Prior Pain Exposure and Mere Possession of a Placebo Analgesic Predict Placebo Analgesia: Findings From a Randomized, Double-Blinded, Controlled Trial

Yeung, Victoria Wai Lan; Geers, Andrew L.

doi:10.1016/j.jpain.2020.10.004

Cited by 4 publications

(2 citation statements)

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“…1b and 1c). In the laboratory context, placebos have been given not only as active analgesics but also in nontreatment forms such as verbal suggestions, perceived controllability, explicit warning cues, or mere possession of an analgesic without using it (Atlas et al, 2010; Jepma et al, 2018; Keltner et al, 2006; Koyama et al, 2005; Porro et al, 2002; Salomons et al, 2004; Sawamoto et al, 2000; Wai-Lan Yeung et al, 2020; Yeung & Geers, 2021), all of which have been shown to be able to significantly influence neural processing and subjective perception of pain. When a placebo is administered under the guise of an analgesic cream in the context of anticipating an upcoming pain, it always drives an appetitive motivation, regardless of context and individual specificities.…”

Section: State-dependent Activation Of the Pag–rvm Network And Its Li...mentioning

confidence: 99%

How Do Expectations Modulate Pain? A Motivational Perspective

Liu

Yu²

2023

Perspect Psychol Sci

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Expectations can profoundly modulate pain experience, during which the periaqueductal gray (PAG) plays a pivotal role. In this article, we focus on motivationally evoked neural activations in cortical and brainstem regions both before and during stimulus administration, as has been demonstrated by experimental studies on pain-modulatory effects of expectations, in the hope of unraveling how the PAG is involved in descending and ascending nociceptive processes. This motivational perspective on expectancy effects on the perception of noxious stimuli sheds new light on psychological and neuronal substrates of pain and its modulation, thus having important research and clinical implications.

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Section: State-dependent Activation Of the Pag–rvm Network And Its Li...mentioning

confidence: 99%

How Do Expectations Modulate Pain? A Motivational Perspective

Liu

Yu²

2023

Perspect Psychol Sci

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“…Although in this article I focus primarily on contextually driven placebo responses to the administration of a clinical treatment, note that the psychosocial context alone can directly elicit therapeutic effects before treatment application or in the absence of discrete treatment interventions at all, possibly through allowing the patient to reappraise the symptom being experienced so that it becomes more controllable and less unpleasant (Tracey, 2010;Wiech et al, 2008), resulting in a reduction in aversive motivation. There has been evidence that the context of usual clinical encounters is an independent factor that potently affects health outcomes (Kaplan et al, 1989;Ong et al, 1995;Stewart, 1995) and that merely possessing a placebo treatment (without actually using it) could create significant benefits (Wai-Lan Yeung et al, 2020;Yeung & Geers, 2021). Some experts have argued that the placebo effect in clinical care can be promoted by reinforcing the therapeutic context through improving communications between the clinician and the patient, with no need to resort to placebo treatments (Brody, 1982;Hrobjartsson, 2008), which are thought to be ethically problematic for inherently involving concealment or deception (Miller & Colloca, 2009).…”

Section: Placebo Effects Without Treatment Applicationmentioning

confidence: 99%

Placebo Effects: A New Theory

Liu

2021

Clinical Psychological Science

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Placebo effects have increasingly aroused scientific and public interest for their clinical and research values. However, underlying mechanisms of this mind–body phenomenon are not yet fully understood. In this article, I propose a new model according to which context-based placebo effects source from positive treatment beliefs but are directly caused by benefit expectations. By virtue of mediating belief-expectation transformation, placebo administration triggers, and thus has a pivotal role in, subsequent therapeutic responses.

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Enhancing placebo analgesia: Unravelling the powerful interplay of ownership and verbal suggestion

Yeung

2024

European Journal of Pain

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BackgroundPlacebo analgesic research demonstrates pain reduction after using a placebo analgesic. Recent studies have documented that sometimes possessing a placebo analgesic induces placebo analgesia. These prior studies used a ‘cream’ as the stimulus and proposed that the effect is driven by an expectancy of obtaining benefits from the owned analgesic. This paper examines three pivotal components of placebo analgesia: placebo form, ownership and expectancy induced by verbal suggestion. We investigate analgesic expectancy between cream versus oil form of placebo stimulus and systematically isolate the effects of ownership, verbal suggestion and their interaction, comparing with the effect of use, to decipher the dynamics of placebo analgesia.MethodsStudy 1 (N = 46) evaluated analgesic expectancy between cream and oil. Study 2 (N = 119) exposed participants to a placebo analgesic oil and randomized them into PU (possess and use), PA (possess and anticipate), P (possess‐only) or A (anticipate‐only) conditions. Pain outcomes were assessed using a cold pressor test. Comparing PA and P conditions assessed the verbal suggestion effect, comparing PA and A conditions evaluated the possession effect, while comparing PU and PA conditions shed light on the use effect.ResultsIn Study 1, participants showed comparable analgesic expectancy for cream and oil. In Study 2, both PA and PU groups performed equally well, reporting higher pain threshold, F(3, 115) = 5.14, p = 0.002, = 0.12; and a greater probability of persistent hand submersion than P and A groups, X2(3) = 8.06, p = 0.045.ConclusionThe findings highlight the significance of integrating possession with expectancy to induce placebo analgesia, which has clinical implications.SignificanceThis study delves into the intricate dynamics of placebo analgesia, shedding light on the significant influence of ownership and verbal suggestion. Through a meticulous exploration of the relationship between ownership and expectancy induced by verbal suggestion, we propose novel avenues for enhancing placebo responses. This research has implications for clinical practice and pain management strategies, potentially revolutionizing approaches to pain relief and therapeutic outcomes. Our findings contribute to a paradigm shift in understanding placebo analgesia, emphasizing the pivotal interaction between ownership and verbal suggestion.

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Prior Pain Exposure and Mere Possession of a Placebo Analgesic Predict Placebo Analgesia: Findings From a Randomized, Double-Blinded, Controlled Trial

Cited by 4 publications

References 89 publications

How Do Expectations Modulate Pain? A Motivational Perspective

How Do Expectations Modulate Pain? A Motivational Perspective

Placebo Effects: A New Theory

Enhancing placebo analgesia: Unravelling the powerful interplay of ownership and verbal suggestion

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