The Placebo: A Reader

The placebo effect is a fascinating but elusive phenomena. Although no standard definition of the placebo effect exists, it is generally understood as consisting of responses of individuals to the psychosocial context of medical treatments or clinical encounters, as distinct from specific physiological effects of medical interventions. The Placebo is the first book to compile a selection of classic and contemporary published articles on the topic. Systematic investigation of the placebo effect emerged in the 1950s in response to the development of randomized controlled clinical trials that used "inert" placebo interventions as a pivotal element of scientific evaluation of novel drugs. In recent years, scientific and scholarly investigation of the placebo effect has increased dramatically, reflecting a growing interest in the connection between mind and body with respect to health, the development of brain imaging techniques, dissatisfaction with the reductionist and technological orientation of biomedicine, and growing attention to the use of complementary and alternative medical treatments. The Placebo is organized into three sections: the nature and significance of the placebo effect, experimental studies of the placebo effect, and ethical issues of placebos in research and in clinical practice. This comprehensive sourcebook will be invaluable to investigators and scholars alike.

Table of Contents:
Preface Acknowledgments Contributors Part I: The Concept and Significance of The Placebo Effect Chapter 1. Conferences on Therapy: The Use of Placebos in Therapy Chapter 2. The Powerful Placebo Chapter 3. How Much of the Placebo "Effect" Is Really Statistical Regression? Chapter 4. The Powerful Placebo Effect: Fact or Fiction? Chapter 5. Is the Placebo Powerless? An Analysis of Clinical Trials Comparing Placebo with No Treatment Chapter 6. The Placebo Concept in Medicine and Psychiatry Chapter 7. Deconstructing the Placebo Effect and Finding the Meaning Response Chapter 8. The Placebo Effect in Alternative Medicine: Can the Performance of a Healing Ritual Have Clinical Significance? Part II: Experimental Studies of the Placebo Effect Section A. Pioneering Efforts Chapter 9. Effects of Suggestion and Conditioning on the Action of Chemical Agents in Human Subjects: The Pharmacology of Placebos Chapter 10. A Study of the Placebo Response Chapter 11. Chance Distribution and the Placebo "Reactor" Chapter 12. Placebo Effect in the Rat Chapter 13. Reduction of Postoperative Pain by Encouragement and Instruction of Patients: A Study of Doctor-Patient Rapport Chapter 14. The Interaction of Psychologic Stimuli and Pharmacologic Agents on Airway Reactivity in Asthmatic Subjects Chapter 15. The Mechanism of Placebo Analgesia Chapter 16. Behaviorally Conditioned Immunosuppression and Murine Systemic Lupus Erythematosus Chapter 17. An Investigation of Drug Expectancy as a Function of Capsule Color and Size and Preparation Form Chapter 18. Clinicians' Expectations Influence Placebo Analgesia Section B. Psychological Mechanisms Chapter 19. The Role of Conditioning and Verbal Expectancy in the Placebo Response Chapter 20. Classical Conditioning and the Placebo Effect Chapter 21. An Analysis of Factors That Contribute to the Magnitude of Placebo Analgesia in an Experimental Paradigm Chapter 22. Neuropharmacological Dissection of Analgesia: Expectation- Activated Opioid Systems versus Conditioning- Activated Specific Subsystems Chapter 23. Placebo Analgesia Induced by Social Observational Learning Section C. Neurobiological Mechanisms Chapter 24. Placebo and Opioid Analgesia: Imaging a Shared Neuronal Network Chapter 25. Placebo- Induced Changes in fMRI in the Anticipation and Experience of Pain Chapter 26. Placebo Effects Mediated by Endogenous Opioid Activity on - Opioid Receptors Chapter 27. Direct Evidence for Spinal Cord Involvement in Placebo Analgesia Chapter 28. The Biochemical and Neuroendocrine Bases of the Hyperalgesic Nocebo Effect Chapter 29. Expectation and Dopamine Release: Mechanism of the Placebo Effect in Parkinson's Disease Chapter 30. Placebo- Responsive Parkinson Patients Show Decreased Activity in Single Neurons of Subthalamic Nucleus Chapter 31. Expectation Enhances the Regional Brain Metabolic and the Reinforcing Effects of Stimulants in Cocaine Abusers Section D. Contextual Factors Chapter 32. Do Double- Blind Studies with Informed Consent Yield Externally Valid Results? An Empirical Test Chapter 33. Response Expectancies in Placebo Analgesia and Their Clinical Relevance Chapter 34. Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome Chapter 35. Finasteride 5 mg and Sexual Side Effects: How Many of These Are Related to a Nocebo Phenomenon? Chapter 36. Overt versus Covert Treatment for Pain, Anxiety, and Parkinson's Disease Chapter 37. Components of Placebo Effect: Randomised Controlled Trial in Patients with Irritable Bowel Syndrome Chapter 38. Conditioned Pharmacotherapeutic Effects: A Preliminary Study Part III: Ethical Issues Raised by the Use of Placebos in Research and Clinical Practice Section A. Research Chapter 39. The Continuing Unethical Use of PlaceboControls Chapter 40. Placebo Orthodoxy in Clinical Research II: Ethical, Legal, and Regulatory Myths Chapter 41. Placebo- Controlled Trials and Active- Control Trials in the Evaluation of New Treatments: Part 1. Ethical and Scientific Issues Chapter 42. The Ethics of Placebo- Controlled Trials: A Middle Ground Chapter 43. Is Placebo Surgery Unethical? Chapter 44. Deception in Research on the Placebo Effect Chapter 45. Inclusion of Authorized Deception in the Informed Consent Pro cess Does Not Affect the Magnitude of the Placebo Effect for Experimentally Induced Pain Chapter 46. False Hopes and Best Data: Consent to Research and the Therapeutic Misconception Section B. Clinical Practice Chapter 47. The Use of Placebo Interventions in Medical Practice: A National Questionnaire Survey of Danish Clinicians Chapter 48. Prescribing "Placebo Treatments": Results of National Survey of U.S. Internists and Rheumatologists Chapter 49. The Ethics of Giving Placebos Chapter 50. The Lie That Heals: The Ethics of Giving Placebo Chapter 51. Placebo as a Treatment for Depression Chapter 52. The Legitimacy of Placebo Treatments in Clinical Practice: Evidence and Ethics Index

About the Author :
Franklin G. Miller is a member of the senior faculty in the Department of Bioethics at the National Institutes of Health (NIH) and a special expert at the National Institute of Mental Health Intramural Research Program. Luana Colloca is a research fellow at the National Center for Complementary and Alternative Medicine and the National Institute of Mental Health, and an adjunct faculty member in the Department of Bioethics at NIH. Robert A. Crouch is an independent consultant. Ted J. Kaptchuk is an associate professor of medicine at Harvard Medical School and the director of the Program in Placebo Studies and the Therapeutic Encounter at the Beth Israel Deaconess Medical Center.

Review :
A 'must' for any professional health collection including discussions of media ethics, and provides a find definition of the placebo effect and its physiological and ethical ramifications. Midwest Book Review Nowadays, we will only buy [readers] if they combine an excellence of editorial taste and readability that beats the temptation of downloading our own selection directly from a journal archive. In this regard, I must admit that the editors of this placebo reader have succeeded in producing a volume worth buying... each section is preceded by a short (but incisive) introduction intended as a road map of the papers to come. These are short and clear, and very accessible for the lay reader. -- David Teira, Ph.D., UNED Metapsychology