Attitude strength has been the focus of a huge volume of research in psychology and related sciences for decades. The insights offered by this literature have tremendous value for understanding attitude functioning and structure and for the effective application of the attitude concept in applied settings. This is the first Annual Review of Psychology article on the topic, and it offers a review of theory and evidence regarding one of the most researched strength-related attitude features: attitude importance. Personal importance is attached to an attitude when the attitude is perceived to be relevant to self-interest, social identification with reference groups or reference individuals, and values. Attaching personal importance to an attitude causes crystallizing of attitudes (via enhanced resistance to change), effortful gathering and processing of relevant information, accumulation of a large store of well-organized relevant information in long-term memory, enhanced attitude extremity and accessibility, enhanced attitude impact on the regulation of interpersonal attraction, energizing of emotional reactions, and enhanced impact of attitudes on behavioral intentions and action. Thus, important attitudes are real and consequential psychological forces, and their study offers opportunities for addressing behavioral change.
This study suggests that placebo effects should be construed not as a nuisance variable with mysterious impact but instead as a psychological phenomenon that can be understood and harnessed to improve treatment outcomes. (PsycINFO Database Record
Background:
Research demonstrates that the placebo effect can influence the effectiveness of medical treatments and accounts for a significant proportion of healing in many conditions. However, providers may differ in the degree to which they consciously or unconsciously leverage the forces that produce placebo effects in clinical practice. Some studies suggest that the manner in which providers interact with patients shapes the magnitude of placebo effects, but this research has yet to distill the
specific
dimensions of patient–provider interactions that are most likely to influence placebo response and the mechanisms through which aspects of patient–provider interactions impact placebo response.
Methods:
We offer a simplifying and unifying framework in which interactions that boost placebo response can be dissected into two key dimensions: patients’ perceptions of
competence
, or whether a doctor “gets it” (i.e., displays of efficiency, knowledge, and skill), and patients’ perceptions of
warmth
, or whether a doctor “gets me” (i.e., displays of personal engagement, connection, and care for the patient).
Results:
First, we discuss how this framework builds on past research in psychology on social perception of competence and warmth and in medical literature on models of effective medical care, patient satisfaction, and patient–provider interactions. Then we consider possible mechanisms through which competence and warmth may affect the placebo response in healthcare. Finally, we share original data from patients and providers highlighting how this framework applies to healthcare. Both patient and provider data illustrate actionable ways providers can demonstrate competence and warmth to patients.
Discussion:
We conclude with recommendations for how researchers and practitioners alike can more systematically consider the role of provider competence and warmth in patient–provider interactions to deepen our understanding of placebo effects and, ultimately, enable providers to boost placebo effects alongside active medications (i.e., with known medical ingredients) and treatment in clinical care.
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