Placebo Effect may be Genetic

[peggy-sue]

Another theory popped into my in-box this morning from the BPS (British Psychological Scociety).
I've copied and pasted it here.

2. Resilient, friendly people are more responsive to placebo treatment
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The placebo effect is a wonderful thing. Inert treatments provoke real medical benefits simply by virtue of the patient expecting the intervention to help. But of course, a lot of times placebos don't work, and some people seem to be more responsive to their benefits than others. A new study by researchers at the University of Michigan has set about discovering if personality plays a role here, specifically in relation to placebo treatment for pain.

Marta Peciña and her colleagues provoked pain in 47 men and women by injecting hypertonic saline solution into their jaw muscle. Pain levels without treatment were then compared against the participants' experience each time they received a placebo, in the form of a 15 second intravenous delivery of harmless isotonic saline solution. All the while, the participants were scanned via PET, to see how much activity occurred at the brain's opioid receptors. This was to provide an objective measure of the activity of the brain's own pain relief system.

There was a clear relationship between participants' scores on various personality measures and their responsiveness to placebo. A mix of ego resilience (measured by statements like "I quickly get over and recover from being startled"); high agreeableness (especially altruism and honesty); and low neuroticism (especially low levels of angry hostility) accounted for 25 per cent of the variance in participants' degree of response to the placebo treatment. Moreover, the participants who matched this pattern of traits tended to show more opioid receptor activation in their brains. Surprisingly perhaps, placebo responsiveness was not related to a person's general optimism.

Why should a person's agreeableness be related to their response to placebo treatments? "In the patient-doctor relationship, agreeableness appears likely to contribute to a strong therapeutic alliance," the researchers said, "as well as to frank, collaborative feedback through the therapeutic process. Thus, it appears that individuals high upon this trait are particularly well equipped to fully engage in therapeutic efforts, and in this sense, be a good responder to treatment, even if it is placebo." Meanwhile, the finding for angry hostility fits with past research showing that angry people tend to exhibit less indigenous opioid activity in their brains.

Peciña and her team said their findings, if replicated, could help with future pain research. "Simple to administer measures may aid in the interpretation of clinical trials and the stratification of clinical research volunteers to reduce variability in therapeutic responses," they said.
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Peciña, M., Azhar, H., Love, T., Lu, T., Fredrickson, B., Stohler, C., and Zubieta, J. (2012). Personality Trait Predictors of Placebo Analgesia and Neurobiological Correlates Neuropsychopharmacology DOI: http://dx.doi.org/10.1038/npp.2012.227

Author weblink: http://www2.med.umich.edu/psychiatry/psy/fac_query4.cfm?link_name=pecina

*Visit the DIGEST BLOG: http://www.researchdigest.org.uk/blog to comment on this research, search past items and discover more links.

 

[PhoenixDown]

If you could entirely eliminate the placebo effect in your trial, by only including in your trial individuals who were not genetically susceptible to the placebo effect, you could roughly halve the number of people involved in your testing, and thus reduce the cost and complexity of running the trial.

I'm afraid not, control groups measure far more variables than just placebo.

 

[Hip]

I'm afraid not, control groups measure far more variables than just placebo.

Can you give some examples of these variables? I assumed in medical testing, placebo effects were the main concern.

 

[Enid]

What will they think of next. Personalities more like it when someone shows some interest in one's illness and appears to be trying to aid I certainly recall some sympathy for them, like yep feels better though it never was.

 

[peggy-sue]

I would not give any credence to the personality/trait correlations.
Personality traits are not properly validated constructs. They change every time somebody with a bit of clout thinks up another name for one!
They cannot be taken seriously until they have biological underpinnings validating them.

 

[Enid]

Not too interested in "personality" either peggy-sue but a very simple response of most totally together human beings. Actually more together than those who pretend to study here grasping at straws. And of which I think we all know utterly tired. Mumbo-jumbo so called science here - trying perhaps to reduce the whole experience of life to graphs - I never was and will not be. My decentness has allowed these SOBS to proliferate.

Don't even ask me about the UK failure in real medicine, real research, real suffering whilst this lot has despite REAL science chunters on.

 

[PhoenixDown]

Can you give some examples of these variables? I assumed in medical testing, placebo effects were the main concern.

For example, control groups would measure improvement or worsening in symptoms in those without treatment, to give a fair measure of how well a drug did. Say a drug improved you by 22% but people without the drug improved by 7%, this doesn't mean the 15% difference is all due to placebo. Some of it is just random chance, things we can't explain or haven't accounted for.

 

[Enid]

GG - placebos (a vague title for sure) - trained in the Arts and henceforth will stick to since so called "science" has gone very astray.

 

[Hip]

For example, control groups would measure improvement or worsening in symptoms in those without treatment, to give a fair measure of how well a drug did. Say a drug improved you by 22% but people without the drug improved by 7%, this doesn't mean the 15% difference is all due to placebo. Some of it is just random chance, things we can't explain or haven't accounted for.

I see what you mean. It reminds me of a study I read some years ago that suggested the "placebo effect" seen in clinical trials was sometimes just down to the fact that, in certain diseases, people naturally improve over time anyway, through normal healing.