Abstract
A model of the placebo response as a conditioned response(CR) is presented and predictions from this model are listed. Through association with active ingredients(UCS), neutral(CS) places, persons, procedures, and things can come to acquire the ability to reduce pain, anxiety, and depressive responses. One major counterintuitive prediction from the model is that therapists who routinely use active ingredients(UCS) or powerful drugs will get stronger placebo effects than those who routinely use “inert” ingredients(CS) or weak drugs. Developmentally, placebo responding appears to involve two successive conditioning stages, which may involve first the left and later the right hemisphere in right-handed subjects. The relationship between placebo responding and hypnotizability is discussed.
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Arons, L. Sleep assisted instructions.Psychological Bulletin 1976,83 1–40.
Bakan, P. Hypnotizability, laterality of eye movements and functional brain assymmetry.Perceptual and Motor Skills 1969,28 927–932.
Bandura, A.Principles of behavior modification New York: Holt, Rinehart & Winston, 1969.
Barber, T. X. Toward a theory of pain: Relief of chronic pain by prefrontal leucotomy, opiates, placebos, and hypnosis.Psychological Bulletin 1959,56 430.
Barber, T. X.Hypnosis, a scientific approach. New York: Van Nostrand, 1969.
Basbaum, A. I., & Fields, H. L. Endogenous pain control mechanisms: Review and hypothesis.Annals of Neurology 1978,4(5), 451–462.
Beecher, H. K.Measurement of subjective responses: Quantitative effects of drugs. New York: Oxford University Press, 1959.
Cerekwicki, L. E., Grant, D., & Porter, E. C. The effect of number and relatedness of verbal discriminanda upon differential eyelid conditioning.Journal of Verbal Learning and Verbal Behavior 1968,7 847–853.
Cohen, H. D., Graham, C., Fotopoulos, S. S., & Cook, M. R. A double-blind methodology for biofeedback research.Psychophysiology 1977,14 603–608.
Dixon, N. F.Subliminal perception: The nature of a controversy. London: McGraw-Hill, 1971.
Drawbraugh, R., & Lal, H. Reversal by narcotic antagonist of a narcotic action elicited by a conditioning stimulus.Nature 1974,247 65–67.
Engstrom, D. R. Hypnotic susceptibility, EEG-alpha and self-regulation. In G. E. Schwartz & D. Shapiro (Eds.),Consciousness and self-regulation. New York: Plenum Press, 1976.
Erdelyi, M. H. A new look at the new look: Perceptual defense and vigilance.Psychological Review 1974,81 1–25.
Evans, F. J. Placebo response: Relationship to suggestibility and hypnotizability.Proceedings of the 77th Annual Convention of the American Psychological Association, 1969, 889–890.
Evans, F. J. The power of a sugar pill.Psychology Today 1974,7(April), 32. (a)
Evans, F. J. The placebo response in pain reduction. In J. J. Bonica (Ed.),Advances in neurology (Vol. 4):Pain. New York: Raven Press, 1974. (b)
Frank, J. D.Persuasion and healing, a comparative study of psychotherapy. Baltimore: Johns Hopkins University Press, 1973.
Gleidman, L. H., Gantt, W. H., & Teitelbaum, H. A. Some implications of conditional reflex studies for placebo research.American Journal of Psychiatry 1957,113 1103–1107.
Goldberg, S. R., & Schuster, C. R. Conditioned suppression by a stimulus associated with nalorphine in morphine dependent monkeys.Journal of the Experimental Analysis of Behavior 1967,10 235–242.
Goldberg, S. R., & Schuster, C. R. Conditioned nalorphine induced abstinence changes: Persistence in post-morphine dependent monkeys.Journal of the Experimental Analysis of Behavior 1970,14 33–46.
Graham, C., & Evans, F. Hypnotizability and the deployment of waking attention.Journal of Abnormal Psychology 1977,86 631–638.
Graham, K., & Pernicano, K.Laterality, hypnosis and the autokinetic effect. Paper presented to the American Psychological Association, Washington, D.C., 1976.
