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Eur J Pain. 2017 Sep;21(8):1366-1377. doi: 10.1002/ejp.1035. Epub 2017 Apr 19.

Placebo-like analgesia via response imagery.

Author information

1
Unit Health, Medical and Neuropsychology, Leiden University, the Netherlands.
2
Leiden Institute for Brain and Cognition, Leiden University, the Netherlands.
3
Department of Psychiatry, Leiden University Medical Center, the Netherlands.
4
Department of Clinical Psychological Science, Maastricht University, the Netherlands.

Abstract

BACKGROUND:

Placebo effects on pain are reliably observed in the literature. A core mechanism of these effects is response expectancies. Response expectancies can be formed by instructions, prior experiences and observation of others. Whether mental imagery of a response can also induce placebo-like expectancy effects on pain has not yet been studied systematically.

METHODS:

In Study 1, 80 healthy participants were randomly allocated to (i) response imagery or (ii) control imagery. In Study 2, 135 healthy participants were randomly allocated to (i) response imagery with a verbal suggestion regarding its effectiveness, (ii) response imagery only, or (iii) no intervention. In both studies, expected and experienced pain during cold pressor tests were measured pre- and post-intervention, along with psychological and physiological measures.

RESULTS:

Participants rated pain as less intense after response imagery than after control imagery in Study 1 (p = 0.044, ηp2 = 0.054) and as less intense after response imagery (with or without verbal suggestion) than after no imagery in Study 2 (p < 0.001, ηp2 = 0.154). Adding a verbal suggestion did not affect pain (p = 0.068, ηp2 = 0.038). The effects of response imagery on experienced pain were mediated by expected pain.

CONCLUSIONS:

Thus, in line with research on placebo effects, the current findings indicate that response imagery can induce analgesia, via its effects on response expectancies.

SIGNIFICANCE:

The reported studies extend research on placebo effects by demonstrating that mental imagery of reduced pain can induce placebo-like expectancy effects on pain.

PMID:
28421648
PMCID:
PMC5573948
DOI:
10.1002/ejp.1035
[Indexed for MEDLINE]
Free PMC Article

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