Heather M. Rasinski

Why does choice enhance treatment effectiveness? Using placebo treatments to demonstrate the role of personal control

In modern health care, individuals frequently exercise choice over health treatment alternatives. A growing body of research suggests that when individuals choose between treatment options, treatment effectiveness can increase, although little experimental evidence exists clarifying this effect. Four studies were conducted to test the hypothesis that exercising choice over treatment alternatives enhances outcomes by providing greater personal control. Consistent with this possibility, in Study 1 individuals who chronically desired control reported less pain from a laboratory pain task when they were able to select between placebo analgesic treatments. Study 2 replicated this finding with an auditory discomfort paradigm. In Study 3, the desire for control was experimentally induced, and participants with high desire for control benefited more from a placebo treatment when they were able to choose their treatment. Study 4 revealed that the benefit of choice on treatment efficacy was partially mediated by thoughts of personal control. This research suggests that when individuals desire control, choice over treatment alternatives improves treatment effectiveness by enhancing personal control.

Choice and placebo expectation effects in the context of pain analgesia

The current experiment examined whether having choice over treatment options facilitates or inhibits the strength of placebo expectations in the context of pain perception. All participants were exposed to an aversive stimulus (i.e., the cold pressor task), and participants in some conditions were given expectations for two pain-relieving treatments (actually the same inert ointment mixture). Critically, participants in these expectation conditions were also given a choice or not about which of the two treatments they preferred to use. Participants in a control condition were not provided with a treatment expectation. Despite receiving the same inert treatment, participants who had a choice over treatments showed increased placebo analgesia as compared to participants not given a choice and participants in the control condition. Moreover, this effect was mediated by changes in anxiety. Explanations and implications for these results are discussed.

Concept priming and pain: an experimental approach to understanding gender roles in sex-related pain differences

Prior research has found that sex differences in pain are partially due to individual variations in gender roles. In a laboratory study, we tested the hypothesis that the presence of covert gender role cues can also moderate the extent to which women and men experience pain. Specifically, we varied gender role cues by asking male and female participants to write about instances in which they behaved in a stereotypically feminine, masculine, or neutral manner. Pain and cardiovascular reactivity to the cold pressor task were then assessed. Results revealed that, when primed with femininity, men reported less pain and anxiety from the cold pressor task than women. However, no differences existed between the sexes in the masculine or neutral prime conditions. The results indicate that covert gender cues can alter pain reports. Further, at least in some situations, feminine role cues may be more influential on pain reports than masculine role cues.

“I Guess What He Said Wasn’t That Bad” Dissonance in Nonconfronting Targets of Prejudice

Although confrontations can be an effective means of reducing prejudicial responding, individuals often do not confront others due to the interpersonal costs. In the present research, we examined the intrapersonal implications of not confronting prejudice. In three studies, female participants were exposed to a confederate who made a sexist remark. Consistent with self-justification theories, in Study 1, participants who valued confronting and were given the opportunity to confront—but did not—subsequently made more positive evaluations of the confederate. Study 2 found that when participants were given a chance to affirm an important aspect of the self prior to evaluating the confederate, these inflated evaluations of the confederate did not occur. Finally, in Study 3, participants who initially valued confronting but did not confront a sexist partner reduced the amount of importance they placed on confronting. These data reveal that there are important intrapersonal consequences of not confronting prejudice.

Choice as a Moderator of Placebo Expectation Effects: Additional Support From Two Experiments

Two experiments investigated the hypothesis that treatment choice enhances placebo treatment efficacy. In Experiment 1, prior to a pain task, participants were given either an expectation that two (inert) products could reduce pain or no expectation. In addition, participants either selected between the two products or were assigned a product to use. Participants given both the placebo expectation and treatment choice reported the lowest pain. Experiment 2 conceptually replicated this finding using a placebo paradigm with aversive auditory stimuli. Additional control conditions indicated that a choice availability (rather than choice restriction) explanation best accounted for these results.

Erratum to: Choice and placebo expectation effects in the context of pain analgesia

Concurrent pain ratings were made on an 11point scale (0 = no pain; 10 = worst possible pain) at four time points during the task (after 15, 30, 45, and 60 s). VAS (visual analogue scale) post-task pain ratings were made by marking 100-mm lines, anchored with no pain/not bad at all on the left side and worst pain possible/most unpleasant feeling possible on the right side. Anxiety ratings were made on a 7-point scale (1 = not at all anxious; 7 = very anxious). The reported means control for participant age, gender, and baseline pain ratings