Placebo effects on stress, but not on pain reports: A multi-experiment study
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Background Contextual factors, such as participant/experimenter sex may moderate the placebo effects. We tested whether the participant and experimenter sex modulated placebo effects on experimentally induced pain and associated stress. Objective To investigate if (i) participant sex and (ii) experimenter sex influence placebo analgesia and subjective and physiological stress in two experiments employing a within-subjects and a mixed design, respectively. Placebo effects were investigated in pain reports, stress, and blood pressure. Methods Participants received painful stimulations and a placebo cream. In Experiment One (N = 59) participants underwent a placebo condition (PC) and a natural history condition (NHC) in random order. A placebo cream was applied in the PC and then the heat stimulation temperature was surreptitiously lowered. Identical stimulations were administered in the NHC, but with no cream, no information, and no lowered temperature. In Experiment Two, participants (N = 93) were randomly assigned to three groups receiving either a placebo cream with surreptitiously lowered intensity of electric stimuli (Placebo, PG), a placebo cream (Cream-Control, CCG) without changing the stimuli, or lowered intensity, but with no cream (Pain-Control, PCG) in a mixed design. All participants in both experiments received the same stimuli in the post-test as in the pre-test. Four experimenters (two females) in Experiment One, and five experimenters (two females) in Experiment Two conducted the studies. Results No placebo effect was seen on pain. However, there were placebo effects on stress, moderated by participant and experimenter sex: in Experiment One males in the PC had lower diastolic blood pressure (DBP) compared to males in the NHC. Participants in the PC had lower DBP compared to the NHC when tested by a female. In Experiment Two, participants expected more cream effectiveness when a female experimenter administered it, and reported lower stress in the PG compared to the PCG when tested by females. Conclusion Our findings highlight a distinction between placebo effects on pain and on associated stress. Secondly, female experimenters recorded lower physiological and subjective stress, higher effectiveness expectations, and lower pain from both sexes compared to male experimenters. Possible reasons for the failure to find a pain placebo effect are discussed.
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Research on positive verbal suggestions and anxiety and stress has shown that these suggestions can have beneficial effects.
“Similarly, research on positive verbal suggestions and anxiety and stress have shown that these suggestions can have beneficial effects (e.g., McCann et al., 1992; Vambheim et al., 2021).”
From Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations (2024) · cites this paper as Vambheim et al., 2021
The Conclusion (page unavailable) reports lower diastolic blood pressure in male participants following a placebo manipulation, supporting a limited beneficial effect on physiological stress. But the General Discussion says the verbal information was not designed to generate a positive expectation on its own, and Experiment One’s Results found no difference between conditions in subjective stress. The paper therefore does not establish that positive verbal suggestions themselves benefited anxiety or stress. (LLM, conf=0.82)
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Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations
Bos, D. P. A., Keesman, M., Roggeveen, A., Vase, L., Evers, A. W. M., & Peerdeman, K. J. (2024) · Behavior Therapy · doi:10.1016/j.beth.2024.03.004 · Cited by 5 · see citing works
- Authors
- Vambheim, S. M., Daniali, H., & Flaten, M. A.
- Affiliations
- Oslo University Hospital (NO)
- Norwegian University of Science and Technology (NO)
- Corresponding author
- Flaten, Magne Arve
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2021-06-07
- Volume
- 12
- Pages
- 639236-639236
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC8215114
- OpenAlex
- W3173023406
- Cited by
- 16
- References
- 72
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 7 · 2023: 3 · 2022: 2
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Universitetet i Tromsø
- Norges Teknisk-Naturvitenskapelige Universitet
- Fundação Bial
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Dentistry › Oral Surgery › Dental Anxiety and Anesthesia Techniques
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- placebo effect, placebo analgesia, stress, sex differences, experimenter sex, blood pressure, pain perception, expectancy, thermal pain
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