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Cited by 208Pain Management and Placebo EffectPsychotherapy Techniques and ApplicationsAcupuncture Treatment Research Studies

Patient and practitioner influences on the placebo effect in irritable bowel syndrome.

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Kelley, John M., Lembo, Anthony J., Ablon, J Stuart, Villanueva, Joel J., Conboy, Lisa A., Levy, Ray, Marci, Carl D., Kerr, Catherine E. +4 more·2009·Psychosomatic Medicine
DOI 10.1097/psy.0b013e3181acee12PMC PMC2818141
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Abstract

OBJECTIVE: To determine whether placebo responses can be explained by characteristics of the patient, the practitioner, or their interpersonal interaction. METHODS: We performed an analysis of videotape and psychometric data from a clinical trial of patients with irritable bowel syndrome who were treated with placebo acupuncture in either a warm empathic interaction (Augmented, n = 96), a neutral interaction (Limited, n = 97), or a waitlist control (Waitlist, n = 96). We examined the relationships between the placebo response and a) patient personality and demographics; b) treating practitioner; and c) the patient-practitioner interaction as captured on videotape and rated by the Psychotherapy Process Q-Set. RESULTS: Patient extraversion, agreeableness, openness to experience, and female gender were associated with placebo response, but these effects held only in the augmented group. Regression analyses controlling for all other independent variables suggest that only extraversion is an independent predictor of placebo response. There were significant differences between practitioners in outcomes; this effect was twice as large as the effect attributable to treatment group assignment. Videotape analysis indicated that the augmented group fostered a treatment relationship similar to a prototype of an ideal healthcare interaction. CONCLUSIONS: Personality and gender influenced the placebo response, but only in the warm, empathic, augmented group. This suggests that, to the degree a placebo effect is evoked by the patient-practitioner relationship, personality characteristics of the patient will be associated with the placebo response. In addition, practitioners differed markedly in effectiveness, despite standardized interactions. We propose that the quality of the patient-practitioner interaction accounts for the significant difference between the groups in placebo response.

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  • Synchrony may influence the patient's beliefs indirectly, by increasing receptiveness to the therapist's suggestions.

    “Synchrony may influence the patient’s beliefs indirectly, by increasing receptiveness to the therapist’s suggestions (Tanner and Chartrand, 2008; Kelley et al., 2009).”

    From Synchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance (2016) · cites this paper as Kelley et al., 2009

    The Results (Effects of the Therapeutic Relationship) describe differences in practitioner behavior, and the Discussion links warm, empathic interaction to placebo outcomes. Neither passage addresses synchrony or whether it increases receptiveness to a therapist’s suggestions and thereby influences beliefs. Searches for synchrony, mimicry, receptiveness, suggestions, and beliefs found no passage establishing that mechanism. (LLM, conf=0.72)

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Research works printed but not linked: 36

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Authors
Kelley, J. M., Lembo, A. J., Ablon, J. S., Villanueva, J. J., Conboy, L. A., Levy, R., Marci, C. D., Kerr, C. E., Kirsch, I., Jacobson, E. E., Riess, H., & Kaptchuk, T. J.
Affiliations
Beth Israel Deaconess Medical Center (US)
Corresponding author
Kelley, John M.
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-09
Volume
71
Issue
7
Pages
789-797
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/psy.0b013e3181acee12
PMC
PMC2818141
OpenAlex
W2171518047
Cited by
208
References
8
Citations by year
2026: 7 · 2025: 4 · 2024: 4 · 2023: 9 · 2022: 10 · 2021: 16 · 2020: 9 · 2019: 12 · 2018: 12 · 2017: 15 · 2016: 19 · 2015: 12 · 2014: 22 · 2013: 16 · 2012: 14
FWCI
6.47
Type
journal article
Language
en
Open access
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (5r21at002564-02)
  • National Center for Complementary and Integrative Health (1R21 AT002564, K24AT004095, R01AT001414, R21 AT002564)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Complementary and alternative medicine › Acupuncture Treatment Research Studies
Keywords
placebo effect, irritable bowel syndrome, sham acupuncture, patient-practitioner interaction, empathic interaction, patient personality, extraversion, gender differences, therapeutic relationship, Psychotherapy Process Q-Set, videotape analysis
MeSH terms
Adult, Aged, Extraversion, Psychological, Female, Humans, Male, Middle Aged, Personality Inventory, Physician-Patient Relations, Quality of Life, Regression Analysis, Video Recording, Waiting Lists, Acupuncture Therapy, Placebo Effect, Randomized Controlled Trials as Topic, Treatment Outcome, Outcome Assessment, Health Care, Sex Distribution, Irritable Bowel Syndrome

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