How does one explain the power of placebo effects in medication and psychotherapy research? Why do people with medical illnesses who strongly anticipate getting better really do? Response expectancies, those unconscious subjective expectations about substances, processes, and social stimuli, actually effect autonomic functioning and may be the key to how we ultimately understand the biochemistry of hope.

In this ground-breaking volume, the pioneer of research in response expectancies, Irving Kirsch, brings together prominent scientists who have studied this effect in human function and dysfunction over the past decade and practitioners who have applied these findings to enhance the effectiveness of both pharmacological and psychological treatment. They have extended our understanding of how response expectancies account for symptom maintenance, motivation, and change in such diverse areas as asthma, substance abuse, sexual dysfunction, and smoking. Their often surprising findings point to expectancy modification as a key to enhancing effectiveness of treatment and prevention across settings and theoretical orientations.

Table of Contents



Response Expectancy: An Introduction
—Irving Kirsch

I. Theoretical Foundations

  1. Expectations and the Social–Cognitive Perspective: Basic Principles, Processes, and Variables
    —James E. Maddux
  2. Expectancy Operation: Cognitive–Neural Models and Architecture
    —Mark S. Goldman

II. Function and Dysfunction

  1. Mood-Related Expectancy, Emotional Experience, and Coping Behavior
    —Salvatore J. Catanzaro and Jack Mearns
  2. Expectancies and Memory: Inferring the Past From What Must Have Been
    —Edward R. Hirt, Steven Jay Lynn, David G. Payne, Elisa Krackow, and Sean M. McCrea
  3. Expectancy and Fear
    —Nancy E. Schoenberger
  4. Expectation and Desire in Pain and Pain Reduction
    —Donald D. Price and James J. Barrell
  5. Response Expectancy and Sexual Dysfunction in Women
    —Eileen M. Palace
  6. Expectancy and Asthma
    —Samantha C. Sodergren and Michael E. Hyland

III. Substance Expectancies and Substance Abuse

  1. Expectancy and Behavioral Effects of Socially Used Drugs
    —M. Vogel-Sprott and Mark T. Fillmore
  2. Expectancy Meditation of Biopsychosocial Risk for Alcohol Use and Alcoholism
    —Mark S. Goldman, Jack Darkes, and Frances K. Del Boca
  3. Expectancies for Tobacco Smoking
    —Thomas H. Brandon, Laura M. Juliano, and Amy L. Copeland

IV. Specifics of Nonspecific Effects

  1. Listening to Prozac but Hearing Placebo: A Meta-Analysis of Antidepressant Medications
    —Irving Kirsch and Guy Sapirstein
  2. Is the Placebo Effect Dependent on Time? A Meta-Analysis
    —Harald Walach and Catharina Maidhof
  3. Expectations of Sickness: Concept and Evidence of the Nocebo Phenomenon
    —Robert A. Hahn
  4. Expectancies: The Ignored Common Factor in Psychotherapy
    —Joel Weinberger and Andrew Eig
  5. Hypnosis and Response Expectancies
    —James R . Council

Author Index

Subject Index

About the Editor

Editor Bio

Irving Kirsch, PhD, is a professor of psychology at the University of Connecticut. The concept of response expectancy was first introduced in his 1985 American Psychologist article, titled "Response Expectancy as a Determinant of Experience and Behavior."

A former president of APA's Division 30, Dr. Kirsch is the author or editor of 5 books, including Changing Expectations: A Key to Effective Psychotherapy (Brooks/Cole, 1990), which was the first full explication of response expectancy theory. In addition, he has authored 29 book chapters and more than 130 journal articles on placebo effects, hypnosis, psychotherapy, history of psychology, and philosophy of science.

His work has been published in American Psychologist, Psychological Bulletin, Behavioral and Brain Sciences, Psychological Science, and other leading journals. In addition, his work has received extensive coverage in Science, Lancet, The New York Times, Smithsonian, and New Scientist and on national and international radio and television programs.

Dr. Kirsch is the North American Editor of Contemporary Hypnosis and a member of the editorial boards of the International Journal of Clinical and Experimental Hypnosis, American Journal of Clinical Hypnosis, and Hypnosis International Monographs.