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Cited by 403Pain Management and Placebo EffectPain Management and Opioid UsePain Mechanisms and Treatments

Perceived self-efficacy and pain control: opioid and nonopioid mechanisms

Bandura, Albert, O'Leary, Ann, Taylor, C. Barr, Gauthier, Janel, Gossard, Denis·1987·Journal of Personality and Social Psychology
DOI 10.1037/0022-3514.53.3.563
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Abstract

In this experiment, we tested for opioid and nonopioid mechanisms of pain control through cognitive means and the relation of opioid involvement to perceived coping efficacy. Subjects were taught cognitive methods of pain control, were administered a placebo, or received no intervention. Their pain tolerance was then measured at periodic intervals after they were administered either a saline solution or naloxone, an opiate antagonist that blocks the effects of endogenous opiates. Training in cognitive control strengthened perceived self-efficacy both to withstand and to reduce pain; placebo medication enhanced perceived efficacy to withstand pain but not reductive efficacy; and neither form of perceived self-efficacy changed without any intervention. Regardless of condition, the stronger the perceived self-efficacy to withstand pain, the longer subjects endured mounting pain stimulation. The findings provide evidence that attenuation of the impact of pain stimulation through cognitive control is mediated by both opioid and nonopioid mechanisms. Cognitive copers administered naloxone were less able to tolerate pain stimulation than were their saline counterparts. The stronger the perceived self-efficacy to reduce pain, the greater was the opioid activation. Cognitive copers were also able to achieve some increase in pain tolerance even when opioid mechanisms were blocked by naloxone, which is in keeping with a nonopioid component in cognitive pain control. We found suggestive evidence that placebo medication may also activate some opioid involvement. Because placebos do not impart pain reduction skills, it was perceived self-efficacy to endure pain that predicted degree of opioid activation.

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  • In chronic pain research, perceived self-efficacy modulates pain perception and determines coping behavior and quality of life, independently of and often more strongly than physical variables such as pain intensity or duration.

    “One exception is the area of chronic pain research, where several studies demonstrated that perceived self-efficacy not only modulates pain perception (Bandura et al., 1987), but crucially determines coping behavior and quality of life, independently of and often more strongly than physical variables, such as pain intensity or duration (Arnstein et al., 1999; Denison et al., 2004; Burke et al., 20”

    From Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression (2016) · cites this paper as Bandura et al., 1987

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Authors
Bandura, A., O'Leary, A., Taylor, C. B., Gauthier, J., & Gossard, D.
Affiliations
Stanford University (US)
ORCID
Venue
Journal of Personality and Social Psychology
Publisher
American Psychological Association (APA)
Published
1987
Volume
53
Issue
3
Pages
563-571
ISSN
  • 0022-3514 (ISSN-L)
  • 1939-1315
DOI
10.1037/0022-3514.53.3.563
OpenAlex
W2166653039
Cited by
403
References
0
Citations by year
2026: 6 · 2025: 5 · 2024: 6 · 2023: 11 · 2022: 7 · 2021: 19 · 2020: 8 · 2019: 15 · 2018: 10 · 2017: 9 · 2016: 5 · 2015: 17 · 2014: 11 · 2013: 16 · 2012: 18
FWCI
4.16
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Personality and Social Psychology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (MH-5162-25)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Keywords
self-efficacy, pain management, cognitive coping, pain tolerance, opioid mechanisms, naloxone, placebo effect, analgesia
MeSH terms
Female, Humans, Male, Nociceptors, Pain, Pain Measurement, Receptors, Opioid, Self Concept, Sensory Thresholds, Set, Psychology

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