Increased placebo analgesia over time in irritable bowel syndrome (IBS) patients is associated with desire and expectation but not endogenous opioid mechanisms
Abstract
A study was conducted to determine whether changes in expected pain levels, desire for pain relief, or anxiety contribute to an increase in placebo analgesia over time as well as to determine whether placebo analgesic effects of IBS patients are related to endogenous opioid mechanisms. Twenty-six women with IBS were exposed to rectal stimulation (35 or 55 mmHg for 30 s) and tested under natural history (NH), rectal placebo (RP) and rectal lidocaine (RL) conditions. During all conditions, 16 patients were given saline intravenously (to test for a placebo effect) and 10 patients were given naloxone intravenously (to test naloxone antagonism of the placebo effect) on a double blind basis. Patients rated expected pain level, desire for pain relief and anxiety at 2 and 22 min after the onset of NH, RP, and RL conditions and they rated actual pain intensity at 5-min intervals for 40 min. There was a large and significant placebo effect (P<0.001) that increased over time. Ratings of expected pain levels, desire for pain relief and anxiety decreased over time and contributed to more variance in placebo and lidocaine responses during the last half of the session. These changes suggest that a reduction in negative emotions may be central to placebo effects. There was no significant difference between psychological mediators (desire, expectation, anxiety) or the placebo effect in the saline and naloxone groups, indicating that neither the psychological mediators nor the placebo analgesic effect were associated with endogenous opioids in this clinically related paradigm.
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In some cases cue effects can persist even after reinforcement ceases, resisting extinction and sometimes even growing over time.
“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 [37]
These two mechanisms explain how expectancy effects are mainly resistant to change and even can grow over time.
“These two mechanisms explain how expectancy effects are mainly resistant to change and even can grow over time (37, 80, 81).”
From Social information creates self-fulfilling prophecies in judgments of pain, vicarious pain, and cognitive effort (2026) · cites this paper as [37]
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- Authors
- Vase, L., Robinson, M. E., Verne, N. G., & Price, D. D.
- Affiliations
- Aarhus University (DK)
- University of Florida Health (US)
- United States Department of Veterans Affairs (US)
- University of Florida (US)
- Corresponding author
- Robinson, Michael E.
- Venue
- Pain
- Published
- 2005-06
- Volume
- 115
- Issue
- 3
- Pages
- 338-347
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W1996294605
- Cited by
- 331
- References
- 29
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 5 · 2023: 10 · 2022: 11 · 2021: 11 · 2020: 20 · 2019: 19 · 2018: 15 · 2017: 19 · 2016: 14 · 2015: 20 · 2014: 27 · 2013: 27 · 2012: 16
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Center for Complementary and Integrative Health (R01AT001424)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Complementary and alternative medicine › Acupuncture Treatment Research Studies
- Keywords
- placebo analgesia, irritable bowel syndrome, pain anticipation, anxiety, endogenous opioids, naloxone, rectal pain, psychological mediators
- MeSH terms
- Adult, Analgesia, Anesthetics, Local, Anxiety, Attitude to Health, Female, Humans, Lidocaine, Naloxone, Narcotic Antagonists, Pain, Pain Measurement, Predictive Value of Tests, Sodium Chloride, Placebo Effect, Opioid Peptides, Irritable Bowel Syndrome
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