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Placebo effects are not the “power of positive thinking”

Discussion in 'Other Health News and Research' started by Snow Leopard, Jan 25, 2014.

  1. Snow Leopard

    Snow Leopard Senior Member

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    Placebo effects are not the “power of positive thinking”
    Posted by David Gorski on January 13, 2014
    http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-placebo-effects-again

    This is a surprisingly intersting article presented on SBM, along with the comments that suggest that much of the "placebo effect" is due to biases in reporting outcomes and pain, rather than underlying biological effects. Along with wishful thinking and speculative interpretations of the data by researchers and physicians after the fact.

    It is very easy to prime patients into reporting different things on self report questionnaires and even general conversation. This is why double-blinded randomised controlled trials are so important and it is why RCTs which rely on self report outcomes and do not have a blinded control group should be considered invalid.
    L'engle, Esther12, beaker and 12 others like this.
  2. golden

    golden Senior Member

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    There are lots of different phenomena hiding under the umbrella term 'placebo'.

    I think simple bias covers one aspect.

    In the book Mind Over Medicine which I havent read yet, it sites other types of placebo including the Cancer cured by a broken radiation machine (the Doctor and Patient were unaware).

    Its an exciting subject which is only recently started to be taken seriously.

    http://www.dailymail.co.uk/health/a...ook-shows-incredible-influence-mind-body.html

    :)
    taniaaust1 and barbc56 like this.
  3. Snow Leopard

    Snow Leopard Senior Member

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    Coincidence (literally two things happening over the same time) is not the same as cause and effect.

    Studies on the effects of all sorts of "mind" related effects, from positive thinking to mental states show that they have no effect on survivability of cancer, given the same (pharmacological) treatment protocol.

    Claims were made in the above article about a study that claims hair loss from placebo-chemotherapy. Seems like an important case of the downsides of (not) providing references.

    Further digging finds that this claim was first made in a 1983 book "The heart of Healing" which apparently referenced a study in the World Journal of Surgery.
    The study is this one:
    http://link.springer.com/article/10.1007/BF01658089

    Note that over two thirds of the participants were males over 60 who had just had gastric surgery and the rate of hair loss in the chemotherapy arms was much higher (79% compared to 30%). Given that no study has ever reported unexpected/unusual hair loss as a result of placebo chemotherapy, I daresay the explanation that this hair loss had nothing to do with the saline injections is the most plausible.
    Last edited: Jan 25, 2014
    Esther12, L'engle, biophile and 3 others like this.
  4. A.B.

    A.B. Senior Member

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    Thanks, I'm glad to see some healthy scepticism in this area.
    barbc56 likes this.
  5. golden

    golden Senior Member

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    Yeah but the 'correlation does not equate to causation' mantra gets a bit silly and extreme too.

    Clear thinking is important. I had wondered too if the 'saline solution' did contain some poisons which is rife in the placebos.

    But whilst the article discusses the book Mind Over Medicine, I think the Doctor who wrote that maybe suppying the references.

    I don't know if the study you quote snowleapord is the one referenced by the Doc.

    It would be good to have honest raw data.

    Better, to view it direct.
  6. she

    she Practically perfect

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    might be that positive thinking reduces stress and stress has negative influences on the immune system, so . .
    but generally speaking: I could strangle all those friends who advice me to be a bit more positivie
    L'engle likes this.
  7. golden

    golden Senior Member

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  8. barbc56

    barbc56 Senior Member

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    The trouble with some of the studies with cancer is that some patients had chemo before turning to alternative medicine, confounding factors to the point that you can't reliably so who knows what is causing what?

    Also with conditions such as ours where symptoms wax and wane, as well as conditions like MS, Lupus to name a few, that may also confabulate (?) factors.

    If something relaxes you it can help in the short run.

    If it's as simple as mind over matter, I would've been cured a long time ago.
  9. Snow Leopard

    Snow Leopard Senior Member

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    How do we know "it works"?

    It is possible that all we are measuring is the same biases - eg patients who are more upbeat, or have had more (positive) attention tend to answer more positively on self report questionnaires even if their disease state is more or less the same. The most revealing part about studies "placebo effect" is that it consistently fails to show objective benefits.

