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Cited by 249Pain Management and Placebo EffectPain Mechanisms and TreatmentsDental Anxiety and Anesthesia Techniques

The contribution of suggestibility and expectation to placebo analgesia phenomenon in an experimental setting

De Pascalis, Vilfredo, Chiaradia, Carmela, Carotenuto, Eleonora·2002·Pain
DOI 10.1016/s0304-3959(01)00485-7
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Abstract

This study reports how placebo analgesia was produced by conditioning whereby the intensity of electric stimulation was surreptitiously reduced in order to examine the contribution of psychological factors of suggestibility and expectancy on placebo analgesia. This strategy was used in order to manipulate expectancy for pain reduction. The magnitudes of the placebo effects were estimated after a manipulation procedure and during experimental trials in which stimulus intensities were reset to original baseline levels. Individual differences in suggestibility, verbal expectancy for drug efficacy and manipulation procedure for pain reduction were tested as possible mediators of placebo analgesia. The following dependent variables were measured: (a) subjective expectancy for drug efficacy in pain relief, (b) expected pain intensity and unpleasantness, (c) concurrent pain intensity and unpleasantness and (d) remembered pain intensity and unpleasantness. Statistically significant placebo effects on sensory and affective measures of pain were obtained independently of the extent of the surreptitious lowering of stimulus strength during manipulation trials. The pairing of placebo administration with painful stimulation was sufficient to produce a generalized placebo analgesic effect. However, verbal expectancy for drug efficacy and individual differences in suggestibility were found to contribute significantly to the magnitude of placebo analgesia. The highest placebo effect was shown by the most pronounced reductions in pain ratings in highly suggestible subjects who received suggestions presumed to elicit high expectancy for drug efficacy. The results also demonstrated that placebo effects established on remembered pain were at least twice as great as those obtained on concurrent placebo effects. This was mainly because baseline pain was remembered as being much more intense than it really was. Moreover, remembered placebo effects, like the concurrent placebo effects, were highly correlated with expected pain scores obtained just after manipulation trials. These results indicate that multiple factors contribute to the placebo effect, including suggestibility, expectancy and conditioning, and that the judgement of placebo analgesia is critically determined by whether pain relief is assessed concurrently or after treatment.

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  • The experience of pain results from both sensory input and psychological variables such as personality traits and anxiety level.

    “The experience of pain results from both sensory input and psychological variables such as personality traits and anxiety level1–5.”

    From Boundary effects of expectation in human pain perception (2019) · cites this paper as [1]

  • The experience of pain is strongly affected by other psychological variables such as optimism, anxiety, suggestibility, and reward responsiveness.

    “Our interest in individual differences was motivated by our own and others’ findings that the experience of pain is strongly affected by other psychological variables such as optimism, anxiety, suggestibility, and reward responsiveness1–5.”

    From Boundary effects of expectation in human pain perception (2019) · cites this paper as [1]

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Authors
De Pascalis, V., Chiaradia, C., & Carotenuto, E.
Affiliations
Sapienza University of Rome (IT)
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-04
Volume
96
Issue
3
Pages
393-402
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/s0304-3959(01)00485-7
OpenAlex
W2063998636
Cited by
249
References
45
Citations by year
2026: 2 · 2025: 9 · 2024: 11 · 2023: 4 · 2022: 8 · 2021: 12 · 2020: 12 · 2019: 11 · 2018: 14 · 2017: 16 · 2016: 8 · 2015: 16 · 2014: 18 · 2013: 11 · 2012: 5
FWCI
4.02
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Dentistry › Oral Surgery › Dental Anxiety and Anesthesia Techniques
Keywords
placebo analgesia, suggestibility, expectancy, classical conditioning, pain perception, pain unpleasantness, pain memory, individual differences
MeSH terms
Adult, Affective Symptoms, Analgesia, Conditioning, Psychological, Electric Stimulation, Female, Humans, Male, Memory, Pain, Suggestion, Placebo Effect, Pain Threshold

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