The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia

Abstract

Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can cause these effects. Especially studies using subliminal stimulus presentation and implicit conditioning (i.e., without contingency awareness) that bypass the development of explicit expectation suggest that conditioning without explicit expectation can lead to placebo and nocebo effects in pain perception. Because only few studies have investigated clinical samples, the picture seems less clear when it comes to patient populations with chronic pain. However, conditioning appears to be a promising means to optimize treatment. In order to get a better insight into the mechanisms of placebo and nocebo effects in pain and the possible benefits of conditioning compared to explicit expectation, future studies should carefully distinguish both methods of induction.

Autoren

Anne-Kathrin Bräscher
Michael Witthöft
Susanne Becker

DOI

10.1155/2018/6841985

eISSN

1918-1523

ISSN

1203-6765

Zeitschrift

Pain Research and Management

Sprache

en

Paginierung

1 - 8

Datum der Veröffentlichung

2018

Status

Published

Herausgeber

Hindawi Limited

Herausgeber URL

http://dx.doi.org/10.1155/2018/6841985

Datum der Datenerfassung

2019

Titel

The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia

Ausgabe der Zeitschrift

2018

Datenquelle: Crossref

Abstract

Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can cause these effects. Especially studies using subliminal stimulus presentation and implicit conditioning (i.e., without contingency awareness) that bypass the development of explicit expectation suggest that conditioning without explicit expectation can lead to placebo and nocebo effects in pain perception. Because only few studies have investigated clinical samples, the picture seems less clear when it comes to patient populations with chronic pain. However, conditioning appears to be a promising means to optimize treatment. In order to get a better insight into the mechanisms of placebo and nocebo effects in pain and the possible benefits of conditioning compared to explicit expectation, future studies should carefully distinguish both methods of induction.

Addresses

Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany.

Autoren

Anne-Kathrin Bräscher
Michael Witthöft
Susanne Becker

DOI

10.1155/2018/6841985

eISSN

1918-1523

Externe Identifier

PubMed Identifier: 29670678
PubMed Central ID: PMC5833150

Open access

true

ISSN

1203-6765

Zeitschrift

Pain research & management

Schlüsselwörter

Humans
Pain
Hyperalgesia
Pain Perception
Nocebo Effect
Conditioning, Psychological

Sprache

eng

Medium

Electronic-eCollection

Online publication date

2018

Open access status

Open Access

Paginierung

6841985

Datum der Veröffentlichung

2018

Status

Published

Publisher licence

CC BY

Datum der Datenerfassung

2018

Titel

The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia.

Sub types

review-article
Review
Journal Article

Ausgabe der Zeitschrift

2018

Files

http://downloads.hindawi.com/journals/prm/2018/6841985.pdf https://europepmc.org/articles/PMC5833150?pdf=render

Datenquelle: Europe PubMed Central

Abstract

Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can cause these effects. Especially studies using subliminal stimulus presentation and implicit conditioning (i.e., without contingency awareness) that bypass the development of explicit expectation suggest that conditioning without explicit expectation can lead to placebo and nocebo effects in pain perception. Because only few studies have investigated clinical samples, the picture seems less clear when it comes to patient populations with chronic pain. However, conditioning appears to be a promising means to optimize treatment. In order to get a better insight into the mechanisms of placebo and nocebo effects in pain and the possible benefits of conditioning compared to explicit expectation, future studies should carefully distinguish both methods of induction.

Date of acceptance

2017

Autoren

Anne-Kathrin Bräscher
Michael Witthöft
Susanne Becker

Autoren-URL

https://www.ncbi.nlm.nih.gov/pubmed/29670678

DOI

10.1155/2018/6841985

eISSN

1918-1523

Externe Identifier

PubMed Central ID: PMC5833150

Zeitschrift

Pain Res Manag

Schlüsselwörter

Conditioning, Psychological
Humans
Hyperalgesia
Nocebo Effect
Pain
Pain Perception

Sprache

eng

Country

United States

Paginierung

6841985

Datum der Veröffentlichung

2018

Status

Published online

Datum, an dem der Datensatz öffentlich gemacht wurde

2018

Titel

The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia.

Sub types

Journal Article
Review

Ausgabe der Zeitschrift

2018

Datenquelle: PubMed

Author's licence

CC-BY

Autoren

Anne-Kathrin Bräscher
Michael Witthöft
Susanne Becker

Hosting institution

Universitätsbibliothek Mainz

Sammlungen

JGU-Publikationen

Resource version

Published version

URN

urn:nbn:de:hebis:77-publ-587978

DOI

10.1155/2018/6841985

Funding acknowledgements

DFG, Open Access-Publizieren Universität Mainz / Universitätsmedizin

File(s) embargoed

false

Open access

true

ISSN

1918-1523

Zeitschrift

Pain research & management

Schlüsselwörter

150 Psychologie
150 Psychology

Sprache

eng

Open access status

Open Access

Paginierung

Art. 6841985

Datum der Veröffentlichung

2018

Public URL

https://openscience.ub.uni-mainz.de/handle/20.500.12030/279

Herausgeber

Hindawi Publishing Corporation

Herausgeber URL

http://dx.doi.org/10.1155/2018/6841985

Datum der Datenerfassung

2019

Datum, an dem der Datensatz öffentlich gemacht wurde

2019

Zugang

Public

Titel

The underestimated significance of conditioning in placebo hypoalgesia and nocebo hyperalgesia

Ausgabe der Zeitschrift

2018

Files

58797.pdf

Datenquelle: OPENSCIENCE.UB

The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia

Files

Files

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