I have recently read a bunch of articles about placebo effects and pain. In the case of pain, placebo effects can be remarkable. In fact, pain-sensitive brain regions are less active when people receive pain and a placebo, compared to the equivalent pain without a placebo. Furthermore, in anticipating pain with a placebo, pre-frontal control regions are more active, which may serve to regulate the experience of pain and/ or to trigger the body’s own anti-pain medication (opioids).

Interestingly, placebo effects can be both positive (as in you feel better after taking a non-active pill, receiving an irrelevant intervention), or negative (you feel side effects from taking the pill, just as with regular meds). Also, placebo effects are often dose-response, and can have time-effect curves, and carryover effects, just like active medications.

This brings me to the topic of mind body interaction. Many people in my department study these types of effects, and certainly don’t think of them as placebo. So, where is the line between placebo and mind-body treatments? Is it just the way we label them?

As a really cool example of mind-body interaction, check out Mike Irwin’s study (press release) of immune response to the virus that causes shingles. In this study, older adults who did tai chi (meditation through movement), had higher levels of immune functioning and quality of life scores than people in a wait-list control group. Interestingly, the effects of the tai chi intervention were additive with the shingles vaccine, such that older adults who received both the tai chi intervention and the vaccine had cell-mediated immune levels comparable to those of younger adults (who are at much lower risk for getting shingles as a result).

Some other articles about pain and placebo:

Turner et al. (1994): The Importance of placebo effects in pain treatment and research.

Hrobjartsson & Gotzsche (2001): Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment.

Stewart-Williams (2004): The placebo puzzle: Putting together the pieces.

Some other articles about Mind-Body stuff:

Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M., Boyers, A.E., Alferi, S.M., Carver, C. S., & Kumar, M. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding about women being treated for early stage breast cancer. Psychosomatic Medicine, 62(3), 304-308. (4 pages)

Davidson, R.J., Kabat-Zinn, J., Schumacher, J. Rosenkranz, M., Muller, D., Santorelli, S.F., Urganowski, R., Harrington, A., Bonus, K. & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570. (6 pages)

Storch, M., Gaab, J., Kuttel, Y., Stussi, A, & Fend, H. (2007). Psychoneuroendocrine effects of resource-activating stress management training. Health Psychology, 26(4), 456-463. (7 pages)