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    Placebo and nocebo effects: The advantage of measuring expectations and psychological factors

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    Author
    Corsi, N.
    Colloca, L.
    Date
    2017
    Journal
    Frontiers in Psychology
    Publisher
    Frontiers Research Foundation
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://www.doi.org/10.3389/fpsyg.2017.00308
    Abstract
    Several studies have explored the predictability of placebo and nocebo individual responses by investigating personality factors and expectations of pain decreases and increases. Psychological factors such as optimism, suggestibility, empathy and neuroticism have been linked to placebo effects, while pessimism, anxiety and catastrophizing have been associated to nocebo effects. We aimed to investigate the interplay between psychological factors, expectations of low and high pain and placebo hypoalgesia and nocebo hyperalgesia. We studied 46 healthy participants using a well-validated conditioning paradigm with contact heat thermal stimulations. Visual cues were presented to alert participants about the level of intensity of an upcoming thermal pain. We delivered high, medium and low levels of pain associated with red, yellow and green cues, respectively, during the conditioning phase. During the testing phase, the level of painful stimulations was surreptitiously set at the medium control level with all the three cues to measure placebo and nocebo effects. We found both robust placebo hypolagesic and nocebo hyperalgesic responses that were highly correlated with expectancy of low and high pain. Simple linear regression analyses showed that placebo responses were negatively correlated with anxiety severity and different aspects of fear of pain (e.g., medical pain, severe pain). Nocebo responses were positively correlated with anxiety sensitivity and physiological suggestibility with a trend toward catastrophizing. Step-wise regression analyses indicated that an aggregate score of motivation (value/utility and pressure/tense subscales) and suggestibility (physiological reactivity and persuadability subscales), accounted for the 51% of the variance in the placebo responsiveness. When considered together, anxiety severity, NEO openness-extraversion and depression accounted for the 49.1% of the variance of the nocebo responses. Psychological factors per se did not influence expectations. In fact, mediation analyses including expectations, personality factors and placebo and nocebo responses, revealed that expectations were not influenced by personality factors. These findings highlight the potential advantage of considering batteries of personality factors and measurements of expectation in predicting placebo and nocebo effects related to experimental acute pain. Copyright 2017 Corsi and Colloca.
    Sponsors
    This research was partially supported by the University of Maryland, Baltimore (LC), the National Institute of Dental and Craniofacial Research (1R01DE025946-0; LC) and the Cooperint Internalization Program from University of Verona, Italy (NC).
    Keyword
    Acute pain
    Anxiety
    Conditioning
    Expectation
    Fear
    Neuroticism
    Suggestibility
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85017007727&doi=10.3389%2ffpsyg.2017.00308&partnerID=40&md5=a344d0985b90a17de6847004366c0cc3; http://hdl.handle.net/10713/9905
    ae974a485f413a2113503eed53cd6c53
    10.3389/fpsyg.2017.00308
    Scopus Count
    Collections
    UMB Open Access Articles 2017

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