The nocebo effect is the adverse physical or emotional response after administering an inert treatment. Previous research suggests that learned negative expectancy is the underlying mechanism....Show moreThe nocebo effect is the adverse physical or emotional response after administering an inert treatment. Previous research suggests that learned negative expectancy is the underlying mechanism. However, recent findings show that many other psychological factors, such as anxiety, might have an influencing role, especially when focusing on pain. Therefore, this study aimed to investigate the relationship between negative expectancies and the nocebo effect, as well as anxiety as the moderator of that relationship. The final sample consisted of 20 healthy participants divided into the nocebo and control groups. During the conditioning phase, as opposed to the control group, participants in the nocebo group were conditioned to expect high-intensity electrical stimulus after seeing a certain colour cue (purple or yellow) and a medium stimulus after the other colour cue (yellow or purple). During the testing phase, they would always receive medium stimuli after each colour cue in both groups. The analysis of the first hypothesis yielded significant results (p < .001) suggesting that negative expectancies do lead to the nocebo effect. However, the analysis investigating anxiety as a moderator did not find significant results (p = .872). The first finding is in line with previous studies and has important clinical implications regarding the experience of symptoms and side effects. The second non-significant finding could be due to the limited sample, the design of the study or due to the complexity of the anxiety distinction.Show less
The universal experience of pain is a burden to all. However, this burden is not experienced the same by everyone. How much pain is actually experienced is influenced by our expectancies and...Show moreThe universal experience of pain is a burden to all. However, this burden is not experienced the same by everyone. How much pain is actually experienced is influenced by our expectancies and interpretation of pain. In this experiment we set the expectations of pain through verbal suggestion and conditioning and investigated the predictive value of anxiety on the nocebo effect. We hypothesized that pain expectations induced through verbal suggestion and conditioning can lead to more pain experienced from the conditioned stimuli. Furthermore, we hypothesized that higher anxiety scores on the STAI-S is able to predict nocebo hyperalgesia. 70 participants (15 male, 54 female, 1 non-binary) were randomly allocated to either a control condition in which they received no verbal suggestions and conditioning or a nocebo condition in which the participants did receive verbal suggestions and conditioning. In this experiment, a significant nocebo effect was found using a repeated measures ANOVA (p= 0.001), confirming that as a result of verbal suggestion and conditioning, there is indeed a nocebo effect present. Unfortunately, no significant predictive value for anxiety on the nocebo scores was found using a simple regression analysis (p = 0.246). This indicates that anxiety does not affect the strength of the nocebo effect. These results further help us understand which mechanisms (and which not) underly the nocebo effect and affect how much pain is experienced. This knowledge can be used to improve therapy and clinical practice to diminish unnecessary pain experiences.Show less
Pain is a subjective experience that can be broadly distinguished into two categories, acute and chronic pain. Acute pain is immediate and has a protective function, whereas chronic pain is...Show morePain is a subjective experience that can be broadly distinguished into two categories, acute and chronic pain. Acute pain is immediate and has a protective function, whereas chronic pain is persistent and its maintenance is influenced by a combination of social, biological, and psychological factors. One of the important elements that can alter pain perception is one’s negative expectations. This happens through a nocebo effect, in which expecting more pain itself increases the pain experience. Moreover, there is evidence suggesting that some emotions, such as fear of pain, may be a predictor of the nocebo effect. It is highly important to understand the nocebo effect and find predictors, as it could have great benefits for individuals with chronic pain. In this paper, two hypotheses were investigated; firstly, whether one’s negative expectancies could induce a nocebo effect, and secondly if the fear of pain was a predictor of the nocebo effect. The study had a between-subjects design that included 20 participants aged between 18-23. Participants were randomly assigned to either conditioning or control group, and the control group was conditioned to expect higher pain by using color cues and verbal suggestions. In order to assess the respondents’ fear of pain at the baseline level, FPQ-III was used. The findings supported the first hypothesis by finding a significant nocebo effect (p = 0.018), however, fear of pain was not found to be a predictor (p = 0.402). The significant nocebo effect highlights the importance of framing information and open communication in clinical settings. Furthermore, it is valuable to conduct further research to identify predictors of the nocebo effect, as it can be helpful in identifying patients that are more vulnerable to pain and in developing effective treatment strategies.Show less
