Affect and emotions in placebo and nocebo effects: What do we know so far?

Once considered nuisance variance in clinical trials, placebo effects and nocebo effects are now widely recognized as important and mutable psychobiological contributors to mental and physical health. Psychological theory explaining these effects emphasizes associative learning and conscious expectations. It has long been suggested, however, that affective states such as moods, emotions, and distress could play a significant role. In this paper, we draw together and review the empirical data linking affective states to placebo and nocebo effects. To organize this disparate literature, three questions are addressed: (1) Does pre‐existing state and trait affect modulate placebo and nocebo effects? (2) Does administering placebo and nocebo treatments change affective states, and if so, does the resulting affect causally influence placebo and nocebo effects? Finally, (3) Can placebo treatments be successfully employed as a regulation strategy to modulate different affective states? In reviewing the evidence in relation to these three questions, it is clear that affect does play a key role in placebo and nocebo effects in many circumstances, and further, there may be a reciprocal dynamic at play between a treatment event, affect, and placebo/nocebo effects. The paper concludes by discussing implications for theory and intervention and recommends future research priorities.     

Re-exposure to reinforcement in Context A during treatment in Context B reduces ABC renewal

Previous work from our laboratory showed that intermittently re-exposing rats to reinforcement for lever pressing in a training (A) context, while eliminating lever pressing in a second (B) context, increased ABA renewal of lever pressing relative to rats that experienced only Context B during response elimination. In the current study, we replicated these procedures while assessing renewal in the presence of a novel context (i.e., ABC renewal). Unlike the findings described above, renewal was reduced in the group that experienced re-exposure to Context A during lever-press elimination relative to rats that experienced only Context B. These findings suggest that alternating between contexts associated with reinforcement and extinction during treatment reduces the probability that organisms will respond in novel contexts. These outcomes may be the result of discrimination and/or generalization processes. Moreover, this training procedure may offer a potential mitigation strategy for ABC renewal.     

Guilt feelings and the intelligibility of moral duties

G.E.M. Anscombe argued that we should dispense with deontic concepts when doing ethics, if it is psychologically possible to do so. In response, I contend that deontic concepts are constitutive of the common moral experience of guilt. This has two consequences for Anscombe's position. First, seeing that guilt is a deontic emotion, we should recognize that Anscombe's qualification on her thesis applies: psychologically, we need deontology to understand our obligations and hence whether our guilt is warranted. Second, the fact that guilt is a deontic moral emotion debunks Anscombe's claim that deontic concepts are a relic of the Western, religious past: guilt feelings–hence the idea of moral duty as well–can be found in cultures without an ethics of divine command. Modern moral philosophers' interest in oughts and obligations is not an academic hobbyhorse, but a vital concern arising out of a primeval human emotion.     

Wittgenstein and Redundant Truth

Philosophia - In the Philosophical Investigations, Wittgenstein is sometimes claimed to hold a redundancy (or deflationary) theory of truth. The main evidence to support this view, however, comes...