Brain Mechanisms of the Placebo Effect: An Affective Appraisal Account

Posted: 15 May 2017

See all articles by Yoni Ashar

Yoni Ashar

University of Colorado at Boulder

Luke Chang

Dartmouth College

Tor Wager

University of Colorado at Boulder

Date Written: May 2017

Abstract

Placebos are sham medical treatments. Nonetheless, they can have substantial effects on clinical outcomes. Placebos depend on a person's psychological and brain responses to the treatment context, which influence appraisals of future well-being. Appraisals are flexible cognitive evaluations of the personal meaning of events and situations that can directly impact symptoms and physiology. They also shape associative learning processes by guiding what is learned from experience. Appraisals are supported by a core network of brain regions associated with the default mode network involved in self-generated emotion, self-evaluation, thinking about the future, social cognition, and valuation of rewards and punishment. Placebo treatments for acute pain and a range of clinical conditions engage this same network of regions, suggesting that placebos affect behavior and physiology by changing how a person evaluates their future well-being and the personal significance of their symptoms.

Suggested Citation

Ashar, Yoni and Chang, Luke and Wager, Tor, Brain Mechanisms of the Placebo Effect: An Affective Appraisal Account (May 2017). Annual Review of Clinical Psychology, Vol. 13, pp. 73-98, 2017. Available at SSRN: https://ssrn.com/abstract=2967817 or http://dx.doi.org/10.1146/annurev-clinpsy-021815-093015

Yoni Ashar (Contact Author)

University of Colorado at Boulder ( email )

1070 Edinboro Drive
Boulder, CO 80309
United States

Luke Chang

Dartmouth College ( email )

Department of Sociology
Hanover, NH 03755
United States

Tor Wager

University of Colorado at Boulder ( email )

Boulder, CO

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