Placebo and nocebo effects and operant pain-related avoidance learning
Abstract. Introduction:. Research on learning in placebo and nocebo has relied predominantly on Pavlovian conditioning procedures. Operant learning procedures may more accurately model learning in real-life situations in which placebo and nocebo effects occur. Objectives:. To investigate the develop...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2019-06-01
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| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000748 |
| _version_ | 1818008070417022976 |
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| author | Thomas Janssens Ann Meulders Bien Cuyvers Luana Colloca Johan W.S. Vlaeyen |
| author_facet | Thomas Janssens Ann Meulders Bien Cuyvers Luana Colloca Johan W.S. Vlaeyen |
| author_sort | Thomas Janssens |
| collection | DOAJ |
| description | Abstract. Introduction:. Research on learning in placebo and nocebo has relied predominantly on Pavlovian conditioning procedures. Operant learning procedures may more accurately model learning in real-life situations in which placebo and nocebo effects occur.
Objectives:. To investigate the development and persistence of placebo and nocebo effects using an operant avoidance learning task.
Methods:. Pain-free participants (n = 58) could learn to avoid pain by performing movements that differed in difficulty and intensity of painful stimulation. Participants performed movements in 2 contexts. In the high cost of avoidance context, pain stimulus intensity reduced with increasing movement difficulty. In the low cost of avoidance context, contingencies were reversed. Participants rated pain expectations and pain intensity. During test, movement difficulties were unchanged, but participants always received a medium-intensity pain stimulus. Placebo and nocebo effects were defined as lower/higher pain intensity ratings for trajectories that previously resulted in low/high-intensity compared with medium-intensity stimulation.
Results:. As expected, participants acquired differential movement-pain expectations and differential movement choices. Testing with a medium-intensity pain stimulus quickly erased differences in movement choice across contexts, but differences in pain expectations were maintained. Pain modulation across context was in line with movement-pain expectations. However, we only observed placebo effects within the low cost of avoidance context and found no evidence of nocebo effects.
Conclusion:. Operant learning can change pain expectations, pain modulation, and pain-related avoidance behavior. Persisting pain expectations suggest that acquired pain beliefs may be resistant to disconfirmation, despite self-initiated experience with novel pain-movement contingencies. |
| first_indexed | 2024-04-14T05:24:23Z |
| format | Article |
| id | doaj.art-7623bac26be749348d1a8e65c7cd4457 |
| institution | Directory Open Access Journal |
| issn | 2471-2531 |
| language | English |
| last_indexed | 2024-04-14T05:24:23Z |
| publishDate | 2019-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj.art-7623bac26be749348d1a8e65c7cd44572022-12-22T02:10:02ZengWolters KluwerPAIN Reports2471-25312019-06-0143e74810.1097/PR9.0000000000000748201906000-00027Placebo and nocebo effects and operant pain-related avoidance learningThomas Janssens0Ann Meulders1Bien Cuyvers2Luana Colloca3Johan W.S. Vlaeyen4a Health Psychology, KU Leuven (University of Leuven), Leuven, Belgiuma Health Psychology, KU Leuven (University of Leuven), Leuven, Belgiuma Health Psychology, KU Leuven (University of Leuven), Leuven, Belgiumc Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, BaltimoreMD, USAa Health Psychology, KU Leuven (University of Leuven), Leuven, BelgiumAbstract. Introduction:. Research on learning in placebo and nocebo has relied predominantly on Pavlovian conditioning procedures. Operant learning procedures may more accurately model learning in real-life situations in which placebo and nocebo effects occur. Objectives:. To investigate the development and persistence of placebo and nocebo effects using an operant avoidance learning task. Methods:. Pain-free participants (n = 58) could learn to avoid pain by performing movements that differed in difficulty and intensity of painful stimulation. Participants performed movements in 2 contexts. In the high cost of avoidance context, pain stimulus intensity reduced with increasing movement difficulty. In the low cost of avoidance context, contingencies were reversed. Participants rated pain expectations and pain intensity. During test, movement difficulties were unchanged, but participants always received a medium-intensity pain stimulus. Placebo and nocebo effects were defined as lower/higher pain intensity ratings for trajectories that previously resulted in low/high-intensity compared with medium-intensity stimulation. Results:. As expected, participants acquired differential movement-pain expectations and differential movement choices. Testing with a medium-intensity pain stimulus quickly erased differences in movement choice across contexts, but differences in pain expectations were maintained. Pain modulation across context was in line with movement-pain expectations. However, we only observed placebo effects within the low cost of avoidance context and found no evidence of nocebo effects. Conclusion:. Operant learning can change pain expectations, pain modulation, and pain-related avoidance behavior. Persisting pain expectations suggest that acquired pain beliefs may be resistant to disconfirmation, despite self-initiated experience with novel pain-movement contingencies.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000748 |
| spellingShingle | Thomas Janssens Ann Meulders Bien Cuyvers Luana Colloca Johan W.S. Vlaeyen Placebo and nocebo effects and operant pain-related avoidance learning PAIN Reports |
| title | Placebo and nocebo effects and operant pain-related avoidance learning |
| title_full | Placebo and nocebo effects and operant pain-related avoidance learning |
| title_fullStr | Placebo and nocebo effects and operant pain-related avoidance learning |
| title_full_unstemmed | Placebo and nocebo effects and operant pain-related avoidance learning |
| title_short | Placebo and nocebo effects and operant pain-related avoidance learning |
| title_sort | placebo and nocebo effects and operant pain related avoidance learning |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000748 |
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