Placebos and their Psychological Effects

Trouton, D. S.

doi:10.1192/bjp.103.431.344

Cited by 44 publications

(7 citation statements)

References 24 publications

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“…Joyce (1959) and Knowles and Lucas (1960). Their publications, together with the review of the literature by Trouton (1957), provide a useful background to placebo studies.…”

Section: Discussionmentioning

confidence: 99%

Placebo Responses in an Arthritis Trial

Morison¹,

Woodmansey²,

Young³

1961

Annals of the Rheumatic Diseases

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Since the publication in this Journal of a description of the effects of placebos in rheumatoid conditions (Traut and Passerelli, 1957), there has been a growing literature on the subject of placebo responses, but little has appeared in print regarding such effects in arthritis.During a recent intra-articular injection trial in which two steroid preparations and a placebo were compared, it became apparent that responses to the latter were frequent and well marked. It was decided, therefore, to make a parallel study of the whole question of placebo responses as these occurred during the trial.The results of injection of the two steroids have already been reported; one paper dealt with the effects on rheumatoid arthritics (Chandler, Wright, and Hartfall, 1958) and the other with the effects on osteo-arthritics (Wright, Chandler, Morison, and Hartfall, 1960).The present paper is concerned chiefly with a detailed examination of the responses to the placebo injections in the same trial. It also reports the results of a subsequent dummy tablet trial on the same group of patients. Finally, some of the implications of these findings as they apply to clinical trials are discussed.Material 49 patients were included in the original trial, and of these, 10 dropped out for various reasons during the 18 months that the trial was in progress. The remaining 39 patients from whom results were complete, comprised 34 females and 5 males; 21 were osteo-arthritics, and the remaining eighteen rheumatoid arthritics, the knees being involved in every case. The age range was 29 to 76 years (mean 58 6). The two steroids used were hydrocortisone acetate, and hydrocortisone tertiary butyl acetate. The placebo consisted of the inert aqueous vehicle. Design of Injection TrialEvery patient received three courses of injections into the affected knee, each course comprising four injections with an interval of 2 weeks between injections. There was a resting period of 2 months between courses, and the order in which courses were given was arranged so that every patient eventually received a course of each steroid and a course of the placebo.Assessments for local pain and tenderness, range of joint movement, and walking time, were carried out at each visit. After careful consideration it was felt that walking-times would give the most useful single objective measurement by which clinical improvement or deterioration could be assessed. Patients were asked to walk a distance of 75 yards as quickly as possible while being timed by a stopwatch. The value taken was the mean of the four walking times which were measured fortnightly during the 2-month resting period following each complete injection course. These values were then expressed as percentages of the original walking time.Alterations of less than ±10 per cent. were classified as "unchanged", while decreases or increases of more than 10 per cent. were classified as "improvement" or "deterioration" respectively. Throughout this article the values of these walking times are referred to as "find...

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“…Joyce (1959) and Knowles and Lucas (1960). Their publications, together with the review of the literature by Trouton (1957), provide a useful background to placebo studies.…”

Section: Discussionmentioning

confidence: 99%

Placebo Responses in an Arthritis Trial

Morison¹,

Woodmansey²,

Young³

1961

Annals of the Rheumatic Diseases

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“…This work sets the stage for current research and anticipated discoveries related to the biology and neurology of hope. The magnitude of the placebo effects evident in some studiesfor example, a saline solution that reduces pain reported by patients so much that it is indistinguishable from morphine (Trouton, 1957) -has opened research into the biological mechanisms behind these effects. This work explores how "belief, expectation and desire activate brain circuits that cause the release of endorphins and enkephalins" (Groopman 2005).…”

Section: Hope Measurement and Empirical Researchmentioning

confidence: 99%

Poverty, Aspirations, and the Economics of Hope

Lybbert

Wydick

2018

Economic Development and Cultural Change

121

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This paper seeks to create a framework for understanding the role of hope and aspirations in economic development. We review the literature on hope from philosophy, theology, psychology, and its relationship to emerging work on aspirations in development economics. We then create an economic model of hope based on recent psychology literature that understands hope as a function of aspirations, avenues, and agency. This model of hope illustrates the vital role hope can play in the realization of causal effects from development interventions and how these effects emerge from the impact and interaction of three constituent elements of hope. By clarifying definitions and relationships among these concepts and by leveraging relevant work from other disciplines, we aim to create a framework within which economists can engage in rigorous empirical and experimental work that seeks to better understand the role of hope in economic development.

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“…206 Moreover, there is a trend that people with unelaborated anxiety are more likely to respond to placebos. 329 If, as Trouton 333 contends, placebo reaction is a learned or conditioned response, the in- make the assessment of antidepressive medications particularly liable to overestimate specific drug effects. From a study with chlorpromazine lysergic acid diethylamide, and secobarbital, ~ it clearly emerged that reactors to treatment are more likely to be found among those people who are more depressed, suffer from more unreasonable fear, and overact to environmental stimuli.…”

Section: Measurement Of Drug Effects In Man and The Meaning Of Controlsmentioning

confidence: 98%

Clinical pharmacology of central stimulant and antidepressant drugs

Werner

1962

Clin Pharma and Therapeutics

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Department of Pharmacology, Cornell University Medical CollegeThis survey illustrates the interdisciplinary nature of psychopharmacologic research. In order to conduct meaningful psychopharmacologic inquiry, a variety of different conceptual and methodic frames of reference must be drawn upon. Lehmann 208 effectively emphasized the eclectic nature of experimental design in psychopharmacology-a design that must critically employ appropriate controls and statistical validation, that must do justice to biochemical, neurophysiologic, and behavioral mechanisms of drug action, that must be sensitive to the dynamics of personality functions, and that must respect the fundamentals of dose and time parameters of drug action. These, then, are the ingredients out of which experience and imagination can shape effective tools to obtain conclusive answers to speCific and meaningful questions on drug effects or normal and pathologic behavior and personality functions. In the beginning was the hypothesisOn the basis of certain, mostly biochemical, key events, three different hypotheses of normal and abnormal behavior have been put forward in the past. While the validity of these hypotheses did not remain uncontested, everyone of them has led to practical developments for drug treatment of pathologically depressed personality functions. In fact, most of the clinical reports on antidepressive drug actions are, in concept of study and interpretation of results, committed to one or another of these hypotheses. In general terms, these hypotheses embody the concept of neurohumoral transmission and receptor specificity in the' central nervous system. The existence of three types of receptors within the brain, related to the physiologic turnover of three types of substrates, has been inferred.'4. 96 Serotonin hypothesis. Originally, the implication of serotonin ( 5-hydroxytrypta- 59

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Placebos and their Psychological Effects

Cited by 44 publications

References 24 publications

Placebo Responses in an Arthritis Trial

Placebo Responses in an Arthritis Trial

Poverty, Aspirations, and the Economics of Hope

Clinical pharmacology of central stimulant and antidepressant drugs

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