Classical conditioning and expectancy in placebo hypoalgesia: a randomized controlled study in patients with atopic dermatitis and persons with healthy skin
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Classical conditioning and expectancy in placebo hypoalgesia: a randomized controlled study in patients with atopic dermatitis and persons with healthy skin. / Klinger, Regine; Soost, Stephanie; Flor, Herta; Worm, Margitta.
in: PAIN, Jahrgang 128, Nr. 1-2, 03.2007, S. 31-9.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Classical conditioning and expectancy in placebo hypoalgesia: a randomized controlled study in patients with atopic dermatitis and persons with healthy skin
AU - Klinger, Regine
AU - Soost, Stephanie
AU - Flor, Herta
AU - Worm, Margitta
PY - 2007/3
Y1 - 2007/3
N2 - The effectiveness of placebos is unchallenged. However, it is still not clear on which mechanisms the placebo effect is based. Besides expectancy theories, classical conditioning is discussed as a major explanatory model. In an experimental conditioning design we tested 96 participants, 48 with atopic dermatitis (24 male, 24 female) and 48 with healthy skin (24 male and 24 female). All of them received a neutral ointment with a different briefing ("pain-reducing ointment" versus "neutral ointment"). Electrical pain stimuli were subsequently applied, which selectively induce a painful sensation. In the case of the learning condition (classical conditioning) and unbeknown to the participants, the intensity of the pain stimulus was reduced by 50% after the ointment had been applied. The study addressed the question whether the pain experienced by the patients with atopic dermatitis could be reduced through a placebo effect and whether the placebo effect was achieved through expectancy or through a process of classical conditioning or both. The results indicate that a placebo effect is achieved via expectancy and classical conditioning. However, conditioning processes seem to be necessary for a longer lasting effect. The extent of this effect seemed to be greater in atopics than in healthy controls. Expectancy, achieved through verbal instruction, might also be seen as a conditioned stimulus that reactivates earlier stimulus associations.
AB - The effectiveness of placebos is unchallenged. However, it is still not clear on which mechanisms the placebo effect is based. Besides expectancy theories, classical conditioning is discussed as a major explanatory model. In an experimental conditioning design we tested 96 participants, 48 with atopic dermatitis (24 male, 24 female) and 48 with healthy skin (24 male and 24 female). All of them received a neutral ointment with a different briefing ("pain-reducing ointment" versus "neutral ointment"). Electrical pain stimuli were subsequently applied, which selectively induce a painful sensation. In the case of the learning condition (classical conditioning) and unbeknown to the participants, the intensity of the pain stimulus was reduced by 50% after the ointment had been applied. The study addressed the question whether the pain experienced by the patients with atopic dermatitis could be reduced through a placebo effect and whether the placebo effect was achieved through expectancy or through a process of classical conditioning or both. The results indicate that a placebo effect is achieved via expectancy and classical conditioning. However, conditioning processes seem to be necessary for a longer lasting effect. The extent of this effect seemed to be greater in atopics than in healthy controls. Expectancy, achieved through verbal instruction, might also be seen as a conditioned stimulus that reactivates earlier stimulus associations.
KW - Adolescent
KW - Adult
KW - Animals
KW - Cognition
KW - Conditioning, Classical
KW - Dermatitis, Atopic
KW - Dermatologic Agents
KW - Female
KW - Humans
KW - Hyperalgesia
KW - Male
KW - Models, Psychological
KW - Pain Threshold
KW - Placebo Effect
KW - Treatment Outcome
KW - Journal Article
KW - Randomized Controlled Trial
U2 - 10.1016/j.pain.2006.08.025
DO - 10.1016/j.pain.2006.08.025
M3 - SCORING: Journal article
C2 - 17030095
VL - 128
SP - 31
EP - 39
JO - PAIN
JF - PAIN
SN - 0304-3959
IS - 1-2
ER -