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placebo revision

placebo effect
by

Heulwen Davies

on 21 April 2010

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Transcript of placebo revision


Double click anywhere & add an idea learning outcomes The question Critically discuss the evidence for the possible theories of the placebo effect critically discuss evidence possible theories There is not one single placebo effect but many A placebo is a medical term for a drug that has no active ingredient. Biologically, it doesn't do anything, but the patient might mistakenly believe it is a powerful medicine. The phrase placebo effect refers to a person's response to a substance only as the result of the expectation of such a response Some theorists suggest that placebo effects are physiological responses induced by the placebo. Others hypothesize that motivations (e.g., to please a doctor), or simply expectations alone may cause placebo effects Conditioning theory appears capable of explaining many placebo effects, but there are also some problems with this explanation Response expectancy theory rests on the discovery that the belief that an automatic subjective response will occur tends to elicit that response
A shortcoming of expectancy theory is that it does not easily account for the physical effects of placebos
It is important to note that conditioning theory and expectancy theory are not mutually exclusive. Specifically, classical conditioning may be one of the means by which expectancies are altered. Thus, if an active drug (the unconditional stimulus) repeatedly elicits a particular therapeutic benefit (the unconditional response), it will also lead people to expect that benefit when they think they are taking the drug, and that expectation might produce the placebo effect (the conditional response). Simpson and colleagues (2006) report their systematic review's finding that good adherence to placebos as well as to drug treatments is associated with reduced mortality. This finding supports the concept of the "healthy adherer" effect, whereby adherence to drug treatment may be a surrogate marker for overall healthy behaviour possible theories:
Non-interactive theories
Nature taking its course
Characteristics of the individual
Characteristics of the treatment
Characteristics of the health professional
Interactive theories
Experimenter bias
Patient expectations
Reporting error
Conditioning effects
Anxiety reduction
Physiological theorie Nature taking its course - Most illnesses are self limiting
A modern view of placebo and placebo-related effects Benedetti (2008) is that the placebo effect, or placebo response, is a psychobiological phenomenon that must not be confounded with other phenomena, such as spontaneous remission and statistical regression to the mean.
Your discussion
This involves structuring and building a logical and coherent argument. A discussion should flow smoothly from one point to the next, draw upon evidence, and possibly present alternative view points. Discussion might also involve evaluating the quality of the evidence presented to support an argument, not simply describing it.
An unconnected list of ‘who said what’ is not a discussion, even if it is littered with authors’ names and dates!
Be critical
Here you need to show you have looked at the material in a critical manner and not just taken it at face value. There are several strategies you could use.
• Try to look at the value of the evidence presented.
• Address inconsistent or incompatible evidence stemming from research and seek to explain it.
• Weigh up the pros and cons of different positions, but don’t be afraid to come down on the side of one argument if the quality of the evidence favours it.
• Try to find original links between different sources, or different strands of an argument.
• Show originality by presenting new ideas or interpretations based upon your own understanding of the material
• Demonstrate an understanding of the theories and research in health psychology used to explain behaviours and cognitions related to health and illness
• Demonstrate a basic knowledge and understanding of current research studies and attempt to evaluate and critically discuss the research material presented
The pacebo effect Non-interactive theories
Nature taking its course
Characteristics of the individual
Characteristics of the treatment
Characteristics of the health professional
Interactive theories
Experimenter bias
Patient expectations
Reporting error
Conditioning effects
Anxiety reduction
Physiological theories
What will you discuss?
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