To Experience or to Be Informed? Classical Conditioning Induces Nocebo Hyperalgesia even when Placebo Analgesia Is Verbally Suggested-Results of a Preliminary Study
To Experience or to Be Informed? Classical Conditioning Induces Nocebo Hyperalgesia even when Placebo Analgesia Is Verbally Suggested-Results of a Preliminary Study
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DOI：
10.1093/pm/pnz123
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发表时间：
2020-03-01
期刊：
影响因子：
3.1
通讯作者：
Babel, Przemyslaw
中科院分区：
文献类型：
--
作者：
Bajcar, Elzbieta A.;Wiercioch-Kuzianik, Karolina;Babel, Przemyslaw
Objective.为了调查是否直接经验（即，经典条件反射）或口头暗示在诱导反安慰剂痛觉过敏中更重要，研究了五组（总样本量，N = 99）：条件反射、一致条件反射、不一致条件反射、口头暗示和对照。方法.条件反射组的参与者在呈现白色圆圈后经历了更强烈的疼痛刺激。在一致性条件反射组中，另外提供了该圆将先于更强烈的疼痛刺激的建议，而在不一致性条件反射组中，使用了相反的建议。控制组和口头建议组接受一种强度的疼痛刺激，然而，后者收到的建议，一个圆圈将之前的疼痛刺激更高的强度。结果反安慰剂效应在所有条件反射组中观察到，无论使用的口头建议。此外，痛觉过敏的经验能够抵消镇痛的口头暗示的效果。言语暗示和疼痛体验之间的不一致产生了影响反安慰剂痛觉过敏的预期。结论.初步研究结果显示，直接经验在诱发反安慰剂痛觉过敏的过程中，似乎比语言暗示更重要。
Objective. To investigate whether direct experience (i.e., classical conditioning) or verbal suggestion is more important in inducing nocebo hyperalgesia, five groups (total sample size, N = 99) were studied: conditioning, congruent conditioning, incongruent conditioning, verbal suggestion, and control. Methods. Participants in groups with conditioning experienced more intensive pain stimuli after presentation of a white circle. In the congruent conditioning group, suggestion that the circle would precede more intensive pain stimuli was additionally provided, whereas in the incongruent conditioning group, the opposite suggestion was used. Control and verbal suggestion groups received pain stimuli of one intensity; however, the latter received suggestion that a circle would precede pain stimuli of higher intensity. Results. The nocebo effect was observed in all conditioning groups, regardless of the verbal suggestions used. Moreover, the experience of hyperalgesia was able to nullify the effect of the verbal suggestion of analgesia. Incongruence between verbal suggestion and pain experience produced expectancies that affected nocebo hyperalgesia. Conclusions. The results of this preliminary study suggest that direct experience seems to be more important than verbal suggestion in inducing nocebo hyperalgesia.