Nocebo Hyperalgesia, Partial Reinforcement, and Extinction

Colagiuri, Ben; Quinn, Veronica F.; Colloca, Luana

doi:10.1016/j.jpain.2015.06.012

Cited by 79 publications

(90 citation statements)

References 31 publications

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“…The studies differed in the number of trials during conditioning (study 1: 6 CS High and 6 CS Low ; study 2: 12 CS High and 12 CS Low ) and in reinforcement schedules (study 1: 100%; study 2: 75%). These alterations in design were applied to test whether a partial reinforcement schedule, inducing higher uncertainty about US appearance, would result in a higher magnitude of conditioned nocebo responses on a behavioral level in this model of visceral pain. Trial numbers were increased to test for the impact of an extended number of learning trials on nocebo responses as previously suggested in an instructed learning paradigm .…”

Section: Methodsmentioning

confidence: 99%

Learning by experience? Visceral pain‐related neural and behavioral responses in a classical conditioning paradigm

Icenhour

Labrenz

Theysohn

et al. 2017

Neurogastroenterology Motil

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We report changes in neural activation patterns during anticipation and visceral stimulation induced by prior conditioning. In the absence of behavioral effects, markedly altered neural responses may indicate conditioning with visceral signals to induce hypervigilance rather than hyperalgesia, involving altered attention, reappraisal, and perceptual acuity as processes contributing to the pathophysiology of visceral pain.

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Section: Methodsmentioning

confidence: 99%

Learning by experience? Visceral pain‐related neural and behavioral responses in a classical conditioning paradigm

Icenhour

Labrenz

Theysohn

et al. 2017

Neurogastroenterology Motil

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“…Another important recent discovery is that both placebo and nocebo effects can be established following partial reinforcement (Au Yeung et al, 2014, Colagiuri et al, in press). Placebo research involving conditioning has almost exclusively involved training with continuous reinforcement, i.e.…”

Section: Learning Mechanismsmentioning

confidence: 99%

“…Partial reinforcement refers to when the cue is paired with the relevant outcome on some, but not all trials (Bouton, 2007). In two recent studies, we compared partial reinforcement with continuous reinforcement for placebo analgesia (Au Yeung et al, 2014) and nocebo hyperalgesia (Colagiuri et al, in press). Partial reinforcement involved pairing activation of a sham electrode with a surreptitious decrease (placebo) or increase (nocebo) in pain during only 62.5% of the training trials and keeping it constant for the remainder.…”

Section: Learning Mechanismsmentioning

confidence: 99%

“…Interestingly there was some asymmetry in terms partial reinforcement’s effect on the nocebo effect (Colagiuri et al, in press), whereby partial reinforcement also led to a weaker nocebo effect than continuous reinforcement, but where both nocebo effects were equally resistant to extinction. This suggests that the same conditioning manipulation can differentially affect placebo effects and nocebo effects.…”

Section: Learning Mechanismsmentioning

confidence: 99%

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The placebo effect: From concepts to genes

et al. 2015

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Despite its initial treatment as a nuisance variable, the placebo effect is now recognized as a powerful determinant of health across many different diseases and encounters. This is in light of some remarkable findings ranging from demonstrations that the placebo effect significantly modulates the response to active treatments in conditions such as pain, anxiety, Parkinson’s disease, and some surgical procedures. Here, we review pioneering studies and recent advances in behavioral, neurobiological, and genetic influences on the placebo effect. Based on a previous developed conceptual framework, the placebo effect is presented as the product of a general expectancy learning mechanism in which verbal, conditioned and social cues are centrally integrated to change behaviors and outcomes. Examples of the integration of verbal and conditioned cues, such as instructed reversal of placebo effects are also incorporated into this model. We discuss neuroimaging studies that using well-established behavioral paradigms have identified key brain regions and modulatory mechanisms underlying placebo effects. Finally, we present a synthesis of recent genetics studies on the placebo effect, highlighting a promising link between genetic variants in the dopamine, opioid, serotonin, and endocannabinoid pathways and placebo responsiveness. Greater understanding of the behavioral, neurobiological, and genetic influences on the placebo effect is critical for evaluating medical interventions and may allow health professionals to tailor and personalize interventions in order to maximize treatment outcomes in clinical settings.

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“…It is these kinds of expectancies that are generally believed to be the core mechanism of placebo and nocebo effects and that are consequently thought to greatly contribute to the efficacy of active treatments (Kirsch, 1997; Benedetti, 2014; Horing et al, 2014). When placebo or nocebo effects are induced, pain expectations are modified, and these response expectations predict changes in the intensity and unpleasantness of both experimental and clinical pain (Atlas et al, 2012; Schmid et al, 2013; Kirsch et al, 2014; Colagiuri et al, 2015; Peerdeman et al, 2016). Stimulus expectancies may exert an indirect influence on pain experiences, e.g., by affecting behavior, but could possibly also influence pain directly.…”

Section: The Influence Of Different Kinds Of Expectancies On Painmentioning

confidence: 99%

An Integrative Review of the Influence of Expectancies on Pain

et al. 2016

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Expectancies can shape pain experiences. Attention for the influence of expectancies on pain has increased particularly due to research on placebo effects, of which expectancy is believed to be the core mechanism. In the current review, we provide a brief overview of the literature on the influence of expectancies on pain. We first discuss the central role of expectancy in the major psychological learning theories. Based on these theories, different kinds of expectancies can be distinguished. Pain experiences are influenced particularly by response expectancies directly pertaining to the pain experience itself, but can also be affected by self-efficacy expectancies regarding one's ability to cope with pain, and possibly by stimulus expectancies regarding external events. These different kinds of expectancies might interact with each other, and related emotions and cognitions, as reflected by various multifaceted constructs in which expectancies are incorporated. Optimism and pain catastrophizing, in particular, but also hope, trust, worry, and neuroticism have been found to be associated with pain outcomes. We conclude with recommendations for further advancing research on the influence of expectancies on pain and for harnessing expectancy effects in clinical practice.

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Nocebo Hyperalgesia, Partial Reinforcement, and Extinction

Cited by 79 publications

References 31 publications

Learning by experience? Visceral pain‐related neural and behavioral responses in a classical conditioning paradigm

Learning by experience? Visceral pain‐related neural and behavioral responses in a classical conditioning paradigm

The placebo effect: From concepts to genes

An Integrative Review of the Influence of Expectancies on Pain

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