Abstract
Nocebo effects are adverse treatment outcomes that are not ascribed to active treatment components. Potentially, their magnitude might be higher in patients with chronic pain compared to healthy controls since patients likely experience treatment failure more frequently. The current study investigated group differences in the induction and extinction of nocebo effects on pressure pain at baseline (N = 69) and 1-month follow-up (N = 56) in female patients with fibromyalgia and matched healthy controls. Nocebo effects were first experimentally induced via classical conditioning combined with instructions on the pain-increasing function of a sham transcutaneous electrical nerve stimulation device, then decreased via extinction. One month later, the same procedures were repeated to explore their stability. Results suggest that nocebo effects were induced in the healthy control group during baseline and follow-up. In the patient group, nocebo effects were only induced during follow-up, without clear group differences. Extinction was only observed during baseline in the healthy control group. Further comparisons of nocebo effects and extinction indicated no significant changes across sessions, possibly suggesting their overall magnitudes were stable over time and across groups. In conclusion, contrary to our expectations, patients with fibromyalgia did not have stronger nocebo hyperalgesia; instead, they might be less responsive to nocebo manipulations than healthy controls. Perspective: The current study is the first to investigate group differences in experimentally manipulated nocebo hyperalgesia between chronic pain and healthy populations at baseline and 1-month follow-up. Since nocebo effects are common in clinical settings, their investigation in different populations is essential to explain and minimize their adverse effects during treatment.
Original language | English |
---|---|
Pages (from-to) | 1696-1711 |
Number of pages | 16 |
Journal | Journal of Pain |
Volume | 24 |
Issue number | 9 |
DOIs | |
Publication status | Published - Sept 2023 |
Externally published | Yes |
Bibliographical note
Funding Information:This study was funded by a VICI grant awarded to A.W.M. Evers from the Netherlands Organization for Scientific Research ( NWO ; grant number 45316004 ). The sham TENS devices were indefinitely loaned from Bentronic GmbH for the purposes of this study. The authors have no conflicts of interest to declare.
Publisher Copyright:
© 2023 United States Association for the Study of Pain, Inc.