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Nocebo hyperalgesia can be induced by classical conditioning without involvement of expectancy
Elżbieta A Bajcar1, Wacław M Adamczyk1,2, Karolina Wiercioch-Kuzianik1
1Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland.
Plos One
|May 8, 2020
Summary
Classical conditioning can induce nocebo hyperalgesia, particularly through hidden procedures that bypass conscious expectations. This effect occurred regardless of participants' fear of pain levels.
Area of Science:
- Psychology
- Neuroscience
- Pain Research
Background:
- Classical conditioning is theorized to influence placebo effects via conscious expectancies.
- Distinguishing conditioning from expectancy is crucial for understanding nocebo hyperalgesia formation.
Purpose of the Study:
- To investigate the role of conscious expectancy in the development of nocebo hyperalgesia.
- To compare the effectiveness of hidden versus open conditioning procedures in inducing nocebo effects.
- To examine how fear of pain influences nocebo hyperalgesia.
Main Methods:
- Eighty-seven healthy females were randomly assigned to hidden conditioning, open conditioning, or control groups.
- Conditioning involved pairing colors with different pain stimulus intensities (moderate vs. high).
- Participants rated pain intensity, expectancy, and fear before and after stimuli exposure.
Main Results:
- Nocebo hyperalgesia was induced more effectively by hidden conditioning than open conditioning.
- Hidden conditioning did not generate conscious pain expectancies.
- Nocebo hyperalgesia was observed in both high and low fear of pain subgroups, with no significant difference in magnitude.
Conclusions:
- Classical conditioning, especially when implicit (hidden), can induce nocebo hyperalgesia independently of conscious expectancies.
- Fear of pain does not appear to moderate the induction of nocebo hyperalgesia.
- These findings highlight the power of non-conscious conditioning in pain modulation.
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