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Placebo EffectsUnderstanding the mechanisms in health and disease$
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Fabrizio Benedetti

Print publication date: 2008

Print ISBN-13: 9780199559121

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780199559121.001.0001

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A modern view of placebo and placebo-related effects

A modern view of placebo and placebo-related effects

(p.19) Chapter 2 A modern view of placebo and placebo-related effects
Placebo Effects

Fabrizio Benedetti

Oxford University Press

The placebo effect, or placebo response, is a psychobiological phenomenon that must not be confounded with other phenomena, such as spontaneous remission and statistical regression to the mean. The nocebo effect, or nocebo response, is a negative placebo effect, which goes in the opposite direction compared to the placebo effect. There are many placebo effects with different biological mechanisms and in different systems and apparatuses that are triggered by the psychosocial context around the patient and the therapy. Expectation of a future outcome plays a central role, and may act through different mechanisms, such as reduction in anxiety and activation of reward circuits. Learning plays a crucial role, and powerful placebo effects may be induced through a conditioning procedure. Placebo and placebo-related effects may be related to other self-regulatory processes and may have emerged during evolution as a defence mechanism of the body.

Keywords:   neurobiological mechanisms, spontaneous remission, regression to the mean, expectation, learning, reward mechanisms, anxiety, self-regulatory processes

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