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Published on: December 14, 2014
Motivation and placebos: do different mechanisms occur in different contexts?
1School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK. mhyland@plymouth.ac.uk
Summary
Short-term placebo effects stem from response expectancy and conditioning. Long-term therapeutic changes involve goal satisfaction impacting the inflammatory response and hypothalamic-pituitary-adrenal axis.
Area of Science:
- Psychology
- Neuroscience
- Medicine
Background:
- Common assumption: short-term and long-term placebo mechanisms are identical.
- Short-term paradigms lack motivation for health improvement.
- Long-term paradigms involve patient valuation of health improvement.
Purpose of the Study:
- Challenge the assumption of identical placebo mechanisms.
- Review motivational theories of placebo effects.
- Propose a new theory differentiating short-term and long-term placebo mechanisms.
Main Methods:
- Review of three motivational theories: classical placebo motivation, goal activation model, and motivational concordance model.
- Analysis of current data to support a new theoretical framework.
- Outline empirical predictions for the proposed theory.
Main Results:
- Short-term placebo effects are attributed to response expectancy, conditioning, and goal activation.
- Long-term therapeutic change is linked to goal satisfaction and affect.
- These effects modulate the inflammatory response system and hypothalamic-pituitary-adrenal axis.
Conclusions:
- Short-term and long-term placebo mechanisms differ significantly.
- A new theory integrates motivational and physiological pathways.
- Potential for combining placebo effects with other psychological interventions is highlighted.
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