Cited by 40Pain Management and Placebo EffectPain Mechanisms and TreatmentsPain Management and Treatment

Nocebo hyperalgesia: contributions of social observation and body-related cognitive styles

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Vögtle, Elisabeth, Kröner-Herwig, Birgit, Barke, Antonia·2016·Journal of Pain Research

Abstract

PURPOSE: Recently, it has been shown that nocebo hyperalgesia can be acquired through observational learning. The aim of this study was to investigate socially induced nocebo hyperalgesia and its relationship with pain catastrophizing, somatic complaints, hypochondriacal concerns, and empathy. PARTICIPANTS AND METHODS: Ninety-seven women (43.1±15.5 years) were randomly assigned to one of the two conditions. Participants in the nocebo condition (NC) watched a video in which a female model displayed more pain when an ointment was applied and less pain when no ointment was applied. In the control condition (CC), the model demonstrated low pain with and without the ointment. Subsequently, all participants received three pressure pain stimuli (60 seconds) on each hand. On one hand, the ointment was applied prior to the stimulation. The order of the stimulation of the fingers (middle, index, or ring finger), the side of ointment application (left or right hand), and the side with which the stimulation began were randomized within each group and balanced across the groups. Depending on the randomization, the pressure pain application started with or without ointment and on the left or right hand. Pain ratings on a numerical rating scale (0-10) were collected. In addition, the participants completed questionnaires regarding body-related cognitive styles and empathy. RESULTS: There was a significant difference in the pain ratings between the CC and the NC. The effect of ointment application was also significant, but no interaction between condition and ointment application was found. Only in the CC did the nocebo response correlate with hypochondriacal concerns and somatic complaints. CONCLUSION: Application of an ointment as well as the observation of a model demonstrating more pain after a treatment produced elevated pain ratings. Cognitive styles were not related to the socially induced nocebo response, but were related to the nocebo response in the CC.

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Crossref · 10.2147/jpr.s96228

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  • The basic psychological mechanisms underlying the formation of negative expectations and nocebo effects are anticipation of and information about negative outcomes, prior lack of therapeutic effectiveness, and observation of other patients' pain worsening.

    “The basic psychological mechanisms underlying the formation of negative expectations and thus, nocebo effects, are anticipation of and information about negative outcomes,34,76 prior lack of therapeutic effectiveness,33,34 and observation of other patients' pain worsening.42,60,74,77,78”
  • Hyperalgesic effects were more potent after observing the male model receiving the painful stimulations, regardless of the sex of the participants.

    “A sex effect was also apparent, as the hyperalgesic effects were more potent after observing the male model receiving the painful stimulations, regardless of the sex of the participants.”
  • Psychological assessments revealed that empathetic traits were a predictor of the level of nocebo hyperalgesia.

    “Moreover, psychological assessments revealed that empathetic traits were a predictor of the level of nocebo hyperalgesia.74”
  • Another study documented that nocebo hyperalgesia was found in a group who observed a male or female model receive less painful stimulations with the appearance of a green-light, and higher pain intensities with appearance of a red-light, for a period of about 5 minutes prior to receiving the stimuli themselves.

    “Another study documented that nocebo hyperalgesia was found in a group who observed a male or female model receive less painful stimulations with the appearance of a green-light, and higher pain intensities with appearance of a red-light, for a period of about 5 minutes prior to receiving the stimuli themselves.”
  • Participants who observed the model rated the red-stimuli as more painful when compared to the control groups who did not engage in the social observation period.

    “Results showed that participants who observed the model rated the red-stimuli as more painful when compared to the control groups who did not engage in the social observation period.”

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Authors
Vögtle, E., Kröner-Herwig, B., & Barke, A.
Affiliations
  • University of Göttingen (DE)
  • Philipps University of Marburg (DE)
Corresponding author
Vögtle, Elisabeth
Venue
Journal of Pain Research
Published
2016-04
Volume
9
Pages
241
ISSN
1178-7090 (ISSN-L)
OpenAlex
W2343882192
Cited by
40
References
34
Citations by year
2026: 1 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 2
FWCI
2.12
Type
journal article
Language
en
Open access
Locations
  • Journal of Pain Research (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by-nc)
Funders
  • Deutsche Forschungsgemeinschaft
  • Georg-August-Universität Göttingen
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
nocebo hyperalgesia, observational learning, social learning, pain catastrophizing, somatic symptoms, empathy, pressure pain, placebo effect

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