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25.09.2017

Warmth and competence enhance placebo effect

The placebo effect enhances the effects of food, supplements, physical exercise - and medicine. Medicines are more effective if the doctor prescribing them does so in a way that shows warmth and involvement. American psychologists at the University of Stanford write about this in Health Psychology.

Study
The researchers got 160 people to be treated by a woman doctor. She did a skin prick test with a little bit of histamine, which resulted in a small swelling. She then spread a cream that had no active ingredients on the swelling.

The doctor behaved in an aloof and incompetent manner with some participants. She didn't smile, she didn't use the patient's name, was clumsy with the medical procedure and spoke in a chaotic way. With the other participants the doctor behaved in a warm and competent way.

The figure below shows exactly how the doctor behaved and the combinations of behavioural patterns that she exhibited towards the patients. Click on the figure for a legible version.

The doctor told some of the participants that the cream would soothe the swelling, thus creating positive expectations. With other participants the doctor said things that would create negative expectations.

Results
The size of the swelling after applying cream depended primarily on the expectations that the doctor had created. If the expectations were negative the cream was not effective. If the doctor created positive expectations, the cream did work.

At least, if the doctor behaved in a competent or warm way, or better was both competent and warm.

Conclusion
"While this study was conducted in a laboratory setting with healthy participants, it has intriguing implications for the practice of medicine," the researchers wrote. "These possibilities could be elaborated on in future research in clinical contexts."

"First, this research suggests that cultivating both warmth and competence may improve medical care by strengthening the impact of a treatment."

"Second, as evidence for the role of expectations in improving medical treatment grows, physicians may be searching for ways to boost patient health outcomes by fostering positive expectations."

"This study suggests that, if physicians have a reason to hold positive expectations about a particular treatment, perhaps because it has a good record of success in the field, physicians may amplify the power of positive expectations by demonstrating warmth (likability) and competence (credibility) in their interactions with their patients."

"Of course, positive expectations are not a panacea for health care, and there are open questions about their limits, such as whether positive expectations may backfire if they are overly optimistic."

Source:
Health Psychol. 2017 Mar 9. doi: 10.1037/hea0000499. [Epub ahead of print].

More:
Empathetic doctors have higher cure rate 20.03.2012

Archives:
Placebo Effect
Psychology

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