Grant, D. A. A preliminary model for processing information conveyed by verbal conditioned stimuli in classical conditioning. In A. Black & W. Prokasy (Eds.),Classical conditioning II: Current research and theory. New York: Meredit, 1972.
Gur, R. C. An attention-controlled operant procedure for enhancing hypnotic susceptibility.Journal of Abnormal Psychology 1974,83 644–650.
Gur, R. C., & Gur, R. E. Handedness, sex and eyedness and moderating variables in relation between hypnotic susceptibility and functional brain symmetry.Journal of Abnormal Psychology 1974,83 635–643.
Herrnstein, R. J. Placebo effect in the rat.Science 1962,138 677–678.
Hilgard, E. R.Hypnotic susceptibility. New York: Harcourt Brace, 1965.
Katz, R. L., et al. Pain, acupuncture, hypnosis. In J. J. Bonica (Ed.),Advances in neurology (Vol. 4);Pain. New York: Raven Press, 1974.
Kazdin, A. E., & Wilcoxon, L. A. Systematic desensitization and nonspecific treatment effects: A methodological evaluation.Psychological Bulletin 83,5 1976, 729–758.
Kimble, G.Conditioning and learning, New York: Appleton-Century-Crofts, 1961.
Kimble, G. Scientific psychology in transition. In F. McGuigan & D. Lumsden (Eds.),Contemporary approaches to conditioning and learning. New York: Wiley, 1973.
Krippner, S., & Bindler, P. R. Hypnosis and attention: A review.American Journal of Clinical Hypnosis 1974,16 166–177.
Lachman, S., & Goode, W. J.Hemispheric dominance and variables related to hypnotic susceptibility. Paper presented to the American Psychological Association, 1976.
Levin, J. D., Gordon, N. C., & Fields, H. L. The mechanism of placebo analgesia.Lancet 1978,2 654–657.
McGlashan, T. H., Evans, F. J., & Orne, M. T. The nature of hypnotic analgesia and placebo response to experimental pain.Psychosomatic Medicine 1969,31 227–246.
Melzack, R.Puzzle of pain. New York: Basic Books, 1973.
Mitchell, M. G.Hypnotic susceptibility and response to distraction. Unpublished doctoral dissertation, Claremont Graduate School, 1967.
Moore, M. E., & Berk, S. M. Acupuncture for chronic shoulder pain, an experimental study with attention to the role of placebo and hypnotic susceptibility.Annals of Internal Medicine 1976,84 381–384.
Mowrer, O. H.Learning theory and behavior. New York: Wiley, 1960.
Orne, M. T. Pain suppression by hypnosis and related phenomena. In J. J. Boinica (Ed.),Advances in Neurology (Vol. 4):Pain. New York: Raven Press, 1974.
Ornstein, R.The psychology of consciousness. New York: Viking, 1973.
Pavlov,I. P. Conditioned reflexes (G. V. Annep). London: Oxford University Press, 1927.
Pena, F.Perceptual isolation and hypnotic susceptibility. Unpublished doctoral dissertation, Washington State University, 1963.
Rogers, M. P., Dubey, D. & Reich, P. The influence of the psyche and the brain on immunity and disease susceptibility: A critical review.Psychosomatic Medicine 1979,41(2), 147–164.
Safer, M. A., & Leventhal, H. Ear differences in evaluating emotional tones of voice and verbal content.Journal of Experimental Psychology; Human Perception and Performance 1977,3 75–82.
Saltz, E. Higher mental processes as the bases for the laws of conditioning. In F. Mcguigan & D. Lumsden (Eds.),Contemporary approaches to conditioning and learning. New York: Wiley, 1973.
Sanders, & Reyher, Sensory deprivation and the enhancement of hypnotic susceptibility.Journal of Abnormal Psychology 1969,74 375–381.
Schacter, D. L. The hypnogogic state: A critical review of the literature.Psychological Bulletin 1976,83 452–481.
Schuster, C., & Thompson, T. Self administration of and behavioral dependence on drugs.Annual Review of Pharmacology 1969,9 483–502.
