From painful joints to intense fatigue: a third of patients with rheumatism suffer serious effects from this chronic condition and rely long-term on medication. Leiden psychologists Andrea Evers, Liesbeth van Vliet, Judy Veldhuijzen, Henriët van Middendorp, and Stefanie Meeuwis are to receive a grant from ReumaNederland to investigate whether placebo techniques can help patients reduce their intake of medication.
Over two million Dutch people suffer from a form of rheumatism such as osteoarthritis, chronic inflammatory rheumatism or gout. Many of them take long-term medication such as anti-inflammatories and painkillers. Unfortunately, these medicines can also have unwelcome side-effects such as liver disorders and an inhibited immune system. A team of Leiden psychologists are therefore going to study whether advanced placebo techniques help to optimise the effects of treatment so that patients need less medication. ‘We will be conducting this study among a group of patients who are in a stable stage of their illness and who would like to reduce their medication,’ commented health psychologist Andrea Evers, who is heading the research programme.
Representatives of the Dutch Arthritis Foundation visited the Leiden research team at the Faculty of Social and Behavioural Sciences. Evers thanked the Foundation and all the donors warmly for this subsidy of half a million euros: ‘It is exceptional and highly important that the Dutch Arthritis Foundation also supports interdisciplinary and social scientific research that can benefit patients.’
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There are 2 positions for 2 research projects. The PhD candidates will be working on both research projects with a focus on one of them.
The aim of the research program is to investigate whether the treatment of patients with inflammatory rheumatoid arthritis can be optimized by applying advanced placebo training aimed at making optimal use of placebo effects through learning principles. The training courses focus on the 3 central factors in the treatment process (care provider, patient and treatment) and will subsequently consist of communication training for care providers, expectation training for patients to reduce nocebo effects (e.g. unnecessary fears about drug withdrawal) and pharmacological conditioning to reduce drug use. The research is part of the Center for Interdisciplinary Placebo Studies Leiden.
Check the vacancies here (in Dutch)
Generalization of placebo and nocebo effects on somatosensory sensations
In clinical settings, a patient’s previous positive and negative experiences of symptoms and treatment can carry across symptoms and across treatments. This transferability from prior experience to a new situation is called generalization, and is a form of adaptive learning. Generalization effects in clinical practice have been experimentally studied in placebo and nocebo effects, which are beneficial and adverse effects that do not arise from active treatment components.
Lingling Weng’s thesis focuses on generalization of placebo and nocebo effects between itch and pain in healthy people. She investigated the mechanisms underlying placebo effects and nocebo effects in itch and pain, and explored common and specific expectation mechanisms in physical symptoms of pain and itch.
Learning to Perceive
Psychological and neural processes underlying placebo and nocebo effects on cutaneous sensations
Expectations hold the power to shape our conscious experience in profound ways. Placebo and nocebo effects on sensations like pain and itch are one manifestation of this process, altering our sensory perception for better or worse.
In his dissertation, Joe Blythe aimed to advance our understanding of the psychological and neural processes that shape the magnitude of these effects. Using meta-analysis, behavioral research, imaging with EEG and pharmacological fMRI, he sought to identify psychological mechanisms that predict placebo and nocebo magnitudes, and neural markers that elucidate how top-down expectations integrate with bottom-up sensory inputs to form our sensory experience.
Health psychologist Liesbeth van Vliet received International recognition for her research on doctor-patient communication in the setting of advanced, life-limiting illnesses. She has been awarded the Post-Doctoral Research Award at the European Association for Palliative Care (EAPC) World Congress in Rotterdam.
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Kaya Peerdeman has been granted the SIPS Early Career Award at the fourth international conference of the Society for Interdisciplinary Placebo Studies in Duisburg, Germany. Central to Kaya Peerdeman's work are studies in the field of placebo effects that bridge fundamental and applied research, with a keen eye for potential clinical implications. Her versatility and methodological expertise are evident in her use of various research designs and methods.
Karacaoglu, M.; Meijer, S.; Peerdeman, K.J.; Dusseldorp, E.; Jensen, K.B.; Veldhuijzen, D.S.; van Middendorp, H. & Evers, A.W.M.
The current paper explores the psychological predictors of nocebo hyperalgesia and whether the reduction of nocebo hyperalgesia can be predicted by susceptibility to nocebo hyperalgesia and psychological characteristics.
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Thomaidou, M.A.; Blythe, J.S.; Peerdeman, K.J.; van Laarhoven, A.I.M.; Van Schothorst, M.M.E.; Veldhuijzen, D.S. & Evers, A.W.M.
In past decades, the field of nocebo research has focused on studying how sensory perception can be shaped by learning. Nocebo effects refer to aggravated sensory experiences or increased sensitivity to sensations such as pain and itch resulting from treatment-related negative experiences. Behavioral conditioning and verbal suggestions of a negative treatment outcome may aggravate pain and itch perception. Gaining a comprehensive view of the magnitude of nocebo effects and contributing factors will help steer nocebo research toward fruitful directions for understanding complex sensory phenomena.
Skvortsova, A.; Veldhuijzen, D.S.; van Dillen, L.F.; Zech, H.; Derksen, S.M.J.C.; Sars, R.H.; Meijer, O.C.; Pijl, H. & Evers, A.W.M.
The objective of this study was to investigate whether placebo effect induced by pharmacological conditioning with intranasal insulin can affect glucose, insulin, C-peptide, hunger, and memory in patients with diabetes type 2 and healthy controls.
Van Lennep, J.P.A.; van Middendorp, H.; Veldhuijzen, D.S.; Peerdeman, K.J.; Blythe J.S.; Thomaidou, M.A.; Heyman, T. & Evers, A.W.M.
This study investigated for the first time the effects of individual and combined application of three learning techniques (verbal suggestions, classical conditioning, and observational learning) on placebo analgesia and extinction.
van Vliet, L.M., Stouthard, J., Gröschel, L.C., Meijers, M.C.
This study explored whether the effect of clinician-expressed empathy on patients' psychological outcomes is moderated by patient ethnicity using an experimental video-vignette design.
Sanders, J.J., Blanch-Hartigan, D., Ericson, J., Tarbi, E., Rizzo, D., Gramling, R., van Vliet, L.
In this publication three methodological innovations to advance the basic science of serious illness communication are proposed.
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