Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans.
Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans.
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DOI：
10.1371/journal.pone.0182959
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Evers AWM
中科院分区：
文献类型：
--
作者：
Bartels DJP;van Laarhoven AIM;Stroo M;Hijne K;Peerdeman KJ;Donders ART;van de Kerkhof PCM;Evers AWM
诺西波效应，即，已知由患者的期望引起的不良治疗效果会导致身体症状如疼痛和瘙痒。更好地了解如何尽量减少反安慰剂反应可能最终有助于增强治疗效果。然而，人们对如何减少反安慰剂效应知之甚少。在目前的随机对照研究中，我们测试了反安慰剂的影响是否可以最大限度地减少积极的预期诱导方面的电和组胺瘙痒刺激。首先，通过言语暗示和条件反射诱导对电瘙痒刺激的负面预期（第1部分：反安慰剂效应的诱导）。其次，参与者被随机分配到实验组或对照组（第2部分：逆转反安慰剂效应）。在实验组中，通过条件反射和言语暗示诱导积极期望。在对照组中，继续进行负期望诱导或应用消退程序。然后，进行组胺应用试验。与两个对照组相比，积极的预期诱导导致显着较小的反安慰剂效应。瘙痒NRS评分的平均变化显示反安慰剂效应甚至被逆转，表明安慰剂效应。组胺应用也发现了类似的效果。这项研究首次证明，反安慰剂效应可以最小化，甚至逆转条件反射与口头建议。目前的研究结果表明，学习通过反条件反射和口头建议是一个有前途的战略，减少反安慰剂的反应。
Nocebo effects, i.e., adverse treatment effects which are induced by patients’ expectations, are known to contribute to the experience of physical symptoms such as pain and itch. A better understanding of how to minimize nocebo responses might eventually contribute to enhanced treatment effects. However, little is known about how to reduce nocebo effects. In the current randomized controlled study, we tested whether nocebo effects can be minimized by positive expectation induction with respect to electrical and histaminic itch stimuli. First, negative expectations about electrical itch stimuli were induced by verbal suggestion and conditioning (part 1: induction of nocebo effect). Second, participants were randomized to either the experimental group or one of the control groups (part 2: reversing nocebo effect). In the experimental group, positive expectations were induced by conditioning with verbal suggestion. In the control groups either the negative expectation induction was continued or an extinction procedure was applied. Afterwards, a histamine application test was conducted. Positive expectation induction resulted in a significantly smaller nocebo effect in comparison with both control groups. Mean change itch NRS scores showed that the nocebo effect was even reversed, indicating a placebo effect. Comparable effects were also found for histamine application. This study is the first to demonstrate that nocebo effects can be minimized and even reversed by conditioning with verbal suggestion. The results of the current study indicate that learning via counterconditioning and verbal suggestion represents a promising strategy for diminishing nocebo responses.
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影响因子：
4.7
作者：
Crichton, Fiona;Petrie, Keith J.
通讯作者：
Petrie, Keith J.
影响因子：
4.1
作者：
BAEYENS, F;EELEN, P;CROMBEZ, G
通讯作者：
CROMBEZ, G
影响因子：
10.3
作者：
Evers, A. W. M.;Duller, P.;Kraaimaat, F. W.
通讯作者：
Kraaimaat, F. W.
DOI：
10.1027/2151-2604/a000180
发表时间：
2014-01-01
影响因子：
1.8
作者：
Hofmann, Mareile;Wrobel, Nathalie;Bingel, Ulrike
通讯作者：
Bingel, Ulrike
影响因子：
3.7
作者：
Bartels DJ;van Laarhoven AI;Haverkamp EA;Wilder-Smith OH;Donders AR;van Middendorp H;van de Kerkhof PC;Evers AW
通讯作者：
Evers AW