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At least 19 recordsLinked to original sources
PubMed2026

Redefining the real problem in psychedelic trials: Why fighting the Lessebo matters more than blinding integrity.

Imperfect blinding is not specific to psychedelic trials. In randomized trials, treatment allocation is frequently correctly guessed, yet blinding integrity is rarely assessed outside of psychedelic research and is generally not considered a barrier in regulatory evaluation. The intense debate in psychedelics may reflect a broader double standard affecting mental health research, when uncertainties arising from imperfect blinding are confounded by those linked to patient-reported outcome measures. Indeed, people living with mental disorders are often viewed as unreliable reporters, despite well-documented limitations of clinician-rated scales and the absence of robust biological markers of symptomatic change. Importantly, it is the maintenance of reasonable doubt of treatment allocation that sustains internal validity and ethical feasibility of placebo-controlled designs, rather than perfect blinding. Concerns about expectancy bias in psychedelic trials are closely tied to blinding debates. When allocation is inferred, expectations may cluster in the arm perceived as active or in stereotyped experiences and influence outcomes differently in active and control arms, leading to a risk of lessebo, a negative placebo effect due to the negative expectation related to receiving a placebo. However, we argue that an underrecognized mechanism of lessebo is disappointment. This risk may reflect insufficient clinical management of disappointment rather than pre-treatment expectation alone. We therefore propose shifting the emphasis from preserving inevitably imperfect blinding towards mitigating disappointment in both arms. Establishing non-stereotyped expectations prior to treatment through structured psychoeducation, strengthened therapeutic alliance, and realistic preparation would help avoid lessebo effects. Such strategies would enhance ethical rigor, interpretability, and the clinical usefulness of psychedelic trials.

Humans↗
PubMed2026

Blinding integrity in psychedelic research: Evidence from a comparative randomized controlled trial of psilocybin, MDMA, and methylphenidate in healthy volunteers.

Maintaining effective blinding is a major methodological challenge in psychedelic research. This study provides a comprehensive evaluation of blinding integrity in 120 healthy volunteers who received either psilocybin, MDMA, or methylphenidate (active placebo) in a double-blind, randomized controlled trial. Using a multi-level assessment incorporating forced-choice substance guesses, certainty ratings, decision factors, and subjective substance effects, the analyses characterize blinding integrity and its relation to the substance experience. Results indicate that overall blinding was insufficient, with psilocybin showing the highest rates of functional unblinding, MDMA moderate levels, and methylphenidate the lowest. As an active placebo, methylphenidate provided more effective blinding for MDMA than for psilocybin. Incorporating certainty levels of substance guesses revealed a more differentiated pattern, with lower functional unblinding rates. Decision factors and subjective substance experiences were associated with phenomenological substance effects. Prior substance experiences did not influence accuracy of forced-choice substance guesses. These findings provide empirical guidance for the design and reporting of blinding procedures in psychedelic trials and underscore the value of systematic, multi-level assessment of blinding integrity.

Humans↗
PubMedDate not supplied

A sensory-integration program for blind campers.

An occupational therapy pilot program with emphasis on sensory integration was introduced into a six-week day camp for 18 blind children. The therapist screened and assessed the children through a number of tests that did not require sight. A treatment session was held five mornings each week that stressed individual therapy, and involved balance, movement, and body form concepts. The campers' performance improved in vestibular integration, in lessening of fear of movement, and, in some, in improved integration of reflexes. Plans have been made to continue the program in succeeding summers.

Adolescent↗
PubMed1979

Sensory integration in the rehabilitation of blind adults.

Learning difficulties displayed by the blind adult prompted an investigation of a link with sensory integrative dysfunction. A review of the literature provided evidence that tactile and vestibular deficiencies were prevalent within this population. Through observational assessment, sensory integrative dysfunction was identified in a number of clients and individual sensory integrative treatment programs were initiated. In the three case studies presented, improvements were noted in mobility, activities of daily living, handwriting, and behaviour after six months of treatment. A discussion is provided on those deficit areas responding to sensory integrative treatment.

Activities of Daily Living↗
PubMed1975

[The blind as a factor in the labour divisioned world (author's transl)].

The problems faced by blind adolescents when leaving special schools to enter employment differ considerably from those encountered by people who lost their sight during adulthood. The realisation of the fact that their blindness leaves little occupational choice often results in job apathy. It is, however, especially work capacity and occupational activity which serve again and again, in discussions on the full integration of the blind, as proof of the visually impaired's equal position within society. In particular W. Thimm has proved that blindness has a decisive impact on the social position of the individual blind person as well as the whole disability group of the blind, because this is essentially determinated by the employment status. The individual job performance of some blind is generalised too rapidly. The fear that jobs carried out by the blind are jeopardised by the increasing automation is certainly not unfounded, especially in large enterprises. At present, however, it is not possible to make a prognosis on whether in the future job opportunities for the blind will be available or not in certain branches of industry or in specific branches of production (this varies from one firm to another and is dependent upon many other factors). Consequently, it seems to be necessary for institutions involved in the vocational training of the blind to adjust in due course to the new situation in the theoretical and practical implementation of rehabilitation.

