Abstract:BackgroundPlacebo effects on pain have been found to vary in size for different routes of medication administration (e.g. oral vs. injection). This has important implications for both clinical research and practice. To enhance our understanding of these differential placebo effects, research on the underlying expectations about multiple routes and symptoms other than pain is vital.MethodsA cross‐sectional, Internet‐based survey was conducted in a representative sample of the Dutch population (n = 508). Respond… Show more
“…The total sample included in the final analysis consisted of 279 participants (149 females, 53.41%) ranging in age from 18 to 65 years (M = 41.12, SD = 14.18), and was representative of the Dutch population in terms of age and sex. 2 The completion rate was similar to that of other online studies (Burgard et al, 2020;Floridou et al, 2019;Müllensiefen et al, 2014;Peerdeman et al, 2018). The sample was primarily of Dutch nationality (94.27% Dutch, 2.15% multiple, 3.58% other) and generally highly educated (65.95% tertiary, 33.69% secondary, 0.36% primary).…”
Mental imagery is a highly common component of everyday cognitive functioning. While substantial progress is being made in clarifying this fundamental human function, much is still unclear or unknown. A more comprehensive account of mental imagery aspects would be gained by examining individual differences in age, sex, and background experience in an activity and their association with imagery in different modalities and intentionality levels. The current online study combined multiple imagery self-report measures in a sample (n = 279) with a substantial age range (18–65 years), aiming to identify whether age, sex, or background experience in sports, music, or video games were associated with aspects of imagery in the visual, auditory, or motor stimulus modality and voluntary or involuntary intentionality level. The findings show weak positive associations between age and increased vividness of voluntary auditory imagery and decreased involuntary musical imagery frequency, weak associations between being female and more vivid visual imagery, and relations of greater music and video game experience with higher involuntary musical imagery frequency. Moreover, all imagery stimulus modalities were associated with each other, for both intentionality levels, except involuntary musical imagery frequency, which was only related to higher voluntary auditory imagery vividness. These results replicate previous research but also contribute new insights, showing that individual differences in age, sex, and background experience are associated with various aspects of imagery such as modality, intentionality, vividness, and frequency. The study’s findings can inform the growing domain of applications of mental imagery to clinical and pedagogical settings.
“…The total sample included in the final analysis consisted of 279 participants (149 females, 53.41%) ranging in age from 18 to 65 years (M = 41.12, SD = 14.18), and was representative of the Dutch population in terms of age and sex. 2 The completion rate was similar to that of other online studies (Burgard et al, 2020;Floridou et al, 2019;Müllensiefen et al, 2014;Peerdeman et al, 2018). The sample was primarily of Dutch nationality (94.27% Dutch, 2.15% multiple, 3.58% other) and generally highly educated (65.95% tertiary, 33.69% secondary, 0.36% primary).…”
Mental imagery is a highly common component of everyday cognitive functioning. While substantial progress is being made in clarifying this fundamental human function, much is still unclear or unknown. A more comprehensive account of mental imagery aspects would be gained by examining individual differences in age, sex, and background experience in an activity and their association with imagery in different modalities and intentionality levels. The current online study combined multiple imagery self-report measures in a sample (n = 279) with a substantial age range (18–65 years), aiming to identify whether age, sex, or background experience in sports, music, or video games were associated with aspects of imagery in the visual, auditory, or motor stimulus modality and voluntary or involuntary intentionality level. The findings show weak positive associations between age and increased vividness of voluntary auditory imagery and decreased involuntary musical imagery frequency, weak associations between being female and more vivid visual imagery, and relations of greater music and video game experience with higher involuntary musical imagery frequency. Moreover, all imagery stimulus modalities were associated with each other, for both intentionality levels, except involuntary musical imagery frequency, which was only related to higher voluntary auditory imagery vividness. These results replicate previous research but also contribute new insights, showing that individual differences in age, sex, and background experience are associated with various aspects of imagery such as modality, intentionality, vividness, and frequency. The study’s findings can inform the growing domain of applications of mental imagery to clinical and pedagogical settings.
“…While that particular study made use of a cream to help induce placebo effects, the current study used a pink-colored tonic. Potentially, the use of this particular attribute may have led towards smaller effects in the current study, since a cream could be perceived as a common treatment for itch by some participants, could trigger previously learned associations, and could thus potentially elicit stronger effects overall (47). Moreover, negative verbal suggestions did not elicit negative expectations for itch in the current study and did not increase itch either during or following the histamine test, which is not in line with previous evidence for verbal suggestion-induced nocebo effects in itch (25, 26, 28).…”
Placebo and nocebo effects have been shown to influence subjective symptoms such as itch. These effects can be induced by influencing outcome expectations through, for example, combining the application of an inert substance (e.g., a cream) with verbal suggestions on the anticipated effects of this substance. Interestingly, placebo effects also occur when it is known that a treatment is inert (i.e., open-label placebo). However, no study to date has examined the efficacy of negative and positive verbal suggestions under similar open-label and closed-label (i.e., concealed placebo/nocebo) conditions in itch. A randomized controlled between-subjects study design was applied in which healthy volunteers (
n
= 92) were randomized to 1) an open-label positive verbal suggestion group, 2) a closed-label positive verbal suggestion group, 3) an open-label negative verbal suggestion group, or 4) a closed-label negative verbal suggestion group. Verbal suggestions were made regarding the topical application of an inert substance. Itch was evoked experimentally by histamine iontophoresis at baseline and again following suggestions. Itch expectations, self-reported itch during and following iontophoresis, and skin response parameters were measured. Positive suggestions were found to result in significantly lower expected itch than were negative suggestions in both open- and closed-label conditions. No effects of the suggestions on itch during iontophoresis were found, but significantly lower itch was reported in the 4 min following iontophoresis in the (combined open- and closed-label) positive compared with negative verbal suggestion groups. In addition, a smaller increase in skin temperature was found in the positive compared with negative suggestion groups. The findings illustrate a potential role of (open- and closed-label) placebo for optimizing expectations and treatment effects for itch in clinical practice.
Clinical Trial Registration:
Netherlands Trial Register, trial number: NTR6530.
“…Similar to the circumstances of NI diagnosis, there is also no specific treatment for this condition [9]. Generally, management of NI begins with non-pharmacological measures used for itch, followed by other therapies in a stepwise approach, wherein the choice of treatment is usually based on the size and localization of the pruritus [12,13]. In particular, treatment of itching caused by neuropathy is often based on NP management [9].…”
Background: In some patients with neuropathic pain (NP), such as complex regional pain syndrome (CRPS), itching rather than pain is the main symptom making diagnosis and treatment difficult.Case: We report a case of a 23-year-old man with a history of hypoxic brain damage who presented with pruritus of the left foot and ankle. His left foot was fractured, and he underwent surgery 6 months previously. After the operation and cast application, he developed uncontrolled pruritus, swelling, sweating, and flushing of the left foot skin with limping. On examination, he showed well-known features of CRPS without pain. He was diagnosed with an atypical CRPS with neuropathic itching (NI). With treatment modalities used for NP and CRPS, his pruritus subsided gradually, and the his ankle mobility improved.Conclusions: Unexplained itching can be the main symptom in some CRPS patients. Treatment according to NP can improve symptoms of NI in CRPS patients.
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