Evidence for the additive effects of dispositional negative mood regulation expectancies and placebo-induced expectancies on mood recovery.

OBJECTIVE: Low negative mood regulation expectancies (NMRE) are associated with greater anticipated and experienced negative mood states, as well as with coping strategies that prolong these states. Individuals with low NMRE may be especially responsive to placebos because confidence in an external source of mood improvement can provide the positive mood expectancies and motivation for active coping that they typically lack. This study investigated how NMRE and placebo-induced expectancies contribute to mood recovery. METHOD: Participants (N = 125) completed personality scales, including NMRE, online. During a subsequent in-person session, participants were randomly assigned to one of three conditions: (1) placebo treatment-participants learned of a mood-enhancing treatment and received it; (2) treatment deprivation-participants learned of the same treatment, but did not receive it; (3) control-treatment was never mentioned. Participants also completed measures of mood, active coping, and expectations. RESULTS: NMRE was a stronger predictor of mood recovery than placebo-induced expectancies regardless of group assignment. Additionally, pessimistic expectations arose when participants believed treatment was being deprived, and these participants exhibited the least active coping. CONCLUSION: Our results confirm the reliability of NMRE in predicting affective outcomes and suggest that personality and placebo-induced expectations have additive effects on mood recovery.

INFLUENCE OF STUDY DESIGN ON TREATMENT RESPONSE IN ANXIETY DISORDER CLINICAL TRIALS.

OBJECTIVE: The influence of study design variables and publication year on response to medication and placebo was investigated in clinical trials for social anxiety disorder (SAD), generalized anxiety disorder (GAD), and panic disorder (PD). METHOD: Hierarchical linear modeling determined whether publication year, treatment assignment (medication vs. placebo), study type (placebo-controlled or active comparator), study duration, and the number of study visits affected the mean change associated with medication and placebo. RESULTS: In the 66 trials examined, the change associated with both medication and placebo increased over time (t = 4.23, df = 39, P < .001), but average drug-placebo differences decreased over time (t = -2.04, df = 46, P = .047). More severe baseline illness was associated with greater drug-placebo differences for serotonin norepinephrine reuptake inhibitors (SNRIs, t = 3.46, df = 106, P = .001) and selective serotonin reuptake inhibitors (SSRI, t = 10.37, df = 106, P < .001). Improvement with medication was significantly greater in active-comparator studies compared to placebo-controlled trials (t = 3.41, df = 39, P = .002). A greater number of study visits was associated with greater symptom improvement in PD trials relative to SAD (t = 2.83, df = 39, P = .008) and GAD (t = 2.16, df = 39, P = .037). CONCLUSIONS: Placebo response is substantial in SAD, GAD, and PD trials, and its rise over time has been associated with diminished drug-placebo differences. Study design features that influence treatment response in anxiety disorder trials include patient expectancy, frequency of follow-up visits, and baseline illness severity.

Gender Differences in the Social Cost of Affective Deviance.

The current study tested whether men and women receive different degrees of social punishment for violating norms of emotional expression. Participants watched videos of male and female targets (whose reactions were pre-tested to be equivalent in expressivity and valence) viewing either a positive or negative slideshow, with their emotional reaction to the slideshow manipulated to be affectively congruent, affectively incongruent, or flat. Participants then rated the target on a number of social evaluation measures. Displaying an incongruent emotional expression, relative to a congruent one, harmed judgments of women more than men. Women are expected to be more emotionally expressive than men, making an incongruent expression more deviant for women. These results highlight the importance of social norms in construing another person's emotion displays, which can subsequently determine acceptance or rejection of that person.