Acute pain has the essential function of protecting organisms from harmful influences through painful signals that trigger protective behavioral responses. Chronic pain, however, has merely stress...Show moreAcute pain has the essential function of protecting organisms from harmful influences through painful signals that trigger protective behavioral responses. Chronic pain, however, has merely stress-inducing and disabling characteristics. To enable the development of treatment, understanding the mechanisms underlying pain experience is indispensable. Previous research has demonstrated how expectancy-induced nocebo effects (i.e., the worsening of a symptom caused by negative expectations) can provoke hyperalgesia, an increased sensitivity towards pain. The present study aimed to reproduce these findings and investigate the precise role of expectancies in the relationship between nocebo-inducing cues and the resulting pain experience. Within the context of expectancy, this study was further exploring the degree of awareness involved in the participants’ perception of their accuracy in predicting upcoming pain intensities. Sixty-nine healthy volunteers were divided between the experimental and the control condition, both of which received repeated electrical pain stimulation. Through verbal suggestion and conditioning, the experimental group learned to associate a specific color with high pain intensity and a second color with a medium intensity stimulus. In the control group, there were no instructions and the order of pain intensities and color cues was randomized. During the test phase, all color cues were accompanied by medium intensity pain to measure the magnitude of nocebo responses associated with the conditioned color as opposed to the control color. Pain expectancy and experience, as well as the extent to which they both matched, were measured through self-report scales after each stimulus-color pair. Nocebo conditioning produced the expected higher pain and expectancy ratings for the conditioned cue, as compared to the unconditioned cue in the nocebo group’s test data. Next, expectancies appeared to significantly mediate the effect of the nocebo-induction on pain experience in the experimental group. Finally, there was no significant indication that participants were aware of their degree of prediction accuracy. These findings confirm the significant involvement of expectation in pain experience and warrant further research on awareness in pain perception. Additional research is needed to provide deeper insight on the psychological processes underlying pain experience, as it will help optimize treatments for patients suffering from chronic pain.Show less
This thesis critiques the notion of development based on a philosophy of Being. Development, and learning, can only occur within Becoming. Inspired by Nietzsche and Deleuze’s project of...Show moreThis thesis critiques the notion of development based on a philosophy of Being. Development, and learning, can only occur within Becoming. Inspired by Nietzsche and Deleuze’s project of overthrowing Platonism, it is shown that transcendental principles explain the conditioning of reason, not its generation. To explain the process of genesis (of reason) we have to understand the principles that make order out of the chaos of life. My main hypothesis is that development is a process of the embodiment of differences, as a process of becoming. And learning is the process of encountering and internalising differences through involuntary memory and pure thought. Conditioning, on the contrary, is a process that reduces development and thought to functions in service of a final state, an Ideal, and therefore obstructs development. The process of development is a process of individuation where essences of becoming, grounded on an eternal return of difference, become internalised and increase someone’s power to resonate with the World. The production of a subject, however, is problematic because it is the result of conditioning, the internalisation of general identities (the symbolic order) in reaction to overpowering negative tensions. Development has its spiritual equivalent in learning and pure thought. Conditioning stops thought, it allows access to a desired feeling against the condition that someone accepts a certain state, or fact, without question. Because of this, conditioning always produces the unfortunate side-effect of anxiety, since the assumed truths lack any grounding in univocity.Show less
Chronic pain is one of the most prominent medical conditions associated with significant limitations in various life aspects. Nocebo hyperalgesia which refers to increased pain perception due to...Show moreChronic pain is one of the most prominent medical conditions associated with significant limitations in various life aspects. Nocebo hyperalgesia which refers to increased pain perception due to negative expectations about pain plays crucial role in pain chronification. Nocebo effects have also been linked to dispositional characteristics. Studies investigating the role of fear of pain and nocebo hyperalgesia found inconsistent results. This study used conditioning and verbal suggestions hypothesizing that nocebo hyperalgesia will occur. We further investigated the association between fear of pain and nocebo hyperalgesia, expecting a positive relationship. In this study, 27 healthy individuals were randomly assigned to either a control group or a nocebo group in which negative expectancies about pain were induced. This was done by means of conditioning, through pairing electrically painful stimuli with color cues, and by giving negative verbal suggestions about an increase in pain related to a color cue and a sham electrode. Pain levels were rated on Numerical Rating Scale (NRS) and compared between groups. Dispositional fear of pain levels was measured using the fear of minor pain subscale of the Fear of Pain Questionnaire-III (FPQ-III). Nocebo hyperalgesia was successfully induced, as reflected by a significant difference (p =.005) in nocebo responding between the two groups. No significant relationship was found between FPQ-III scores and nocebo hyperalgesia. Findings are in line with previous research suggesting that conditioning and verbal suggestions can induce nocebo hyperalgesia. Since no association has been found between fear of pain and nocebo hyperalgesia, future research should investigate this relationship using other subscales of the FPQ-III.Show less