Schwartz, G. E. Self-regulation of response patterning: Implications for psychophysiological research and therapy.Biofeedback and Self-Regulation 1976,1 7–30.
Schwartz, G. E., Davidson, R. J., & Maer, F. Right hemisphere lateralization for emotion in the human brain: Interactions with cognition.Science 1975,190 286–290.
Schwitzgebel, R., & Traugott, M. Initial note on the placebo effect of machines.Behavioral Science 1968,13 267–273.
Shapiro, A. Placebo effects in medicine, psychotherapy and psychoanalysis. In A. Bergin & S. Garfield (Eds.),Handbook of psychotherapy and behavior change. New York: Wiley, 1971.
Siegel, S. In N. A. Krasnegor (Ed.),National Institute on Drug Abuse Research Monograph Series: Behavioral Tolerance. Washington, D.C.: Public Health Service, 1978. pp. 27–53.
Spence, K., & Taylor, J. A. Anxiety and the strength of the UCS as determiners of the amount of eyelid conditioning.Journal of Experimental Psychology 1951,42 183–188.
Sperry, R. The great cerebral commissure.Scientific American 1964,210 42–52.
Thorn, W. F. The placebo reactor.Australian Journal of Pharmacy 1962,43 1035–1037.
Van Nuys, D. Meditation, attention, and hypnotic susceptibility: A correlational study.International Journal of Clinical and Experimental Hypnosis 1973,21 59–69.
Verebey, K., Volavka, J., & Clouet, D. Endorphins in psychiatry.Archives of General Psychiatry 1978,35 877–888.
Wickramasekera, I. The effects of sensory restriction on susceptibility to hypnosis, a hypothesis and some preliminary data.International Journal of Clinical and Experimental Hypnosis 1969,17 217–224.
Wickramasekera, I. Effects of sensory restriction on susceptibility to hypnosis: More data.Journal of abnormal Psychology 1970,76 69–75.
Wickramasekera, I. Effects of EMG feedback training on susceptibility to hypnosis: Preliminary observations. In J. Stoyva et al. (Eds.),Biofeedback and self-control, Chicago: Aldine, 1971.
Wickramasekera, I. A technique for controlling a certain type of sexual exhibitionism.Psychotherapy Theory Research and Practice 1972,9 207–210.
Wickramasekera, I. The effects of EMG feedback on susceptibility to hypnosis.Journal of Abnormal Psychology 1973,82 174–177.
Wickramasekera, I. (Ed.).Biofeedback, behavior therapy and hypnosis. Chicago: Nelson-Hall, 1976. (a)
Wickramasekera, I. Aversive behavior rehearsal for sexual exhibitionism.Behavior Therapy 1976b,7 167–176.
Wickramasekera, I. The placebo effect and biofeedback for headache pain.Proceedings of the San Diego Biomedical Symposium. New York: Academic Press, 1977. (a)
Wickramasekera, I. The placebo effect and medical instruments in biofeedback.Journal of Clinical Engineering 1977,2 227–230. (b)
Wickramasekera, I. On attempts to modify hypnotic susceptibility: Some psychophysiological procedures and promising directions.Annals of the New York Academy of Sciences, 1977, 143–153. (c)
Wickramasekera, I. An inquiry into the modification of maladaptive belief systems. In I. Wickramasekera,Behavioral medicine, psychological stress and the placebo response. New York: Garland Press, 1978 (in press).
Wickramasekera, I.An inquiry into belief systems and maladaptive behavior, hypnosis, biofeedback, and behavior modification. Unpublished manuscript, 1978.
Wilker, A., & Pesor, F. T. Persistence of relapse tendencies of rats previously made physically dependent on morphine.Psychopharmacologia 1970,16 375–384.
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Wickramasekera, I. A conditioned response model of the placebo effect. Biofeedback and Self-Regulation 5, 5–18 (1980). https://doi.org/10.1007/BF00999060
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DOI: https://doi.org/10.1007/BF00999060