What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian consensus conference on pain in neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy

What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian Consensus Conference on Pain in Neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy

The Psychology of Social Networking Vol.1. Personal Experience in Online Communities

Using a novel approach to consider the available literature and research, this book focused on the psychology of social media based on the assumption that the experience of being in a social media has an impact on both our identity and social relationships. In order to ‘be online’, an individual has to create an online presence – they have to share information about themselves online. This online self is presented in different ways, with diverse goals and aims in order to engage in different social media activities and to achieve desired outcomes. Whilst this may not be a real physical presence, that physicality is becoming increasingly replicated through photos, video, and ever-evolving ways of defining and describing the self online. Moreover, individuals are using both PC-based and mobile-based social media as well as increasingly making use of photo and video editing tools to carefully craft and manipulate their online self. This book therefore explored current debates in Cyberpsychology, drawing on the most up-to-date theories and research to explore four main aspects of the social media experience (communication, identity, presence and relationships). In doing so, it considered the interplay of different areas of psychological research with current technological and security insight into how individuals create, manipulate and maintain their online identity and relationships. The social media were therefore at the core of every chapter, with the common thread throughout being the very unique approach to considering diverse and varied online behaviours that may not have been thus far considered from this perspective. It covered a broad range of both positive and negative behaviours that have now become integrated into the daily lives of many westernised country’s Internet users, giving it an appeal to both scholarly and industry readers alike

The Psychology of Social Networking Vol.2. Identity and Relationships in Online Communities

Using a novel approach to consider the available literature and research, this book focused on the psychology of social media based on the assumption that the experience of being in a social media has an impact on both our identity and social relationships. In order to ‘be online’, an individual has to create an online presence – they have to share information about themselves online. This online self is presented in different ways, with diverse goals and aims in order to engage in different social media activities and to achieve desired outcomes. Whilst this may not be a real physical presence, that physicality is becoming increasingly replicated through photos, video, and ever-evolving ways of defining and describing the self online. Moreover, individuals are using both PC-based and mobile-based social media as well as increasingly making use of photo and video editing tools to carefully craft and manipulate their online self. This book therefore explored current debates in Cyberpsychology, drawing on the most up-to-date theories and research to explore four main aspects of the social media experience (communication, identity, presence and relationships). In doing so, it considered the interplay of different areas of psychological research with current technological and security insight into how individuals create, manipulate and maintain their online identity and relationships. The social media were therefore at the core of every chapter, with the common thread throughout being the very unique approach to considering diverse and varied online behaviours that may not have been thus far considered from this perspective. It covered a broad range of both positive and negative behaviours that have now become integrated into the daily lives of many westernised country’s Internet users, giving it an appeal to both scholarly and industry readers alike

How can virtual reality interventions help reduce prescription opioid drug misuse?

The recent death from a heroin overdose of actor Philip Seymour Hoffman at the age of 46 highlights the danger of opioid addiction. However, according to the U.S. Centers for Disease Control, prescription opioids such as OxyContin, Percocet, and Vicodin may be gateway drugs for heroin addiction and are responsible for five times as many deaths. ‘‘The main driver of overdoses right now in our country is from opioid medications, more than from heroin,’’ said Nora Volkow, director of the National Institute on Drug Abuse (NIDA).1 Prescription drug overdose rates have more than tripled since 1990, paralleling a 300% increase in sales of strong prescription opioid

Future directions: Advances and implications of virtual environments designed for pain management

Pain symptoms have been addressed with a variety of therapeutic measures in the past, but as we look to the future, we begin encountering new options for patient care and individual health and well-being. Recent studies indicate that computer-generated graphic environments - virtual reality (VR) - can offer effective cognitive distractions for individuals suffering from pain arising from a variety of physical and psychological illnesses. Studies also indicate the effectiveness of VR for both chronic and acute pain conditions. Future possibilities for VR to address pain-related concerns include such diverse groups as military personnel, space exploration teams, the general labor force, and our ever increasing elderly population. VR also shows promise to help in such areas as drug abuse, at-home treatments, and athletic injuries

The New Dawn of Virtual Reality in Health Care: Medical Simulation and Experiential Interface

The 90s and 00s saw great hopes that virtual reality was poised to sweep health care and change everything. But it didn't. Though researchers could immerse themselves in more complex virtual environments, the chasm between that digital experience and the complexity of real life - using a VR system in an hospital without a dedicated technician was a real challenge - just was too great. Now the situation is changing quickly. The rise of Oculus Rift and the shift of virtual reality from PC to mobile phones thanks to both the Oculus designed Gear VR headsets for Samsung phones and the Google Cardboard project are going to transform health care tools and experiences

Positive change: Connecting the virtual and the real

How do we lastingly change our lives for the better? There is not an easy answer to this question. However, due to the advances in psychology and neuroscience, now we have a better view of personal change, that is not limited to a specific viewpoint. In particular, the emergence of integrative and transdiagnostic accounts suggests that change is contextual, depending on the person, the issues, and the situation. More, personal change is a process, happening in discontinuous and nonlinear ways, following life transitions and traumatic events. In this process a key role can be played by technology: using the 'Positive Technology' approach it is possible to use technology to manipulate the quality of experience, with the goal of increasing wellness, and generating strengths and resilience in individuals, organizations and society

Future Directions: How Virtual Reality Can Further Improve the Assessment and Treatment of Eating Disorders and Obesity

Transdisciplinary efforts for further elucidating the etiology of eating and weight disorders and improving the effectiveness of the available evidence-based interventions are imperative at this time. Recent studies indicate that computer-generated graphic environments\u2014virtual reality (VR)\u2014can integrate and extend existing treatments for eating and weight disorders (EWDs). Future possibilities for VR to improve actual approaches include its use for altering in real time the experience of the body (embodiment) and as a cue exposure tool for reducing food craving

Virtual Reality in the Assessment and Treatment of Weight-Related Disorders

Virtual Reality (VR) has, for the past two decades, proven to be a useful adjunctive tool for both assessment and treatment of patients with eating disorders and obesity. VR allows an individual to enter scenarios that simulate real-life situations and to encounter food cues known to trigger his/her disordered eating behavior. As well, VR enables three-dimensional figures of the patient's body to be presented, helping him/her to reach an awareness of body image distortion and then providing the opportunity to confront and correct distortions, resulting in a more realistic body image and a decrease in body image dissatisfaction. In this paper, we describe seminal studies in this research area