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Conditioned Placebo Analgesia Persists When Subjects Know They Are Receiving a Placebo
Open accessAbstract
Unlabelled Belief in the effectiveness of a placebo treatment is widely thought to be critical for placebo analgesia. Many types of placebo responses--even those that depend on conditioning--appear to be mediated by expectations that are strengthened as treatment cues are reinforced with positive outcomes. However, placebo effects may occur even when participants are aware they are receiving a placebo. To address the question of whether conditioned placebo analgesia can persist in the absence of expectations, we studied the effects of long (4 days) versus short (1 day) conditioning to a placebo treatment. After an initial placebo test, a "reveal" manipulation convincingly demonstrated to participants that they had never received an active drug. Placebo analgesia persisted after the reveal in the long conditioning group only. These findings suggest that reinforcing treatment cues with positive outcomes can create placebo effects that are independent of reported expectations for pain relief.Perspective This article demonstrates a form of placebo analgesia that relies on prior conditioning rather than current expected pain relief. This highlights the importance of prior experience on pain relief and offers insight into the variability of placebo effects across individuals.
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“However, in some cases cue effects can persist even after reinforcement ceases, resisting extinction and sometimes even growing over time (34–37).”
From Social information creates self-fulfilling prophecies in judgments of pain, vicarious pain, and cognitive effort (2026) · cites this paper as [35]
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Metadata
- Authors
- Schafer, S. M., Colloca, L., & Wager, T. D.
- Affiliations
- University of Colorado Boulder (US)
- University of Maryland, Baltimore (US)
- Corresponding author
- Schafer, Scott M.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 16
- Issue
- 5
- Pages
- 412-420
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC4424173
- OpenAlex
- W2085650940
- Cited by
- 117
- References
- 38
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 16 · 2023: 4 · 2022: 12 · 2021: 7 · 2020: 11 · 2019: 12 · 2018: 12 · 2017: 15 · 2016: 9 · 2015: 8
- FWCI
- 8.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1f31da034516-01)
- National Institute of Mental Health (R01MH076136)
- National Institute on Drug Abuse (5F31DA034516-03, F31 DA034516)
- National Center for Complementary and Integrative Health (Z99AT999999)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Complementary and alternative medicine › Acupuncture Treatment Research Studies
- Keywords
- placebo effect, expectations, conditioning, analgesia, prior experience, interindividual variability
- MeSH terms
- Adolescent, Adult, Analgesia, Conditioning, Psychological, Female, Humans, Male, Middle Aged, Placebo Effect, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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