The DOI matches its Crossref record; 24 of the 25 references it cites were found in a registry or an index.
Response expectancies in placebo analgesia and their clinical relevance
Abstract
Response expectancies have been proposed as the major determinant of placebo effects. Here we report that different expectations produce different analgesic effects which in turn can be harnessed in clinical practice. Thoracotomized patients were treated with buprenorphine on request for 3 consecutive days, together with a basal intravenous infusion of saline solution. However, the symbolic meaning of this basal infusion was changed in three different groups of patients. The first group was told nothing about any analgesic effect (natural history). The second group was told that the basal infusion was either a powerful painkiller or a placebo (classic double-blind administration). The third group was told that the basal infusion was a potent painkiller (deceptive administration). Therefore, whereas the analgesic treatment was exactly the same in the three groups, the verbal instructions about the basal infusion differed. The placebo effect of the saline basal infusion was measured by recording the doses of buprenorphine requested over the three-days treatment. We found that the double-blind group showed a reduction of buprenorphine requests compared to the natural history group. However, this reduction was even larger in the deceptive administration group. Overall, after 3 days of placebo infusion, the first group received 11.55 mg of buprenorphine, the second group 9.15 mg, and the third group 7.65 mg. Despite these dose differences, analgesia was the same in the three groups. These results indicate that different verbal instructions about certain and uncertain expectations of analgesia produce different placebo analgesic effects, which in turn trigger a dramatic change of behaviour leading to a significant reduction of opioid intake.
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“In a clinical setting, it has been demonstrated that either or both placebo (positive expectancy of pain relief) and nocebo effects (negative expectancy of increased pain) influence the effectiveness of medical treatment (Kam-Hansen et al., 2014; Pollo et al., 2001).”
From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Pollo et al., 2001
Citations
Cites
Pavlovian conditioning: it's not what you think it is
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Classical conditioning and the placebo effect
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The role of conditioning and verbal expectancy in the placebo response
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Somatotopic Activation of Opioid Systems by Target-Directed Expectations of Analgesia
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Self-citationChanging expectations: a key to effective psychotherapy
(1990) · Choice Reviews Online · doi:10.5860/choice.28-2424 · Cited by 342
CLINICIANS' EXPECTATIONS INFLUENCE PLACEBO ANALGESIA
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Biological, clinical, and ethical advances of placebo effects
Finniss, D. G., Kaptchuk, T. J., Miller, F. G., & Benedetti, F. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61706-2 · Cited by 1,309
Self-citationA Comprehensive Review of the Placebo Effect: Recent Advances and Current Thought
Price, D. D., Finniss, D. G., & Benedetti, F. (2008) · Annual Review of Psychology · doi:10.1146/annurev.psych.59.113006.095941 · Cited by 1,146
Self-citationState-dependent opioid control of pain
Fields, H. (2004) · Nature Reviews Neuroscience · doi:10.1038/nrn1431 · Cited by 946
Benedetti, F., Pollo, A., Lopiano, L., Lanotte, M., Vighetti, S., & Rainero, I. (2003) · The Journal of Neuroscience · doi:10.1523/jneurosci.23-10-04315.2003 · Cited by 788
Self-citationPlacebo interventions for all clinical conditions
Hróbjartsson, A., & Gøtzsche, P. C. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003974.pub3 · Cited by 777
Metadata
- Authors
- Pollo, A., Amanzio, M., Arslanian, A., Casadio, C., Maggi, G., & Benedetti, F.
- Affiliations
- University of Turin (IT)
- Corresponding author
- Benedetti, Fabrizio
- Venue
- Pain
- Published
- 2001-07
- Volume
- 93
- Issue
- 1
- Pages
- 77-84
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W1987206591
- Cited by
- 442
- References
- 25
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 12 · 2023: 16 · 2022: 11 · 2021: 8 · 2020: 29 · 2019: 16 · 2018: 24 · 2017: 27 · 2016: 17 · 2015: 23 · 2014: 25 · 2013: 20 · 2012: 20
- FWCI
- 6.64
- 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
- Centre National de la Recherche Scientifique
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- placebo analgesia, response expectancy, placebo effect, buprenorphine, thoracotomy, verbal instructions, deception
- MeSH terms
- Aged, Analgesics, Analgesics, Opioid, Buprenorphine, Double-Blind Method, Female, Humans, Male, Middle Aged, Postoperative Pain, Placebo Effect
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