L. Geers

  2. Hartwick College, Oneonta, NY, USA

    Justin A. Wellman

  3. University of Toledo, Toledo, OH, USA

    Stephanie L. Fowler & Heather M. Rasinski

  4. Adrian College, Adrian, MI, USA

    Suzanne G. Helfer

Authors
  1. Andrew L. Geers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Justin A. Wellman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephanie L. Fowler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Heather M. Rasinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Suzanne G. Helfer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew L. Geers.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Geers, A.L., Wellman, J.A., Fowler, S.L. et al. Placebo expectations and the detection of somatic information. J Behav Med 34, 208–217 (2011). https://doi.org/10.1007/s10865-010-9301-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-010-9301-9

Keywords

Search

Navigation