Blindness↗
PubMed1990

Computer access for persons who are blind or visually impaired: human factors issues.

Suitably adapted computers hold considerable potential for integrating people who are blind or visually impaired into the mainstream. The principal problems that preclude the achievement of this potential are human factors issues. These issues are discussed, and the problems presented by icon-based interfaces are reviewed. An argument is offered that these issues, which ostensibly pertain to the blind or visually impaired user, are fundamental issues confronting all users. There is reason to hope that the benefits of research into the human factors issues of people with vision impairments will also extend to the sighted user.

Blindness↗
PubMed1988

Electroencephalographic activity and plasma ACTH during ethanol-induced euphoria.

Covariance of brain electrical activity (EEG), plasma adrenocorticotrophic hormone (ACTH) and cortisol levels, and mood states were determined for healthy adult men during the first 2 hr after ingestion of ethanol or ethanol placebo under controlled double-blind conditions. Analysis of integrated plasma ACTH and cortisol levels at 5-min intervals, EEG power spectral analysis during consecutive 2-min epochs, and continuous assessment of mood states with a nonverbal instrumental device were carried out during the ascending phase of the blood ethanol curve. Ethanol induced rapid changes in brain electrical activity and plasma ACTH levels that were significantly correlated with subjective perception of changes in mood. The paroxysmal short epochs of euphoria associated with electroencephalographic and ACTH responses during the ascending phase of the blood ethanol curve may reflect physiological concomitants of pharmacological and behavioral reinforcers that enhance risk for perpetuation of drinking and alcohol abuse.

Adrenocorticotropic Hormone↗
PubMed1989

Conjunctive search for one and two identical targets.

The assumptions of feature integration theory as a blind, serial, self-terminating search (SSTS) mechanism are extended to displays containing 2 identical targets. The SSTS predicts no differences in negative-response displays, which require an exhaustive search of the display. Quantitative predictions are confirmed for the positive responses, but not for the negatives, suggesting that the SSTS model is incorrect. Two possible explanations for the results in the negative conditions, differential search rates and early quitting in the negatives, are rejected. It is suggested that using any self-terminating search mechanism will lead to difficulty in interpreting the results, including accounts for which the search is parallel over small groups of items. A resource-limited parallel model, which is based on the diffusion model of Ratcliff (1978), appears to fit the data well.

Adult↗
PubMed1990

Fitting a prosthesis over phthisis bulbi or discolored blind eyes.

An ocular prosthesis fitted over phthisis bulbi or a discolored blind eye of near normal size is a positive approach to improve the cosmetic appearance and psychological well-being of the patient. Unless surgical intervention is essential, fitting a prosthesis over the residual eye is a successful alternative to enucleation or evisceration. In general, for these individuals there is minimal disruption of the periocular tissues, thus, reducing fitting problems associated with enucleation and evisceration. A prosthesis properly fitted over phthisis bulbi or a discolored blind eye will maintain the integrity of the orbital anatomy, enhance cosmesis, and accelerate the rehabilitation of the patient.

Blindness↗
PubMed1979

Integrating the physically handicapped child.

This paper will serve several purposes: (1) to provide information on the incidence of physically handicapped children (exclusive of the blind and deaf) who are likely to be integrated into schools for normal non-physically impaired children, (2) to describe briefly the major handicapping conditions and their educational implications, (3) to comment on why integration has come about and why it promises to enrich the lives of normal children, (4) to suggest how physicians, physical therapists, and occupational therapists might help to make schools programs successful, (5) to comment briefly on financial implications of this program and to suggest ways in which the complexity of the medical management might be simplified, (6) to provide factual knowledge about the handicapped child and his potential to teachers who are already on the firing line to "improve" the academic achievement of the alleged normal child.

Arthritis, Juvenile↗
PubMed1992

The role of international non-governmental organisations in dealing with cataract blindness in developing countries.

