Tags

Type your tag names separated by a space and hit enter

Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans.
PLoS One. 2017; 12(9):e0182959.Plos

Abstract

Nocebo effects, i.e., adverse treatment effects which are induced by patients' expectations, are known to contribute to the experience of physical symptoms such as pain and itch. A better understanding of how to minimize nocebo responses might eventually contribute to enhanced treatment effects. However, little is known about how to reduce nocebo effects. In the current randomized controlled study, we tested whether nocebo effects can be minimized by positive expectation induction with respect to electrical and histaminic itch stimuli. First, negative expectations about electrical itch stimuli were induced by verbal suggestion and conditioning (part 1: induction of nocebo effect). Second, participants were randomized to either the experimental group or one of the control groups (part 2: reversing nocebo effect). In the experimental group, positive expectations were induced by conditioning with verbal suggestion. In the control groups either the negative expectation induction was continued or an extinction procedure was applied. Afterwards, a histamine application test was conducted. Positive expectation induction resulted in a significantly smaller nocebo effect in comparison with both control groups. Mean change itch NRS scores showed that the nocebo effect was even reversed, indicating a placebo effect. Comparable effects were also found for histamine application. This study is the first to demonstrate that nocebo effects can be minimized and even reversed by conditioning with verbal suggestion. The results of the current study indicate that learning via counterconditioning and verbal suggestion represents a promising strategy for diminishing nocebo responses.

Authors+Show Affiliations

Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands. Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands.Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands. Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands.Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands.Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands.Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands. Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands.Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands. Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands. Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands. Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28910291

Citation

Bartels, Danielle J P., et al. "Minimizing Nocebo Effects By Conditioning With Verbal Suggestion: a Randomized Clinical Trial in Healthy Humans." PloS One, vol. 12, no. 9, 2017, pp. e0182959.
Bartels DJP, van Laarhoven AIM, Stroo M, et al. Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans. PLoS ONE. 2017;12(9):e0182959.
Bartels, D. J. P., van Laarhoven, A. I. M., Stroo, M., Hijne, K., Peerdeman, K. J., Donders, A. R. T., van de Kerkhof, P. C. M., & Evers, A. W. M. (2017). Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans. PloS One, 12(9), e0182959. https://doi.org/10.1371/journal.pone.0182959
Bartels DJP, et al. Minimizing Nocebo Effects By Conditioning With Verbal Suggestion: a Randomized Clinical Trial in Healthy Humans. PLoS ONE. 2017;12(9):e0182959. PubMed PMID: 28910291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans. AU - Bartels,Danielle J P, AU - van Laarhoven,Antoinette I M, AU - Stroo,Michiel, AU - Hijne,Kim, AU - Peerdeman,Kaya J, AU - Donders,A Rogier T, AU - van de Kerkhof,Peter C M, AU - Evers,Andrea W M, Y1 - 2017/09/14/ PY - 2016/10/20/received PY - 2017/07/25/accepted PY - 2017/9/15/entrez PY - 2017/9/15/pubmed PY - 2017/10/13/medline SP - e0182959 EP - e0182959 JF - PloS one JO - PLoS ONE VL - 12 IS - 9 N2 - Nocebo effects, i.e., adverse treatment effects which are induced by patients' expectations, are known to contribute to the experience of physical symptoms such as pain and itch. A better understanding of how to minimize nocebo responses might eventually contribute to enhanced treatment effects. However, little is known about how to reduce nocebo effects. In the current randomized controlled study, we tested whether nocebo effects can be minimized by positive expectation induction with respect to electrical and histaminic itch stimuli. First, negative expectations about electrical itch stimuli were induced by verbal suggestion and conditioning (part 1: induction of nocebo effect). Second, participants were randomized to either the experimental group or one of the control groups (part 2: reversing nocebo effect). In the experimental group, positive expectations were induced by conditioning with verbal suggestion. In the control groups either the negative expectation induction was continued or an extinction procedure was applied. Afterwards, a histamine application test was conducted. Positive expectation induction resulted in a significantly smaller nocebo effect in comparison with both control groups. Mean change itch NRS scores showed that the nocebo effect was even reversed, indicating a placebo effect. Comparable effects were also found for histamine application. This study is the first to demonstrate that nocebo effects can be minimized and even reversed by conditioning with verbal suggestion. The results of the current study indicate that learning via counterconditioning and verbal suggestion represents a promising strategy for diminishing nocebo responses. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28910291/Minimizing_nocebo_effects_by_conditioning_with_verbal_suggestion:_A_randomized_clinical_trial_in_healthy_humans_ L2 - http://dx.plos.org/10.1371/journal.pone.0182959 DB - PRIME DP - Unbound Medicine ER -