副作用期待とノセボ副作用に対する尤度フレーミングの影響:プラセボ鎮痛クリームを用いた3つの実験的研究の結果
Tobias Kube1,2,3, John M Kelley3,4, Arthur J Barsky3,5
1Department of Clinical Psychology and Experimental Psychopathology, Goethe University Frankfurt, Frankfurt, Germany.
Objectives:
This research examined whether different framings of the likelihood of side effects influence their occurrence in response to a placebo analgesic.
Design:
Three independent experimental studies in non-clinical samples were performed.
Methods:
Study 1 investigated the effects of likelihood framing on side effect expectations, while Studies 2 and 3 investigated the effects of likelihood framing on side effect experiences in terms of nocebo side effects.
Results:
Study 1 (N = 244) showed that participants had higher side expectations when the side effect likelihood was negatively framed (e.g. 1% occurrence) than positively framed (e.g. 99% no occurrence). Side effect expectations were also more negative when frequencies (e.g. 1 in 100) rather than percentages were used. Study 2 tested the effects of positive vs. negative framing and percentages vs. frequencies on the occurrence of itch as a side effect of a placebo analgesic cream, which was applied in an experimental heat pain paradigm in a non-clinical sample (N = 179). Only 11% reported itch, with no significant differences between conditions. Study 3 (N = 110) increased the stated likelihood of itch, yet only 17% reported experiencing it. Crucially, reports of itch did not differ between experimental groups and a control group where itch was not mentioned as a possible side effect.
Conclusion:
This research failed to induce itch as a nocebo response. While examining likelihood framing in nocebo side effects is valuable, establishing an appropriate experimental model remains challenging. Future research directions and methodological considerations to move forward are discussed.
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