A randomized trial that compared brain activity, efficacy and plausibility of open-label placebo treatment and cognitive repappraisal for reducing emotional distress

Reducing Emotional Distress with Open-Label Placebos: Assessing the Role of Motor Engagement in Pill Consumption

It has been posited that ingesting a pill constitutes a pivotal action that facilitates the effects of open-label placebos (OLPs: placebos honestly prescribed). In the present OLP experiment, the motor components of a placebo treatment were systematically varied. The participants (n = 183) were randomly allocated to one of four groups that all viewed aversive pictures. The 'active OLP' group took a placebo pill with specific instructions concerning the sequence of motor actions for the intake. The 'usual OLP' group swallowed the pill (without specific motor instructions), while the third group received an 'imaginary OLP' (no pill intake). The fourth group applied cognitive reappraisal (CR; active control group) to reduce emotional distress. The participants rated their affective state as well as the efficacy and plausibility of the treatment approach. Moreover, blood pressure and pulse were recorded as indicators of bodily arousal. The four groups did not differ in their valence ratings and physiological measures. The 'imaginary OLP' received higher ratings for both effectiveness and plausibility than the 'usual OLP'. CR was rated as superior relative to all OLP conditions. In conclusion, reducing emotional distress with OLPs does not necessitate the consumption of a placebo pill. In terms of acceptability and ease of implementation, CR stands as a well-established alternative.

Would You Take an Open-Label Placebo Pill or Give One to Your Child? Findings from a Cross-Sectional Survey

Background

Open-label placebos (OLPs), honestly prescribed regarding their inert nature, have been associated with positive health-related effects in both children and adults. However, OLPs are not always perceived by laypeople as a viable treatment option.

Methods

A brief online survey with 806 adult participants (age range: 18-75 years; 29% parents) was conducted to identify predictor variables that are associated with the willingness to take an OLP pill (criterion 1) or to give an OLP to one's child (criterion 2). The survey covered aspects including the perceived plausibility of the treatment concept for both OLPs and deceptive placebos (DPs), self-reported knowledge about placebos, the expected effectiveness of OLPs in treating emotional/ somatic problems, and attitudes concerning taking pills in general. Multiple hierarchical regressions were carried out.

Results

The expected effectiveness of OLPs in alleviating both emotional and physical ailments and the plausibility of the treatment concepts for both OLPs and DPs significantly predicted the willingness to use OLPs (R2 = 0.485). A similar finding was observed when predicting the willingness to administer an OLP to one's child (R2 = 0.443).

Conclusion

Favorable expectations regarding the reduction of emotional and somatic symptoms with OLPs, along with a strong belief in the credibility of placebo mechanisms, play a vital role in influencing the willingness to accept this kind of treatment. These factors can be incorporated into psychoeducational programs.