Placebo can enhance creativity

How the inner repetition of a desired perception changes actual tactile perception

Autosuggestion is a cognitive process where the inner repetition of a thought actively influences one's own perceptual state. In spite of its potential benefits for medical interventions, this technique has gained little scientific attention so far. Here, we took advantage of the known link between intensity and frequency perception in touch ('Békésy effect'). In three separate experiments, participants were asked to modulate the perceived intensity of vibrotactile stimuli at the fingertip through the inner reiteration of the thought that this perception feels very strong (Experiment 1, n = 19) or very weak (Experiments 2, n = 38, and 3, n = 20), while they were asked to report the perceived frequency. We show that the task to change the perceived intensity of a tactile stimulus via the inner reiteration of a thought modulates tactile frequency perception. This constitutes the first experimental demonstration that an experimental design that triggers autosuggestion alters participants' tactile perception using a response orthogonal to the suggested variable. We discuss whether this cognitive process could be used to influence the perception of pain in a clinical context.

Microdosing with classical psychedelics: Research trajectories and practical considerations

Microdosing-the intermittent ingestion of minute, sub-hallucinogenic amounts of psychedelic substances, repeatedly and over time-has become a widespread, albeit largely understudied, phenomenon. Regulations around using psychedelics at any dose-micro, mini, macro, or mega-pose all sorts of difficulties for those who wish to systematically study the effects of Schedule I drugs, especially in the United States. Microdosers commonly claim that taking a sub-hallucinogenic (pre-hallucinogenic or sub-perceptual) dose improves higher brain functions, including creativity, productivity, and mood. If true, these results would provide an important experimental edge in distinguishing psychosocial effects (e.g. caused by expectation) from those related to the active psychedelic ingredient. In this critical integrative synthesis, we explore the psychobiological science of dose amounts and how it informs microdosing with classical psychedelics (e.g. lysergic acid diethylamide [LSD] and psilocybin) to highlight and fuel research into questions (e.g. in cognitive neuroscience, consciousness studies, and metacognition). We sketch the hurdle-laden regulatory landscape and the procedures that shroud research with Schedule I drugs. Finally, we offer some future directions relevant to both scholars and clinicians in the social and behavioral sciences as well as in mental health and neurological science.

Placebo: a brief updated review

Our aims were to provide updated information on placebo/nocebo effect and the potential use of placebo in clinical practice. This article can only provide a rough overview on the placebo and nocebo effect and is intended to serve as a starting point for the reader to go deeper into the corresponding literature. The placebo effect has been observed in multiple medical conditions, after oral administration, with manual therapies as well as with surgery and invasive procedures. The use of placebo in clinical trials is fundamental, although the ethics of its use is under discussion. The placebo may behave like a drug from the pharmacokinetic and pharmacodynamic point of view and can also be associated with adverse events (nocebo effect). Placebo can modify treatment by increasing or decreasing the effects of drugs. The factors associated with the occurrence of placebo effect are multiple, but in addition to those that depend on the placebo itself, the doctor-patient relationship would be the most important. As a result of findings that were published in the last two decades, the psycho-neurobiological basis of placebo is becoming better understood, although further studies are needed. In conclusion, the placebo effect in the clinic exhibits weak to moderate intensity. Placebo, in addition to its use in the clinical trial, should be considered another therapeutic remedy either as stand alone or in association with treatment, and could be useful in certain circumstances. The use of placebo should be regulated by the European health authorities through a guide in clinical practice that will improve patient care.

Can positive expectations help to improve the learning of risk literacy? A cluster-randomized study in undergraduate medical students

BACKGROUND

Risk literacy, i.e., the ability to calculate and apply risk parameters, represents a key competence for risk communication and medical decision making. However, risk literacy is reportedly low in medical students. The successful acquisition of statistical competencies is often difficult, and can be hampered by emotional learning obstacles, calling for interventions to support learning. In this cluster-randomized study, we aimed to translate findings from placebo research to medical education. Specifically, we tested if the acquisition of risk literacy during a seminar unit can be facilitated by positive expectations, induced by a positive and non-threatening framing of the content and learning goals.

METHODS

The study took place during a mandatory 2.5-h seminar on "risk literacy" for 2^nd year medical students. The seminar teaches both statistical knowledge and its application in patient communication. To test the effects of expectations on risk literacy acquisition, the (otherwise identical) seminar was framed either as "communication training" (positive framing condition) or "statistics seminar" (negative framing condition). All N = 200 students of the semester were invited to participate, and cluster-randomized to the positive or negative framing condition (4 seminar groups each condition). Risk literacy was assessed with the "Quick Risk Test" (QRT) at the beginning and end of the seminar, along with statistics anxiety and subjective learning success using questionnaires.

RESULTS

Data from N = 192 students were included. At the end of the seminar, risk literacy was increased in both framing conditions, with a significantly greater increase in QRT scores in the positive framing condition. Statistics anxiety was significantly decreased in both framing conditions, with no evidence of group differences. Subjective learning success was overall high and comparable between groups.

CONCLUSIONS

Supporting our hypothesis, positive framing led to a significantly greater increase in risk literacy (i.e., in QRT scores). Our data offer first support that positive framing of learning goals may help to facilitate the acquisition of statistical knowledge. Expectation-orientated interventions may thus offer a feasible tool to optimize learning settings and framing of learning objectives in medical statistics courses.

