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Is fear of pain related to placebo analgesia?

Lyby PS, et al. J Psychosom Res. 2010.


OBJECTIVE: Verbal information that a painkiller has been administered generates an expectation of pain relief which in turn decreases pain. This expectation-based pain reduction is termed placebo analgesia. We hypothesized that fear of pain would be related to higher stress and pain intensity and to reduced placebo analgesia.

METHODS: Sixty-three students (30 females) participated in a Two-Condition (placebo, natural history)xFive-Test (one pretest, four post-tests) within-subjects design. Heat pain was induced by a 30x30-mm contact thermode to the medial volar forearm. Each pain test lasted for 4 min at a temperature of 46 degrees C. Stress, arousal, and pain intensity and pain unpleasantness were rated on 100-mm visual analogue scales.

RESULTS: Fear of pain was related to higher anticipatory stress and to higher stress and pain intensity during pain. Fear of pain was also related to reduced placebo analgesic responding.

CONCLUSION: Fear of pain was positively related to stress both during pain and in the anticipation of pain, and negatively related to placebo analgesia. Previous research has indicated a role for increased stress in the nocebo response, and the present findings suggest that decreased stress may strengthen the placebo response.

Copyright 2010 Elsevier Inc. All rights reserved.


20307704 [PubMed - indexed for MEDLINE]

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