Non-Deceptive Placebos Can Promote Acts of Kindness: A Randomized Controlled Trial

Placebos have often been used to reduce emotional distress but rarely to increase positive feelings. The present study investigated whether a placebo can promote acts of kindness (AoKs) that are associated with emotional well-being. A total of 160 university students were asked to perform an AoK daily for one week. They evaluated their emotional state (feelings of pleasantness, arousal, satisfaction) directly before and after the AoKs. This was monitored via a smartphone app. One group performed each AoK after taking a non-deceptive placebo; the other group received no placebo. Before and after the one-week program, the participants completed three questionnaires that assessed satisfaction with life, positive/negative affect, and flourishing. The participants reported higher pleasantness directly after engaging in an AoK and more satisfaction with life after the program. The motivation to carry out AoKs decreased strongly over the week. However, placebo receivers completed more AoKs than the no-placebo group. The results indicate that placebo treatment can promote the performance of acts of kindness

INTERACTION BETWEEN DISGUST PRONENESS AND PERCEPTION OF TREATMENT EFFICACY PREDICTS RESPONSE TO A DISGUST PLACEBO

Placebo responsiveness is highly variable across individuals and has been shown to be difficult to predict solely based on personality traits. The present study examined the interaction between a specific trait and state variable (disgust proneness and perceived effectiveness of a disgust placebo) on placebo responsiveness. We presented 145 participants with an inert pill, which was introduced as an effective anti nausea drug. Disgust responses were elicited by a validated picture set, which was viewed once with and once without the disgust placebo. The results showed that the placebo was effective in reducing experienced disgust. When predicting placebo responsiveness, the results showed a significant interaction between perceived treatment effectiveness and disgust proneness. Specifically, effectiveness ratings were a significant predictor of placebo response only for individuals high in disgust proneness. The results suggest that the joint consideration of specific state and trait factors can be used to optimize placebo responsiveness

Effects of placebos vs. SMS reminders on homework compliance in cognitive behavioral therapy for depression: a randomized trial

Background: Nonadherence to homework assignments is a frequent problem among patients with depression during cognitive-behavioral therapy (CBT). The present study investigated the effects of two additional treatment components of CBT: a placebo and SMS (short message service) reminders. These components aimed at improving homework compliance (the practicing of a daily relaxation exercise at home) during a four-week outpatient program. Subjects and Methods: Eighty-six patients diagnosed with major depressive disorder were randomly assigned to one of three groups: ‘Coping with Depression’ course (treatment as usual; TAU group), ‘Coping with Depression’ course with additional daily placebo treatment (PLA group), or ‘Coping with Depression’ course with additional daily SMS reminders (SMS group). The placebo (sunflower oil) was introduced as a natural medicine to mobilize the body’s natural healing powers. SMS messages were sent out once a day to remind the patients of their homework. Results: The placebo group showed better homework compliance than the two other groups with improved quantity and quality of relaxation exercises. The SMS group practiced more often than TAU but did not differ in homework quality (relaxation level) from TAU. All groups showed a significant reduction of depression symptoms at the end of the course with the most pronounced reduction in the PLA group. Conclusions: The results suggest that placebo treatment is more effective than SMS reminders to support relaxation training in patients with depression. Additionally, the placebo was associated with a larger reduction of depression symptoms

Divergent attentional effects of nondeceptive placebo treatment and cognitive reappraisal during visually induced emotional distress: an eye-tracking study

Background: Emotion regulation often involves shifting attentional focus. This eye-tracking study with a divided attention task compared nondeceptive placebo treatment and cognitive reappraisal for reducing emotional distress. It was investigated whether the two types of interventions would differ in attentional processes (directing attention toward the external environment vs. one’s body). Method: A total of 116 participants (mean age = 26.5 years; 50% female) were randomly allocated to one of three groups that were each exposed to images depicting body parts with or without injuries. One group received a placebo pill to reduce emotional distress, while another group engaged in cognitive reappraisal. The third group passively viewed the images. Half of the images were coupled with an electrocutaneous stimulus (at the perceptual threshold level) that was administered to participants’ forearms. The task was to view these images with eye-tracking glasses while also responding as quickly as possible to the tactile sensation evoked by the electrocutaneous stimulus (pressing a response button). Results: Cognitive reappraisal provoked a relative increase in total gaze time for injuries as predicted. The majority of participants in this group responded accurately to the electrocutaneous stimuli administered during injury images (no omissions). In contrast, the maximal number of omission errors was most prevalent in the placebo group. Limitations: Participants reported a low level of fear concerning injuries, which could indicate a self-selection bias. Conclusion: Both regulation strategies exerted a protective effect against emotional distress. However, cognitive reappraisal heightened attention, while a reverse pattern was found for placebo treatment. To assess the clinical implications of these findings, future studies should target patients with blood-injury phobia

Olfactory imagery as a retrieval method for autobiographical memories

Introduction The retrieval of autobiographical memories is infuenced by several factors, such as sensory modality and the emotional salience of memory cues. This study aimed at investigating the interaction between sensory modalities (olfaction, vision) and emotional dimensions (valence, arousal) of imagery cues, on the frequency, quality, and age distribution of the autobiographical memories (AMs) elicited. Method A total of 296 females (aged between 18 and 35 years) received one out of eight brief instructions for olfactory or visual imagery. The participants were asked to create a mental image with either high arousal/positive valence, high arousal/ negative valence, low arousal/positive valence, or low arousal/negative valence (e. g., ‘imagine an unpleasant and arousing odor/scene’)no specifc stimulus was mentioned in the instruction. Results The approach used elicited imagery with autobiographical content in the majority of participants (78%). In terms of frequency, odor imagery, compared to visual imagery, turned out to be more efective at retrieving either unpleasant memories associated with experiences in adulthood, or pleasant childhood memories. In terms of quality, the imagery was rated as less vivid in the olfactory compared to the visual condition (irrespective of valence and arousal of the imagery instruction). Visual imagery was associated with the experience of more diverse emotions (happiness, sadness, anxiety, anger) than odor imagery, which was related primarily with disgust and happiness. Conclusion Our fndings indicate that nonspecifc imagery induction is a useful approach in accessing AM. Implication This approach presents promising clinical applications, such as in working with autobiographical memory narratives in psychotherapy

THE ROLE OF MORAL DISGUST AND DISGUST REGULATION DEFICITS IN SKIN-PICKING DISORDER

Background: Relative to other body-focused repetitive behaviors, skin-picking has received little investigation. In particular, its association with disgust has hardly been studied. This is surprising because one etiological model of skin-picking disorder (SPD) suggests that the excessive picking is a form of disgust-motivated grooming that aims at the removal of pathogens from the skin. Subjects and methods: This questionnaire study explored whether SPD patients (n=46) and healthy controls (n=36) differ in different facets of trait disgust (tendency to experience pathogen disgust, moral disgust, self-disgust, and disgust regulation ability). Moreover, a multiple regression analysis was calculated in order to investigate whether skin-picking symptoms can be predicted based on these components of trait disgust. Results: Patients received higher scores on all disgust measures than controls. The degree of patients’ skin picking (symptom severity, resulting impairment) could be predicted based on moral disgust (disgust experienced when confronted with moral transgressions) and difficulties in disgust regulation. Conclusion: This study provides evidence for the role of specific disgust components in SPD