The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia
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 learni...
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| Language: | English |
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Wiley
2018-01-01
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| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2018/6841985 |
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| author | Anne-Kathrin Bräscher Michael Witthöft Susanne Becker |
| author_facet | Anne-Kathrin Bräscher Michael Witthöft Susanne Becker |
| author_sort | Anne-Kathrin Bräscher |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3e0a5f5931204946b6a970ce2d6800b9 |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-3e0a5f5931204946b6a970ce2d6800b92025-02-03T01:09:33ZengWileyPain Research and Management1203-67651918-15232018-01-01201810.1155/2018/68419856841985The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo HyperalgesiaAnne-Kathrin Bräscher0Michael Witthöft1Susanne Becker2Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, GermanyDepartment for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, GermanyDepartment of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, GermanyPlacebo 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.http://dx.doi.org/10.1155/2018/6841985 |
| spellingShingle | Anne-Kathrin Bräscher Michael Witthöft Susanne Becker The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia Pain Research and Management |
| title | The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia |
| title_full | The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia |
| title_fullStr | The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia |
| title_full_unstemmed | The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia |
| title_short | The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia |
| title_sort | underestimated significance of conditioning in placebo hypoalgesia and nocebo hyperalgesia |
| url | http://dx.doi.org/10.1155/2018/6841985 |
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