The international non-governmental organisations (INGOs) dealing with the prevention and cure of blindness in developing countries are closely networked with each other and are an integral part of the International Agency for the Prevention of Blindness (IAPE) and the World Health Organization (WHO) Global Programme for the Prevention of Blindness. As operable cataract accounts for more than half of world blindness. As operable cataract accounts for more than half of world blindness the INGOs have a particular interest in this blinding condition which took on major proportions with the eye camp movement in South Asia from the end of the 1960s. Despite this initiative, and the use of paramedic cataract surgeons in many African countries, the volume of cataract surgery is being outstripped by increased incidence arising from greater longevity as a product of improved general health. Among the options facing the INGOs in the 1991s are the increased utilisation of eye beds through year round surgery in South Asia and shorter post-operative hospital occupancy and the possibility of putting lens implantation surgery within the economic reach of INGOs and partner NGOs and governments.

Africa↗
PubMedDate not supplied

The OR and significance.

A brief review was conducted of past and current research and theory as well as future implications of the problem of significance and the OR. Research and theory in the field is judged to be at a choice point: advance to interesting and important problems integrated with biobehavioral research or enter a blind alley of pseudo-problems derived from computer metaphors and cognitive folk psychology.

Animals↗
PubMedDate not supplied

The role of instruction and a brushing device on the oral hygiene of blind children.

A brushing device using the tactile ability of blind children was compared to the use of a toothbrush. The experimental group consisted of 18 blind children, 7-14 years old; controls consisted of two groups of sighted classmates of the blind children. All children studied together in an integrated school and were match-paired. The brushing device was made from a valcran strip worn on a fingertip and used for cleaning the tooth surfaces. The experiment was conducted for 36 weeks with alternating periods of reinforcement and non-reinforcement. General oral hygiene improved after instruction and declined after non-reinforcement periods. The performance of the blind children improved with the cleaning device. The device was also helpful in developing a sense of "tooth cleanliness" and could be used as a pre-learning aid to prepare the blind children to efficiently use a toothbrush. Instruction followed by individual supervision and reinforcement will encourage all children to improve their oral hygiene level.

Adolescent↗
PubMed1975

Betamethasone valerate in corticosteroid-dependent asthmatics. The integrity of the hypothalamic pituitary adrenal axis.

In a single-blind trial 29 patients with corticosteroid-dependent asthma reduced their daily dose of oral prednisolone by 1 mg/week while using a placebo inhaler until an unacceptable degree of asthma occurred. Betamethasone-17-vlaerate in a dose of 800 mug/day and if necessary 1600 mug/day was then substituted for the placebo inhaler and the reduction of oral prednisolone continued until the prednisolone was withdrawn completely or an unacceptable degree of asthma recurred. In 22 patients (76%) prednisolone was withdrawn completely, 11 on 800 mug and 11 on 1600 mug betamethasone-17-valerate. The mean reduction of prednisolone was 3-8 mg on placebo, 5-4 mg on 800 mug and a further 1-8 mg in patients requiring 1600 mug of betamethasone-17-valerate. The hypothalamic pituitary adrenal (HPA) axis was assessed by tetracosactrin and insulin stress tests at the start of the study and after withdrawal of oral prednisolone. The results indicate that an HPA axis which is completely suppressed by systemic corticosteroids can regain normal integrity when the systemic steroid is replaced by betamethasone-17-valerate in a dose of either 800 mug/day or 1600 mug/day. Candidiasis was observed, but will be reported later.

Adrenal Glands↗
PubMed1991

Points of action in the campaign against blindness in developing countries.

This article provides a survey of the problems of prevention of blindness in developing countries. The World Health Organization estimates that 31 million people are blind and 15 million people partially-sighted. The main cause of blindness is cataract. Other causes are trachoma, glaucoma, xerophthalmia, river blindness, corneal scars and leprosy. Prevention or treatment of these causes is possible in more than 80% of cases. The number of blind persons, however, is still increasing due to the increase in population and the immense shortage of all kinds of ophthalmological equipment and personnel. An effective strategy for the prevention of blindness in developing countries should focus on: more cheap cataract operations, increasing teaching facilities for ophthalmic personnel, integration of ophthalmic care into the general health system and the promotion of blindness prevention in political organizations.

Blindness↗
PubMed1990

[Visual loss and prejudice].

Major or complete loss of eyesight is a serious interference with the activity and life of the affected subject. It is generally assumed that these subjects are quite helpless and that they suffer general deterioration. This is at variance with results of training and rehabilitation during which many thus affected subjects become independent, which is essential for their social integration. Despite this they have to experience sociopsychological attitudes which are prejudices with a typical stereotype which ignore the unique structure of everybody's potential who lost eyesight. The source of prejudices is general lack of information of people as regards actual sequelae of loss of eyesight and the emotional reaction of people with normal eyesight. A certain part is also played by tradition which does not take into account results of modern care of thus affected subjects. Prejudices cause in subjects with severely affected eyesight and in blind persons mental stress and render their actual social integration (employment, partnership etc.) more difficult. The solution is to train resistance against prejudices in thus affected subjects and to intensify health education on the given problem.

Attitude↗