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Advisor(s)
Abstract(s)
Background
The efficacy of open-label placebos (OLPs) has been increasingly demonstrated and their
use holds promise for applications compatible with basic ethical principles. Taking this concept one step further an imaginary pill (IP) intervention without the use of a physical pill was
developed and tested in a randomized controlled trial (RCT). To explore participants’ experiences and views, we conducted the first qualitative study in the field of IPs.
Methods
A reflexive thematic analysis (RTA) of semi-structured interviews with test anxious students
(N = 20) was nested in an RCT investigating an IP and OLP intervention. In addition, openended questions from the RCT were evaluated (N = 114) to corroborate the RTA and pill
characteristics were included to more accurately capture the IP experience.
Results
Four key themes were identified: (1) attitude towards the intervention, (2) applicability of the
intervention, (3) experience of effects, and (4) characteristics of the imagination. The IP
intervention was well-accepted, easily applicable, and various effects, pill characteristics
and appearances were described. While many participants did not desire a physical pill,
either due to the absence of the imagination component or aversion to pills, the approach
was considered to be cognitively and time demanding, which in turn, however, encouraged
the establishment of a therapeutic ritual that protected against the increase in test anxiety
during the preparation phase. OLP findings were comparable, and especially the importance of a treatment rationale was stressed in both groups, counteracting an initial ambivalent attitude. The RTA findings were supported by the open-ended questions of the RCT.IPs appear to be a well-accepted and easily applicable intervention producing a variety of
beneficial effects. Thus, the IP approach might serve as an imaginary based alternative to
OLPs warranting further investigations on its application to harness placebo effects without
a physical pill.
Description
Keywords
Citation
Buergler, S., Sezer, D., Busch, A., Enzmann, M., Bakis, B., Locher, C., Bagge, N., Kirsch, I., Carvalho, C., & Gaab, J. (2023). A qualitative study of imaginary pills and open-label placebos in test anxiety. PLoS ONE, 18(9), 1–22. https://doi.org/10.1371/journal.pone.0291004
Publisher
Public Library of Science