Robert Todd Carroll
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Research suggests
one in four believe Friday the 13th is unlucky - People who see themselves
as unlucky should stay indoors on Friday the 13th, according to new
research.
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nocebo and nocebo effect
Research has...shown that the nocebo
effect can reverse the body's response to true medical treatment from
positive to negative. (Root-Bernstein 1998)
A nocebo (Latin for "I will harm") is something that should be
ineffective but which causes symptoms of ill health. A nocebo effect is an
ill effect caused by the suggestion or belief that something
is harmful. The term 'nocebo' became popular in the 1990s. Prior to that,
both pleasant and harmful effects thought to be due to the power of
suggestion were usually referred to as being due to
the placebo effect.
Because of ethical concerns, nocebos are not commonly used in medical
practice or research. Thus, it is not unexpected that the nocebo effect is
not well-established in the scientific literature. However, there are some
anecdotes and some studies that are commonly appealed to in the literature
to support its validity.
- More than two-thirds of 34 college students developed headaches when
told that a non-existent electrical current passing through their heads
could produce a headache.
- "Japanese researchers tested 57 high school boys for their sensitivity
to allergens. The boys filled out questionnaires about past experiences
with plants, including lacquer trees, which can cause itchy rashes much as
poison oak and poison ivy do. Boys who reported having severe reactions to
the poisonous trees were blindfolded. Researchers brushed one arm with
leaves from a lacquer tree but told the boys they were chestnut tree
leaves. The scientists stroked the other arm with chestnut tree leaves but
said the foliage came from a lacquer tree. Within minutes the arm the boys
believed to have been exposed to the poisonous tree began to react,
turning red and developing a bumpy, itchy rash. In most cases the arm that
had contact with the actual poison did not react." (Gardiner Morse,
"The nocebo effect," Hippocrates, November 1999, Hippocrates.com)
- In the Framingham
Heart Study, women who believed they are prone to heart disease were
nearly four times as likely to die as women with similar risk factors who
didn't believe.*
(Voelker, Rebecca. "Nocebos Contribute to a Host of Ills." Journal of
the American Medical Association 275 no. 5 (1996): 345-47. ) [Of
course, one might argue that the women in both groups had good intuitions.
The objective risk factors may have been the same, but subjectively the
women knew their bodies better than the objective tests could reveal.]
- C.K. Meador claimed that people who believe in voodoo may
actually get sick and die because of their belief ("Hex Death: Voodoo
Magic or Persuasion?" Southern Medical Journal 85, no. 3 (1992):
244-47).
- "In one experiment, asthmatic patients breathed in a vapor that
researchers told them was a chemical irritant or allergen. Nearly half of
the patients experienced breathing problems, with a dozen developing
full-blown attacks. They were “treated” with a substance they believed to
be a bronchodilating medicine, and recovered immediately. In actuality,
both the “irritant” and the “medicine” were a nebulized saltwater
solution."*
Arthur Barsky, a psychiatrist at Boston's Brigham and Women's Hospital,
found in a recent review of the nocebo literature that patient
expectation of adverse effects of treatment or of possible harmful
side-effects of a drug, played a significant role in the outcome of
treatment (Barsky et al. 2002).
Since patients' beliefs and fears may be generated by just about anything
they come in contact with, it may well be that many things that are unattended to by many if not
most physicians, such as the color of the pills they give, the type of
uniform they wear, the words they use to give the patient information, the
kind of room they place a patient in for recovery, etc., may be imbued with
rich meaning for the patient and have profound effects for good or for ill
on their response to treatment.
See also placebo effect.
further reading
Barsky, Arthur J., M.D. et al.
"Nonspecific Medication Side Effects and the Nocebo Phenomenon,"
Journal of the American Medical Association, Vol. 287 No. 5, February 6,
2002.
Engel, Linda W. et al. The Science of the Placebo - Toward an
Interdisciplinary Research Agenda ( BMJ Books, 2002).
Morse, Gardiner. 1999.
"The Nocebo Effect - Scattered studies suggest that negative thinking can
harm patients’ health," Hippocrates,
November, Vol. 13, No. 10.
Root-Bernstein, Robert and Michele. Honey, Mud, Maggots and Other Medical
Marvels: The Science Behind Folk Remedies and Old Wives' Tales (Houghton
Mifflin Co., 1998). |
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