How prior experience shapes placebo analgesia
Abstract
Some studies indicate that placebo analgesia is stronger when pre-conditioning with effective analgesic treatments is performed, thereby suggesting that the placebo response is a learning phenomenon. Here we further tested this hypothesis in order to better understand when and how previous experience affects the placebo analgesic response. To do this, we used a conditioning procedure whereby the intensity of painful stimulation was reduced surreptitiously, so as to make the subjects believe that an analgesic treatment was effective. This procedure induced strong placebo responses after minutes, and these responses, albeit reduced, lasted up to 4-7 days. In addition, in a second group of subjects we repeated the same conditioning procedure 4-7 days after a totally ineffective analgesic treatment, and found that the placebo responses were remarkably reduced compared to the first group. Thus we obtained small, medium and large placebo responses, depending on several factors, such as the previous positive or negative experience of an analgesic treatment and the time lag between the treatment and the placebo responses. We also ran extinction trials, and found that these effects did not undergo extinction in a time span of several minutes. These findings indicate that placebo analgesia is finely tuned by prior experience and these effects may last, albeit reduced, several days. These results emphasize that the placebo effect is a learning phenomenon in which many factors come into…
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For Dataset 1, a sample size of 30 subjects was determined by examining previous studies investigating the effect of expectation on electrical pain and more subtle effects such as the effect of certainty or subliminally presented cue on pain intensity rating, which typically recruit 15-30 participants.
“For Dataset 1 we determined an appropriate sample size of 30 subjects by examining previous studies investigating the effect of expectation on electrical pain and more subtle effects such as the effect of certainty or subliminally presented cue on pain intensity rating, which typically recruit 15–30 participants (Brown, Seymour, El-Deredy, & Jones, 2008; Colloca & Benedetti, 2006; Jensen, Kaptchuk”
From Boundary effects of expectation in human pain perception (2019) · cites this paper as Colloca & Benedetti, 2006
The placebo phenomenon may promote appetitive and safety behaviors, while nocebo effects may favor perceptual mechanisms that are initiated to prevent dangerous events and negative outcomes.
“The placebo phenomenon may promote appetitive and safety behaviors, while nocebo effects may favor perceptual mechanisms that are initiated to prevent dangerous events and negative outcomes.23”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [23]
Evolutionarily, nocebo responses and placebo responses may represent 2 opposite pathways that coexist in the organism.
“Evolutionarily, nocebo responses and placebo responses may represent 2 opposite pathways that coexist in the organism.”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [23]
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Partial reinforcement, extinction, and placebo analgesia
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Self-citationTeaching neurons to respond to placebos
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Relieving pain using dose-extending placebos: a scoping review
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Self-citationSensitivity to pain expectations: A Bayesian model of individual differences
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Brain Activity Associated with Placebo Suppression of the Urge-to-Cough in Humans
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Self-citationClassical conditioning without verbal suggestions elicits placebo analgesia and nocebo hyperalgesia
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Self-citationMechanisms of the placebo response in pain in osteoarthritis
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Placebo analgesia: understanding the mechanisms
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Autonomic Arousal as a Mechanism of the Persistence of Nocebo Hyperalgesia
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Self-citationAre Blue Pills Better Than Green? How Treatment Features Modulate Placebo Effects
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Placebo-Induced Changes in Excitatory and Inhibitory Corticospinal Circuits during Motor Performance
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How Does Observational Learning Produce Placebo Effects? A Model Integrating Research Findings
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Can Psychological Expectation Models Be Adapted for Placebo Research?
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Self-citationThe Biology of Placebo and Nocebo Effects on Experimental and Chronic Pain: State of the Art
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Placebo, Nocebo, and Learning Mechanisms
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Self-citationBoundary effects of expectation in human pain perception
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“It has been previously proposed that pain perception reflects the precision-weighted average of expectation and sensation (Colloca & Benedetti, 2006; Colloca, Sigaudo, & Benedetti, 2008; Yeung, Colagiuri, Lovibond, & Colloca, 2014).”
BackgroundNocebo effects can make you feel pain
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Can expectancies produce placebo effects for implicit learning?
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- Authors
- Colloca, L., & Benedetti, F.
- Affiliations
- University of Turin (IT)
- Venue
- Pain
- Published
- 2006-09
- Volume
- 124
- Issue
- 1
- Pages
- 126-133
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2042891620
- Cited by
- 443
- References
- 34
- Citations by year
- 2026: 18 · 2025: 28 · 2024: 24 · 2023: 24 · 2022: 16 · 2021: 15 · 2020: 31 · 2019: 28 · 2018: 31 · 2017: 27 · 2016: 25 · 2015: 28 · 2014: 35 · 2013: 23 · 2012: 15
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- Ministero dell'Università e della Ricerca
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- placebo analgesia, placebo response, prior experience, conditioning, learning, extinction, analgesic treatment, pain perception
- MeSH terms
- Adult, Analgesia, Analysis of Variance, Child, Electroshock, Female, Humans, Male, Pain, Pain Measurement, Placebos, Placebo Effect, Pain Threshold
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