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Manipulating the Placebo Response in Experimental Pain by Altering Doctor’s Performance Style

Overview of attention for article published in Frontiers in Psychology, June 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (87th percentile)

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2 news outlets
blogs
1 blog
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24 X users
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1 Facebook page

Citations

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42 Dimensions

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90 Mendeley
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Title
Manipulating the Placebo Response in Experimental Pain by Altering Doctor’s Performance Style
Published in
Frontiers in Psychology, June 2016
DOI 10.3389/fpsyg.2016.00874
Pubmed ID
Authors

Efrat Czerniak, Anat Biegon, Amitai Ziv, Orit Karnieli-Miller, Mark Weiser, Uri Alon, Atay Citron

Abstract

Performance is paramount in traditional healing rituals. From a Western perspective, such performative behavior can be understood principally as inducing patients' faith in the performer's supernatural healing powers and effecting positive changes through the same mechanisms attributed to the placebo response, which is defined as improvement of clinical outcome in individuals receiving inactive treatment. Here we examined the possibility of using theatrical performance tools, including stage directions and scripting, to reproducibly manipulate the style and content of a simulated doctor-patient encounter and influence the placebo response in experimental pain. A total of 122 healthy volunteers (18-45 years, 76 men) exposed to experimental pain (the cold pressor test) were assessed for pain threshold and tolerance before and after receiving a placebo cream from a "doctor" impersonated by a trained actor. The actor alternated between two distinct scripts and stage directions, i.e., performance styles created by a theater director/playwright, one emulating a standard doctor-patient encounter (scenario A) and the other emphasizing attentiveness and strong suggestion, elements also present in ritual healing (scenario B). The placebo response size was calculated as the %difference in pain threshold and tolerance after exposure relative to baseline. In addition, subjects demonstrating a ≥30% increase in pain threshold or tolerance relative to baseline were defined as responders. Each encounter was videotaped in its entirety. Inspection of the videotapes confirmed the reproducibility and consistency of the distinct scenarios enacted by the "doctor"-performer. Furthermore, scenario B resulted in a significant increase in pain threshold relative to scenario A. Interestingly, this increase derived from the placebo responder subgroup; as shown by two-way analysis of variance (performance style, F = 4.30; p = 0.040; η(2) = 0.035; style × responder status interaction term, F = 5.21; p = 0.024) followed by post hoc analysis showing a ∼60% increase in pain threshold in responders exposed to scenario B (p = 0.020). These results support the hypothesis that structured manipulation of physician's verbal and non-verbal performance, designed to build rapport and increase faith in treatment, is feasible and may have a significant beneficial effect on the size of the response to placebo analgesia. They also demonstrate that subjects, who are not susceptible to placebo, are also not susceptible to performance style.

X Demographics

X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 90 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 90 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 13 14%
Student > Master 13 14%
Student > Bachelor 8 9%
Researcher 6 7%
Student > Doctoral Student 6 7%
Other 19 21%
Unknown 25 28%
Readers by discipline Count As %
Psychology 21 23%
Medicine and Dentistry 14 16%
Nursing and Health Professions 6 7%
Pharmacology, Toxicology and Pharmaceutical Science 3 3%
Neuroscience 3 3%
Other 10 11%
Unknown 33 37%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 37. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 April 2023.
All research outputs
#1,047,913
of 24,620,113 outputs
Outputs from Frontiers in Psychology
#2,186
of 33,208 outputs
Outputs of similar age
#20,152
of 358,597 outputs
Outputs of similar age from Frontiers in Psychology
#50
of 394 outputs
Altmetric has tracked 24,620,113 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 33,208 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.0. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 358,597 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 394 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 87% of its contemporaries.