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dc.contributor.authorJanssens, T.
dc.contributor.authorMeulders, A.
dc.contributor.authorColloca, L.
dc.date.accessioned2019-09-10T17:30:16Z
dc.date.available2019-09-10T17:30:16Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85071125668&doi=10.1097%2fPR9.0000000000000748&partnerID=40&md5=a3c8ab57c45be24d71e8d0016b35ddb9
dc.identifier.urihttp://hdl.handle.net/10713/10502
dc.description.abstractIntroduction: Research on learning in placebo and nocebo has relied predominantly on Pavlovian conditioning procedures. Operant learning procedures may more accurately model learning in real-life situations in which placebo and nocebo effects occur. Objectives: To investigate the development and persistence of placebo and nocebo effects using an operant avoidance learning task.Methods:Pain-free participants (n = 58) could learn to avoid pain by performing movements that differed in difficulty and intensity of painful stimulation. Participants performed movements in 2 contexts. In the high cost of avoidance context, pain stimulus intensity reduced with increasing movement difficulty. In the low cost of avoidance context, contingencies were reversed. Participants rated pain expectations and pain intensity. During test, movement difficulties were unchanged, but participants always received a medium-intensity pain stimulus. Placebo and nocebo effects were defined as lower/higher pain intensity ratings for trajectories that previously resulted in low/high-intensity compared with medium-intensity stimulation. Results: As expected, participants acquired differential movement-pain expectations and differential movement choices. Testing with a medium-intensity pain stimulus quickly erased differences in movement choice across contexts, but differences in pain expectations were maintained. Pain modulation across context was in line with movement-pain expectations. However, we only observed placebo effects within the low cost of avoidance context and found no evidence of nocebo effects. Conclusion: Operant learning can change pain expectations, pain modulation, and pain-related avoidance behavior. Persisting pain expectations suggest that acquired pain beliefs may be resistant to disconfirmation, despite self-initiated experience with novel pain-movement contingencies. Copyright 2019 The Author(s).en_US
dc.description.sponsorshipThis research was supported by the “Asthenes” long-term structural funding Methusalem grant by the Flemish Government, Belgium. A. Meulders is a postdoctoral researcher of the Research Foundation Flanders (FWO-Vlaanderen), Belgium (grant ID 12E3717N), and is supported by a Vidi grant from the Netherlands Organization for Scientific Research (NWO), the Netherlands (grant ID 452-17-002).en_US
dc.description.urihttps://doi.org/10.1097/PR9.0000000000000748en_US
dc.language.isoen-USen_US
dc.publisherLippincott Williams and Wilkinsen_US
dc.relation.ispartofPain Reports
dc.subjectAvoidanceen_US
dc.subjectExpectationsen_US
dc.subjectNoceboen_US
dc.subjectOperant learningen_US
dc.subjectPlaceboen_US
dc.titlePlacebo and nocebo effects and operant pain-related avoidance learningen_US
dc.typeArticleen_US
dc.identifier.doi10.1097/PR9.0000000000000748


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