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PSYC180 - Online Readings Notes.docx

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PSYC 180
Amir Raz

Online Readings Notes Anomalous Cognition  Science thrives on a skeptical approach, and scientists are typically conservative in what they consider a “generally accepted view”  Two errors: nonexistent phenomena may pass as real or generally accepted; real phenomena, which should be generally accepted, may pass as nonexistent  Experimental results that do not replicate, effects that are very small and tenuous, flaws of design and methodology, insufficient sample size, inadequate statistical analyses, and lack of a theoretical basis may all contribute to weak evidence  Statistical analysis is independent of the quality of the unprocessed information  Meta-analytical studies are retrospective, and confound exploratory with confirmatory investigation  Experimenter’s beliefs may introduce a substantive bias to the interpretation of data and sometimes even to more nuanced aspects  Psi effects are not amenable to standard scientific scrutiny because the alleged effects, when they do occur, typically disappear soon after the initial experiment, thereby preventing replication  “decline effect” – the tendency of psi phenomena to wane over time, sometimes reaching chance levels  “experimenter effect” – a difference in participants’ performance as a function of the individual who is administering the experiment  Karl Popper – a theory is scientific if it permits the possibility of being shown false (falsifiability criterion)  Members of the scientific community should be amenable to the possibility of novel phenomena. At the same time, proponents of new claims should provide compelling proof, and everyone should be sufficiently critical to dismiss claims that have already been found specious Asthma as a Model for Placebo Effects in Modern Medicine Placebo effect – diverse set of changes that accompany each individual treatment and disease  Placebo group comprises almost 100% of the drug effect in the antidepressant treatment for mild-to- moderate depression, but almost none in treating strep throat  RCT – “placebo response” encompasses the full change in the group receiving the inert pill, “placebo effect” refers to the difference between the placebo response and the no-treatment group Objective Measures of Placebo Effects  Sham bronchodilator and acupuncture conferred no measurable benefit over no-treatment, but were indistinguishable from active bronchodilator according to subjective reports  Inert substances enable robust and objective immunosuppression and immunostimulation  Stress can, depending on duration and intensity, both enhance and depress immune function  Administering saline while suggesting that it was a bronchoconstrictor could elicit bronchoconstriction. Conversely, pairing saline with the suggestion that it was actually a bronchodilator reverse the initial bronchoconstricting effect  FEV measurements indicated that placebo bronchodilators suppressed airway response to subsequent methacholine administration Future Directions  Because the processes of informed consent diminish patient expectation for “active treatment” the RCT design should display the weakest placebo effects in medicine  Youth is emerging as a potential factor associated with susceptibility to suggestion (children who suffer from migraine headaches also experience greater placebo effects than adults) Foxes in Boxes  Suggestion can exert dramatic effects on the body  Language is the primary vehicle of suggestion, which in turn, catalyzes both conscious and unconscious cognition, ultimately translating into altered perception and behaviour  What distinguishes human from animal is our ability to conceive and convey abstract thought through language  When chemical events and bodily sensations affect our thoughts = “bottom-up” (physical dehydration generates thirst perception which motivates drinking behaviour)  When cognition shapes our corporeal reality = “top-down” processing (highly variable and difficult to identify and measure, their therapeutic potential has been marginalized)  To be considered legitimate, an agent must conform to scientific standards  Carefully crafted words administered during hypnosis can over-ride our knowledge of ourselves and our surroundings  Suggestion has also been shown to induce food aversions  Culture acts a powerful medium of suggestion, influencing the presentation of psychopathology  The apparent gap between theory and practice is fuelled by a lack of consensus on how to define a placebo effect  Blue pills (depressant), red (stimulant)  Brand name labels bolster treatment outcomes, while discounted prices can diminish the effectiveness of energy drinks  Invasiveness of the method may yield the highest benefit  Placebo effect = no-treatment group – placebo response  Expectation is also a major determinant of placebo responsiveness  Open administration of an inert substance paired with the suggestion that enlists a powerful top-down process may be employed in certain instances to effect healing Active Albuterol or Placebo  There were no significant differences between the three inactive interventions  Albuterol exhibited the highest improvement rates  Difference in drug effect between the albuterol inhaler and the placebo inhaler, was significant  The placebo effects did not differ significantly between the two placebo interventions and the control  Patients assigned to the active substance had a much larger response rate than with the placebo remedies  Substantial improvement with active and placebo substances  control group had less  Subjective drug effect between active and placebo inhaler was not significant  Subjective effects between placebo and control group was large  Physiological outcome = medication effect but no placebo effect  Subjective outcome = placebo effects were equivalent to the drug effect  Placebo interventions had a strong effect on subjective outcome, but none on objective; the reverse is true for the active drug  Apparent equivalence of placebos may be because the patients may have become conditioned to the setting and personnel at a well-known hospital as much as to the inhaler itself  High credibility of sham acupuncture might have resulted in a greater expectation of improvement with sham acupuncture A systematic review of systematic review of homeopathy  Homeopathy is a therapeutic method using preparations of substances whose effects when administered to healthy subject correspond to the manifestations of the disorder in the individual patient  “like cures like” – patients with particular signs and symptoms can be helped by a homeopathic remedy that produces these signs and symptoms in healthy individuals  homeopathic remedies retain biological activity after repeated dilution and sucussion even when diluted beyond Avogadro’s number  only systematic review of controlled clinical trials of homeopathy with human patients or volunteers were included  results of these re-analyses demonstrate that the more rigorous trials are associated with smaller effect sizes, which render the overall effect insignificant  one re-analysis suggests that the initial positive meta-analytic result was largely due to publication bias  independent systematic reviews do not provide strong evidence in favour of homeopathy (with the exception of postoperative ileus and influenza)  the definitive study designed as a multicenter trial to replicate sev
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