    That goes for animals too, the bias is in the way the symptoms are assessed.
    L'engle, SOC and Svenja like this.
  10. lansbergen

    lansbergen Senior Member

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    yep
  11. Ecoclimber

    Ecoclimber Senior Member

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    Debunking the theory of positive thinking

    How a student debunked the established theory of applied positive psychology

    ....A couple of years ago that suspicion began to grow while he sat in a lecture at the University of East London, where he was taking a postgraduate course in applied positive psychology. There was a slide showing a butterfly graph – the branch of mathematical modelling most often associated with chaos theory. On the graph was a tipping point that claimed to identify the precise emotional co-ordinates that divide those people who "flourish" from those who "languish".

    According to the graph, it all came down to a specific ratio of positive emotions to negative emotions. If your ratio was greater than 2.9013 positive emotions to 1 negative emotion you were flourishing in life. If your ratio was less than that number you were languishing. It was as simple as that. The mysteries of love, happiness, fulfilment, success, disappointment, heartache, failure, experience, random luck, environment, culture, gender, genes, and all the other myriad ingredients that make up a human life could be reduced to the figure of 2.9013.
  12. golden

    golden Senior Member

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    Yes. All that is most definately accurate.

    Its other types of placebo that interest me.

    The article i linked to suggested this study on epileptic dogs was double blinded. can't access original to check. Dont know if its been replicated.

    http://www.ncbi.nlm.nih.gov/m/pubmed/19912522/
  13. lansbergen

    lansbergen Senior Member

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    First question, what was the placebo?

    Besides environmental conditions are important variants in dog epilepsy
  14. golden

    golden Senior Member

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    What was the placebo, and what was the placebo was my first question too!

    I was hoping people here may have access.

    I expect the environment was kept consistent.
  15. Snow Leopard

    Snow Leopard Senior Member

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    The decrease was from baseline, there was a decrease in seizure percentage in basically all groups. There were 2 trials, with 3 different treatments - surgical implant, novel drug, dietary modification.

    The implant/drug study was a crossover study, with a 4 week washout in between.

    The "placebo" was not stated, it was described simply as
    I would conclude that the treatments are not effective and the reduction in seizure percentage was probably just due to different conditions between baseline and trial/regression to the mean.

    Oh and the dogs were recieving Phenobarbital and potassium bromide at the same time (was part of the inclusion criteria) but it was not discussed how long the dogs had been receiving this before the trial.

    The study was not designed to test the placebo effect, I dare say this is just a novel/speculative interpretation of their results (the alternative was for them to simply claim null results between the additional treatments tried and placebo).
  16. golden

    golden Senior Member

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    Disgraceful, the lack of facts I think. So many variables too.

    Thanks for the additional info. I had thought it was designed to test the placebo. Bleary eyed Sunday Morning is my reason.

    " For the 3 trials evaluated, the average reduction in seizures during placebo administration relative to baseline was 26% (P = .0018), 29% (P = .17), and 46% (P = .01). "

    What different conditions might you mean?
  17. natasa778

    natasa778 Senior Member

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    OK anyone remember details and name of that doc in NY somewhere, who was giving some of his patients morphine for chronic pain, and some were given placebo, without being told?

    He then one day administered, without informing the patients, a substance that blocks the effects of morphine. The patients started started telling him they were in lots more pain that day, including those who had been getting saline placebo!! If this story is true and can be replicated it would have massive implications ...
  18. Snowdrop

    Snowdrop Senior Member

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    Of course, no graph was provided showing how the delusionally happy have really f$@#%d up the world because they refuse to consider a downside.
  19. golden

    golden Senior Member

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    I recall but not in detail. Will try and find a link.

    Placebo treatments have been scientifically varified using brain scans....

    The morphine example is an interesting one.

    I wonder about some collective hypnosis effect as one mechanism.
  20. SOC

    SOC Moderator and Senior Member

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    [my bolding]
    Surely that is neither legal nor ethical. I suspect a myth or misunderstanding.
    L'engle likes this.

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