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Unconscious emotional reasoning and the therapeutic misconception
  1. A Charuvastra1,
  2. S R Marder2
  1. 1
    NYU Child Study Center, New York City, New York, USA
  2. 2
    UCLA Psychiatry & Biobehavioral Science, West Los Angeles Healthcare Center, Los Angeles, California, USA
  1. Dr A Charuvastra, NYU Child Study Center, 577 First Ave. New York, New York 10016, USA; ACharuvastra{at}


The “therapeutic misconception” describes a process whereby research volunteers misinterpret the intentions of researchers and the nature of clinical research. This misinterpretation leads research volunteers to falsely attribute a therapeutic potential to clinical research, and compromises informed decision making, therefore compromising the ethical integrity of a clinical experiment. We review recent evidence from the neurobiology of social cognition to provide a novel framework for thinking about the therapeutic misconception. We argue that the neurobiology of social cognition should be considered in any ethical analysis of how people make decisions about participating in clinical trials. The neurobiology of social cognition also suggests how the complicated dynamics of the doctor-patient relationship may unavoidably interfere with the process of obtaining informed consent. Following this argument we suggest new ways to prevent or at least mitigate the therapeutic misconception.

  • therapeutic misconception
  • psychiatry
  • social cognition
  • clinical trial
  • ethics

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  • Competing interests: None.

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