The contribution of suggestibility and expectation to placebo analgesia phenomenon in an experimental setting
The contribution of suggestibility and expectation to placebo analgesia phenomenon in an experimental setting
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DOI：
10.1016/s0304-3959(01)00485-7
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发表时间：
2002-04-01
期刊：
影响因子：
7.4
通讯作者：
Carotenuto, E
中科院分区：
文献类型：
--
作者：
De Pascalis, V;Chiaradia, C;Carotenuto, E
本研究报告如何安慰剂镇痛产生的条件反射，即电刺激的强度被偷偷地降低，以检查心理因素的贡献，安慰剂镇痛的可接受性和期望。使用该策略是为了操纵疼痛减轻的预期。安慰剂效应的大小是在操作程序后和刺激强度重置为原始基线水平的实验试验期间估计的。作为安慰剂镇痛的可能介质，对药物疗效的可吸收性、口头预期和减轻疼痛的操作程序的个体差异进行了测试。测量以下因变量：（a）对疼痛缓解药物疗效的主观预期，（B）预期疼痛强度和不愉快，（c）并发疼痛强度和不愉快，（d）记忆疼痛强度和不愉快。统计学上显着的安慰剂效应的感觉和情感措施的疼痛，获得独立的程度的surrepandibly降低刺激强度在操纵试验。安慰剂给药与疼痛刺激的配对足以产生普遍的安慰剂镇痛作用。然而，对药物疗效的口头预期和个体差异的可吸收性被发现显着贡献安慰剂镇痛的幅度。最高的安慰剂效应表现为高度易消化的受试者的疼痛评分最明显的降低，这些受试者接受了假定会引起对药物疗效的高期望的建议。结果还表明，对记忆疼痛建立的安慰剂效应至少是同时安慰剂效应的两倍。这主要是因为人们记忆中的基线疼痛比实际上要强烈得多。此外，记忆安慰剂效应，如并发安慰剂效应，与操作试验后获得的预期疼痛评分高度相关。这些结果表明，多种因素有助于安慰剂效应，包括可吸收性，预期和条件反射，以及安慰剂镇痛的判断是由同时或治疗后评估疼痛缓解决定的。(C)2002年国际疼痛研究协会。由Elsevier Science B.V.出版，版权所有。
This study reports how placebo analgesia was produced by conditioning whereby the intensity of electric stimulation was surreptitiously reduced in order to examine the contribution of psychological factors of suggestibility and expectancy on placebo analgesia. This strategy was used in order to manipulate expectancy for pain reduction. The magnitudes of the placebo effects were estimated after a manipulation procedure and during experimental trials in which stimulus intensities were reset to original baseline levels. Individual differences in suggestibility, verbal expectancy for drug efficacy and manipulation procedure for pain reduction were tested as possible mediators of placebo analgesia. The following dependent variables were measured: (a) subjective expectancy for drug efficacy in pain relief, (b) expected pain intensity and unpleasantness, (c) concurrent pain intensity and unpleasantness and (d) remembered pain intensity and unpleasantness. Statistically significant placebo effects on sensory and affective measures of pain were obtained independently of the extent of the surreptitious lowering of stimulus strength during manipulation trials. The pairing of placebo administration with painful stimulation was sufficient to produce a generalized placebo analgesic effect. However, verbal expectancy for drug efficacy and individual differences in suggestibility were found to contribute significantly to the magnitude of placebo analgesia. The highest placebo effect was shown by the most pronounced reductions in pain ratings in highly suggestible subjects who received suggestions presumed to elicit high expectancy for drug efficacy. The results also demonstrated that placebo effects established on remembered pain were at least twice as great as those obtained on concurrent placebo effects. This was mainly because baseline pain was remembered as being much more intense than it really was. Moreover, remembered placebo effects, like the concurrent placebo effects, were highly correlated with expected pain scores obtained just after manipulation trials. These results indicate that multiple factors contribute to the placebo effect, including suggestibility, expectancy and conditioning, and that the judgement of placebo analgesia is critically determined by whether pain relief is assessed concurrently or after treatment. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.