Putting the 'Art' Into the 'Art of Medicine': The Under-Explored Role of Artifacts in Placebo Studies

doi:10.3389/fpsyg.2020.01354

Review

. 2020 Jul 22:11:1354.

doi: 10.3389/fpsyg.2020.01354. eCollection 2020.

Putting the 'Art' Into the 'Art of Medicine': The Under-Explored Role of Artifacts in Placebo Studies

Michael H Bernstein¹, Cosima Locher^{2

3}, Tobias Kube^{4

5}, Sarah Buergler³, Sif Stewart-Ferrer⁶, Charlotte Blease^{4

7}

Affiliations

¹ Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, United States.
² School of Psychology, University of Plymouth, Plymouth, United Kingdom.
³ Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
⁴ Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
⁵ Pain and Psychotherapy Research Lab, University of Koblenz-Landau, Landau, Germany.
⁶ Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
⁷ School of Psychology, University College Dublin, Dublin, Ireland.

PMID: 32774310
PMCID: PMC7387723
DOI: 10.3389/fpsyg.2020.01354

Review

Putting the 'Art' Into the 'Art of Medicine': The Under-Explored Role of Artifacts in Placebo Studies

Michael H Bernstein et al. Front Psychol. 2020.

. 2020 Jul 22:11:1354.

doi: 10.3389/fpsyg.2020.01354. eCollection 2020.

Authors

Michael H Bernstein¹, Cosima Locher^{2

3}, Tobias Kube^{4

5}, Sarah Buergler³, Sif Stewart-Ferrer⁶, Charlotte Blease^{4

7}

Affiliations

¹ Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, United States.
² School of Psychology, University of Plymouth, Plymouth, United Kingdom.
³ Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
⁴ Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
⁵ Pain and Psychotherapy Research Lab, University of Koblenz-Landau, Landau, Germany.
⁶ Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
⁷ School of Psychology, University College Dublin, Dublin, Ireland.

PMID: 32774310
PMCID: PMC7387723
DOI: 10.3389/fpsyg.2020.01354

Abstract

Research in social psychology demonstrates that physical environmental factors - or "artifacts" such as provider clothing and office décor - can influence health outcomes. However, the role of artifacts in augmenting or diminishing health outcomes is under-explored in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts may carry significant potential in informing how placebo effects can be maximized, and nocebo effects minimized in clinical settings. We discuss the potential mechanisms, including classical conditioning, response expectancy, and mindsets, by which artifacts might enhance or diminish these effects. Next, we propose testable hypotheses to investigate how placebo and nocebo effects might be elicited by artifacts in care settings, and conclude by providing innovative research designs to advance this novel research agendum.

Keywords: classical conditioning; expectancy; mindset; placebo; placebo effects; psychology.

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References

1. Adam H., Galinsky A. D. (2012). Enclothed cognition. J. Exp. Soc. Psychol. 48 918–925. 10.1016/j.jesp.2012.02.008 - DOI
1. Alfano M. (2015). Placebo effects and informed consent. Am. J. Bioethics 15 3–12. 10.1080/15265161.2015.1074302 - DOI - PubMed
1. Al-Ghobain M. O., Al-Drees T. M., Alarifi M. S., Al-Marzoug H. M., Al-Humaid W. A., Asiry A. M. (2012). Patients’ preferences for physicians’ attire in Saudi Arabia. Saudi Med. J. 33 763–767. - PubMed
1. Amanzio M., Benedetti F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. J. Neurosci. 19 484–494. 10.1523/jneurosci.19-01-00484.1999 - DOI - PMC - PubMed
1. Andrade C. C., Lima M. L., Pereira C. R., Fornara F., Bonaiuto M. (2013). Inpatients’ and outpatients’ satisfaction: The mediating role of perceived quality of physical and social environment. Health Place 21 122–132. 10.1016/j.healthplace.2013.01.013 - DOI - PubMed

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[1] Adam H., Galinsky A. D. (2012). Enclothed cognition. J. Exp. Soc. Psychol. 48 918–925. 10.1016/j.jesp.2012.02.008 - DOI

[2] Adam H., Galinsky A. D. (2012). Enclothed cognition. J. Exp. Soc. Psychol. 48 918–925. 10.1016/j.jesp.2012.02.008 - DOI

[3] Alfano M. (2015). Placebo effects and informed consent. Am. J. Bioethics 15 3–12. 10.1080/15265161.2015.1074302 - DOI - PubMed

[4] Alfano M. (2015). Placebo effects and informed consent. Am. J. Bioethics 15 3–12. 10.1080/15265161.2015.1074302 - DOI - PubMed

[5] Al-Ghobain M. O., Al-Drees T. M., Alarifi M. S., Al-Marzoug H. M., Al-Humaid W. A., Asiry A. M. (2012). Patients’ preferences for physicians’ attire in Saudi Arabia. Saudi Med. J. 33 763–767. - PubMed

[6] Al-Ghobain M. O., Al-Drees T. M., Alarifi M. S., Al-Marzoug H. M., Al-Humaid W. A., Asiry A. M. (2012). Patients’ preferences for physicians’ attire in Saudi Arabia. Saudi Med. J. 33 763–767. - PubMed

[7] Amanzio M., Benedetti F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. J. Neurosci. 19 484–494. 10.1523/jneurosci.19-01-00484.1999 - DOI - PMC - PubMed

[8] Amanzio M., Benedetti F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. J. Neurosci. 19 484–494. 10.1523/jneurosci.19-01-00484.1999 - DOI - PMC - PubMed

[9] Andrade C. C., Lima M. L., Pereira C. R., Fornara F., Bonaiuto M. (2013). Inpatients’ and outpatients’ satisfaction: The mediating role of perceived quality of physical and social environment. Health Place 21 122–132. 10.1016/j.healthplace.2013.01.013 - DOI - PubMed

[10] Andrade C. C., Lima M. L., Pereira C. R., Fornara F., Bonaiuto M. (2013). Inpatients’ and outpatients’ satisfaction: The mediating role of perceived quality of physical and social environment. Health Place 21 122–132. 10.1016/j.healthplace.2013.01.013 - DOI - PubMed

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Putting the 'Art' Into the 'Art of Medicine': The Under-Explored Role of Artifacts in Placebo Studies

Affiliations

Putting the 'Art' Into the 'Art of Medicine': The Under-Explored Role of Artifacts in Placebo Studies

Authors

Affiliations

Abstract

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