Chapter Nine - The Role of Social and Interpersonal Factors in Placebo Analgesia
Section snippets
Patient–Provider Interactions and Placebo Effects
Characteristics of the physician critically influence the relation between patients’ expectations and placebo effects, as revealed by studies that have measured or manipulated features of the medical provider (rather than focusing simply on the patient). In the clinic, a supportive patient–provider relationship can reduce symptom severity twice as much as receiving placebo treatment alone (Kaptchuk et al., 2008), and positive expectations delivered by a physician in a supportive and reassuring
Loneliness as a Potential Determinant of Placebo Effects
Perceived social isolation, i.e., loneliness, is a potent example of the influence psychosocial factors can have on health outcomes. Loneliness can be considered a psychosocial motivational state—just as hunger motivates eating behavior, loneliness motivates attempts at social reconnection (Qualter et al., 2015). Many people experience bouts of transitory loneliness from time to time and change their behavior to foster relationship development (Qualter, Brown, Munn, & Rotenberg, 2010; Vanhalst
What Loneliness and the Study of Individual Differences in Social Perceptions Can Tell Us About Placebo
Psychosocial factors modulate endogenous physiological processes that impact clinical outcomes in placebo. Accumulating scientific literature echoes Hippocrates’ ancient observation: the patient–provider therapeutic alliance is critical in determining placebo effects. In many cases, the patient's experience (that is, their perceptions) may be a more meaningful predictor of their likelihood to exhibit a placebo effect than more objective assessments of providers’ social behaviors. Thus, a key
Acknowledgment
This work was supported by the Intramural Research program of the NIH's National Center for Complementary and Integrative Health.
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