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.     

Three constructions of transference in Freud, 1895-1915

Three distinct constructions of transference which have related though differentiable histories can be identified in Freud's writings. The postulation of discrete meta-psychological, clinical, and universal constructions was completed by 1915, although many significant revisions within those constructions were made thereafter. Most significant is the distinction drawn between the clinical and universal constructions which (while both are founded on the metapsychological construction) facilitates recognition of cultural critical uses of transference as distinct from the clinical transference phenomena and as applicable far beyond the confines of psychopathology.     

The self and eating disorders

In our review, we focus on self-related constructs in the context of eating disorders with four aims. First, we examine a variety of self-related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well-researched constructs of self-esteem and self-efficacy, we also report on findings related to selflessness, contingent self-worth, self-objectification, ego-syntonicity, self-concept clarity, self-compassion, social comparison, self-oriented perfectionism/self-criticism, and narcissism. Second, we discuss self-related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self-related constructs play a prominent role. Lastly, we share future research directions regarding self-related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders.     

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.     

Decolonizing the demarcation of the ethical

Philosophical Studies - The question of what distinguishes moral problems from other problems is important to the study of the evolution and functioning of morality. Many researchers concerned with...     

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...     

Inward- and Outward-Directed Violence in the Lives of Urban Minority Adults Followed from Middle School into Their Thirties

This study explores connections between inward-directed violence and outward-directed violence using data from the Reach for Health sample, which was originally recruited in the 1990s from three middle schools in economically distressed, predominantly African American neighborhoods of New York City. Now in their thirties, participants (N = 595) completed surveys assessing current suicidal thoughts and behaviors as well as other violence involvements, including intimate partner violence victimization and perpetration. About 10% of males and females reported any suicidal ideation or attempt in the past 12 months. In logistic regression analyses adjusting for sociodemographics, prior reports of feeling blue in middle school (OR: 1.12, CI: 1.02–4.39) and young adult suicidality (OR: 2.54, CI: 1.30–4.95) are significantly related to later suicidality. So are concurrent aggressive behaviors, including reports of physical fighting outside the home (OR: 2.70, CI: 1.29–5.67) and IPV perpetration (OR: 2.09, CI: 1.11–3.94). Neither IPV victimization nor witnessing neighborhood violence is correlated. Findings shed light on the persistence of suicidality in the lives of those who come of age, and often remain, in communities with high levels of poverty, and confirm linkages of suicidality with externally directed aggression. Life-stage interventions are needed to counter the interwoven causes and consequences of multiple forms of violence.