A Fictionalist Account of Open-Label Placebo

The placebo effect is now generally defined widely as an individual's response to the psychosocial context of a clinical treatment, as distinct from the treatment's characteristic physiological effects. Some researchers, however, argue that such a wide definition leads to confusion and misleading implications. In response, they propose a narrow definition restricted to the therapeutic effects of deliberate placebo treatments. Within the framework of modern medicine, such a scope currently leaves one viable placebo treatment paradigm: the non-deceptive and non-concealed administration of "placebo pills" or open-label placebo (OLP) treatment. In this paper, I consider how the placebo effect occurs in OLP. I argue that a traditional, belief-based account of OLP is paradoxical. Instead, I propose an account based on the non-doxastic attitude of pretence, understood within a fictionalist framework.

Young children share imagined possibilities: evidence for an early-emerging human competence

Children's ability to reason about junctures leading to two different destinations emerges slowly, with convergent evidence for a conceptual watershed at approximately 4 years. Young children and great apes misrepresent such junctures, planning for only one expected outcome. However, singular possibilities, as opposed to two mutually exclusive possibilities, are readily imagined, shared and acted upon by 2- and 3-year-olds. Analysis of three domains supports this claim. First, 2- and 3-year-olds respond appropriately to pretend spatial displacements enacted for them by a play partner. Second, they not only respond accurately to claims regarding an alleged but unwitnessed spatial displacement, they also ask their interlocutors about the possible whereabouts of missing objects and absent persons. Third, in ordinary conversation, they appropriately mark some of their assertions as possibilities rather than actualities. In summary, although the ability to reason about mutually inconsistent possibilities develops slowly in the preschool years, the ability to imagine and share information about possibilities is evident among 2- and 3-year-olds. Nothing comparable has been observed in great apes. Young children's ability to entertain shared possibilities diverges from that of non-human primates well before any potential watershed at 4 years with respect to the understanding of mutually exclusive possibilities. This article is part of the theme issue 'Thinking about possibilities: mechanisms, ontogeny, functions and phylogeny'.

Young children expect pretend object identities to be known only by their partners in joint pretence

The present study examined whether three-year-old children (age = 42-48 months, n = 57; 31 boys) understand that object identities stipulated during pretend play could only be known by people witnessing the stipulation. Children participated in pretend scenarios that included some objects and two experimenters. Two pretend episodes corresponded to an object: one connected to its conventional function, the other to a pretend identity made-up on the spot. These episodes happened either in the presence or absence of the other person. In the test phase, this experimenter expressed an intention to do something with an object and asked for a 'missing' prop. The prediction was that in case she was present previously, children would be more likely to select the prop corresponding to a pretence stipulation, compared to when she was absent. The results confirmed this pattern: in the absent condition, 68.42% of the participants chose the prop connected to the conventional use of the object, while 31.58% chose the prop corresponding to its identity stipulated in pretend play. It seems that preschool aged children refrain from generalizing their knowledge about the pretend identity of an object, in case their interactive partner could not know of this identity.

Limitations in social anticipation are independent of imaginative and Theory of Mind abilities in children with autism but not in typically developing children

Anticipating future interactions is characteristic of our everyday social experiences, yet has received limited empirical attention. Little is known about how children with autism spectrum disorder, known for their limitations in social interactive skills, engage in social anticipation. We asked children with autism spectrum disorder and their typically developing counterparts to consider an interaction with another person in the near future. Our results suggest that children with autism spectrum disorder and typically developing children performed similarly when anticipating the age, gender, and possible questions of another person, but children with autism spectrum disorder struggled more to anticipate what they would say in response to an anticipated interaction. Furthermore, such responses were robustly associated with imaginative capacities in typically developing children but not children with autism spectrum disorder. Our findings suggest that the cognitive mechanisms of social anticipation may differ between these groups.

Why do alternative ways of responding improve children's performance on tests of strategic reasoning?

Changing the way in which children respond significantly improves performance across a variety of cognitive domains. However, the basis for this response-mode effect is unknown. To address this issue, the current study tested 78 preschool children on a measure of executive functioning (the windows task: Hala & Russell, ). The task requires children to point to an empty box to receive a box with a treat in it. There were four versions of the task, differing only in the way in which children made their responses. Children in the baseline condition, who pointed with their finger, performed poorly. However, children in three alternative response-mode conditions won the treat significantly more often. Strikingly, even children who pretended to be pointing with an arrow - but were in reality pointing with their finger - performed significantly better than baseline. We suggest that non-standard response modes encourage children to reflect on their actions and that this reduces the number of unreflective errors they make. The findings demonstrate that response-mode effects do not depend on the presence of a physical means of responding (such as an arrow), but can be achieved via a purely cognitive means (such as engaging in pretence).

The power of possibility: causal learning, counterfactual reasoning, and pretend play

We argue for a theoretical link between the development of an extended period of immaturity in human evolution and the emergence of powerful and wide-ranging causal learning mechanisms, specifically the use of causal models and Bayesian learning. We suggest that exploratory childhood learning, childhood play in particular, and causal cognition are closely connected. We report an empirical study demonstrating one such connection--a link between pretend play and counterfactual causal reasoning. Preschool children given new information about a causal system made very similar inferences both when they considered counterfactuals about the system and when they engaged in pretend play about it. Counterfactual cognition and causally coherent pretence were also significantly correlated even when age, general cognitive development and executive function were controlled for. These findings link a distinctive human form of childhood play and an equally distinctive human form of causal inference. We speculate that, during human evolution, computations that were initially reserved for solving particularly important ecological problems came to be used much more widely and extensively during the long period of protected immaturity.

Getting back to the rough ground: deception and 'social living'

At the heart of the social intelligence hypothesis is the central role of 'social living'. But living is messy and psychologists generally seek to avoid this mess in the interests of getting clean data and cleaner logical explanations. The study of deception as intelligent action is a good example of the dangers of such avoidance. We still do not have a full picture of the development of deceptive actions in human infants and toddlers or an explanation of why it emerges. This paper applies Byrne & Whiten's functional taxonomy of tactical deception to the social behaviour of human infants and toddlers using data from three previous studies. The data include a variety of acts, such as teasing, pretending, distracting and concealing, which are not typically considered in relation to human deception. This functional analysis shows the onset of non-verbal deceptive acts to be surprisingly early. Infants and toddlers seem to be able to communicate false information (about themselves, about shared meanings and about events) as early as true information. It is argued that the development of deception must be a fundamentally social and communicative process and that if we are to understand why deception emerges at all, the scientist needs to get 'back to the rough ground' as Wittgenstein called it and explore the messy social lives in which it develops.