Utilizing placebos to leverage effects of cognitive-behavioral therapy in patients with depression

BACKGROUND

Patients with depression often experience difficulties with completing homework assignments during cognitive-behavioral therapy (CBT). In the present study, we investigated the effects of a specific placebo which aimed at improving the practice of a daily relaxation exercise during a four-week outpatient program.

METHODS

A total of 126 patients diagnosed with major depressive disorder were randomly assigned to one of three groups: 'Coping with Depression' course, 'Coping with Depression' course with additional daily placebo treatment, and waiting-list group. The placebo (sunflower oil) was introduced as a natural medicine to help the patients focus on their inner strengths and to mobilize their bodies' natural healing powers. The placebo was taken orally before the daily relaxation exercise.

RESULTS

The placebo improved homework quantity and quality (both p < .001). The placebo group practiced more often and experienced greater relaxation effects than the no-placebo group. Additionally, the placebo group showed a greater reduction of depression symptoms (p < .001).

LIMITATIONS

The primary limitation of the study is the lack of a psychophysiological measure of relaxation.

CONCLUSIONS

Placebos can be used to leverage CBT effects in patients with depression.

When Beliefs Face Reality: An Integrative Review of Belief Updating in Mental Health and Illness

Belief updating is a relatively nascent field of research that examines how people adjust their beliefs in light of new evidence. So far, belief updating has been investigated in partly unrelated lines of research from different psychological disciplines. In this article, we aim to integrate these disparate lines of research. After presenting some prominent theoretical frameworks and experimental designs that have been used for the study of belief updating, we review how healthy people and people with mental disorders update their beliefs after receiving new information that supports or challenges their views. Available evidence suggests that both healthy people and people with particular mental disorders are prone to certain biases when updating their beliefs, although the nature of the respective biases varies considerably and depends on several factors. Anomalies in belief updating are discussed in terms of both new insights into the psychopathology of various mental disorders and societal implications, such as irreconcilable political and societal controversies due to the failure to take information into account that disconfirms one’s own view. We conclude by proposing a novel integrative model of belief updating and derive directions for future research.

Promoting Individual and Collective Creativity in Science Students

Creativity is a scientific skill necessary to develop a successful research career. We expose the importance of a growth mindset, divergent, lateral, and associative thinking, serendipity, and being part of a nonhierarchical and diverse research team to improve both individual and collective creativity.

Placebo Brain Stimulation Affects Subjective but Not Neurocognitive Measures of Error Processing

The aim of this preregistered EEG study was to show how expectations about enhanced or impaired performance through transcranial stimulation affect feelings of agency and error processing. Using a single-blind experimental design, participants (N = 57) were attached to a transcranial direct current stimulation (tDCS) device, and in different blocks, they were verbally instructed to expect enhanced or impaired cognitive performance, or no effects of the brain stimulation. In all cases, but unbeknownst to the participants, we used an inert sham tDCS protocol. Subsequently, we measured their response to errors on a cognitive control task. Our expectancy manipulation was successful: participants reported improved subjective performance in the enhancement compared with the impairment condition—even though objective performance was kept at a constant level across conditions. Participants reported the highest feelings of agency over their task performance in the control condition, and lowest feelings of agency in the impairment condition. The expectancy manipulation did not affect the error-related negativity (ERN) in association with incorrect responses. During the induction phase, expecting impaired versus enhanced performance increased frontal theta power, potentially reflecting a process of increased cognitive control allocation. Our findings show that verbally induced manipulations can affect subjective performance on a cognitive control task, but that stronger manipulations (e.g., through conditioning) are necessary to induce top-down effects on neural error processing.

Mental Training for Better Achievement: Effects of Verbal Suggestions and Evaluation (of Effectiveness) on Cognitive Performance

Objective: There is only some literature regarding the influence of verbal suggestions on cognitive performance in healthy volunteers. For example, the performance in a knowledge test was enhanced when participants were told that they had subliminally received the correct answer. However, enhancing cognitive performance only via verbal suggestions without prior conditioning phases has not yet been examined. The goal of our study was therefore to investigate the effects of a mental training based on verbal suggestions compared to a control training on cognitive performance in a student population using a balanced-placebo-design. Methods: In total, 103 participants were randomly assigned either to listening to a 20 min audio-taped mental training or to a 20 min philosophy lecture (control training) via headphones. Participants were individually tested before and after the training concerning their cognitive performance. Information about the type of training were varied in both intervention conditions ("You are part of our experimental condition and you will receive an effective mental training" or "You are part of our control group and you will receive the control condition"). At the end of the assessment, participants were asked what kind of training they believed they had received and how effective they would rate the received training. Results: Overall, the cognitive performance improved in all participants, F _{(1, 99)} = 490.01, p < 0.001. Contrary to our hypotheses, we found no interaction of the type of training and type of instruction on the cognitive performance. Participants who rated the received training as being effective at the end of the experiment (regardless if it was the mental or the control training), have before experienced a greater improvement in their cognitive performance [F _(2,100) = 7.26, p = 0.001] and showed higher scores in the ability to absorb [F _{(2, 99)} = 3.75, p = 0.027]. Conclusion: The subjects' own experiences in the task might have influenced the rating of the training rather than the actual training or the information they receive regarding the type of training. This finding underlines the relevance of enhancing the subjective beliefs and self-efficacy in situations where cognitive attention processes are important and of individually tailoring mental trainings.