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EN
The paper summarizes the common aspects and the differences of the placebo/nocebo and suggestion. To understand better the placebo effect, it would be important to take into consideration that the suggestibility of patients is hightened compared to the rational, waking, healthy person. This way patients interpret the communicative messages differently. So in the everyday practice - to increase the benefit of placebo effect and decrease the nocebo effect - a much greater role of carefully applied suggestive communication is recommended.
EN
The authors summarize the different approaches, arguments, and implicit beliefs for and against the therapeutic usage of placebo. The previous investigations, proposed solutions and ideas are also reviewed and evaluated. As the therapeutic effectivity of placebo is proven regarding both subjective and objective symptoms in many diseases and disorders, the complete denial of possible usage is not acceptable any more. Observing the recommended rules and guidelines (e.g. proven effectivity for the given symptoms, informed consent, as adjuvant therapy, etc.) the placebo would be already usable as a therapy, and the underlying psychological (primarily cognitive) and psychophysiological mechanisms could also be discovered and understood with more research. The usage of the placebo does not mean deception and limiting of autonomy under any circumstances. In the appropriate context it can help patients participating actively in their own recovering and can give them the opportunity of further personality development.
EN
The main goal of our theoretical work has been critically summarizing the previous theories about the adaptivity of the placebo-phenomenon and synthetizing them. From the biological point of view, the phenomenon in itself is not unambiguously adaptive thus its evolution cannot be fully explained by direct selection. After overviewing the underlying biological and psychological mechanisms, the authors consider the human placebo-phenomenon as an evolutionary by-product, that had originally emerged from interaction of other adaptive characteristics (such as sociability, learning, consciousness, theory of mind). On the other hand, the placebo-phenomenon is culturally determined hence it goes beyond the frames of Darwinian evolution. Due to its cultural embeddedness and to the increasing number of disorders of partially psychic origin, the importance of placebo is growing in our age. As the representation of the environment had become more and more complex, the importance of mind-visceral connections also increased. Perhaps the placebo can be the tool which should be able to activate the biological self-healing mechanisms repressed by our modern culture - even within the frames of the contemporary medicine that in many ways is symptom-oriented, overspecialized, rigid and non-personal. This is why the authors consider the human placebo-phenomenon as culturally potentially adaptive.
Psychological Studies
|
2008
|
vol. 46
|
issue 1
13-24
EN
The aim of the paper is an attempt to research psychological mechanisms of the placebo action (expectancy, classical conditioning and anxiety) and their relationships.The effect of negative placebo as one of the potential effects of the action of placebo administered in the guise of an adverse method or as its component is distinguished. An experiment on psychological mechanisms of negative placebo action (namely hyperalgesic) is presented. The results of the experiment show that expectations are sufficient to induce the effect of negative placebo but conditioning is not sufficient to induce this effect and have no impact on the strength of the effect induced by expectations. A significant relationship between expectations and pain anxiety was determined. It was also demonstrated that it was possible to induce the effect of negative placebo despite the lack of intentionally evoked expectations. The results support expectancy and anxiety but doesn't exclude classical conditioning as the mechanisms of negative placebo action.
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