How positive and negative expectations shape the experience of visceral pain: an experimental pilot study in healthy women

Background  In order to elucidate placebo and nocebo effects in visceral pain, we analyzed the effects of positive and negative expectations on rectal pain perception, rectal pain thresholds, state anxiety and cortisol responses in healthy women. Methods  Painful rectal distensions were delivered at...

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Bibliographic Details
Published in:Neurogastroenterology and motility 2012-10, Vol.24 (10), p.914-e460
Main Authors: Elsenbruch, S., Schmid, J., Bäsler, M., Cesko, E., Schedlowski, M., Benson, S.
Format: Article
Language:English
Subjects:
Adult
Anxiety
Aversion
Cognitive ability
cortisol
Distension
Emotions
Emotions - physiology
expectations
Female
Humans
Hydrocortisone
Manometry
nocebo
Pain perception
Pain Threshold - psychology
Pilot Projects
placebo
Rectum
Stress
visceral pain
Visceral Pain - psychology
Young Adult
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Summary:Background  In order to elucidate placebo and nocebo effects in visceral pain, we analyzed the effects of positive and negative expectations on rectal pain perception, rectal pain thresholds, state anxiety and cortisol responses in healthy women. Methods  Painful rectal distensions were delivered at baseline, following application of an inert substance combined with either positive instructions of pain relief (placebo group, N = 15), negative instructions of pain increase (nocebo group, N = 17), or neutral instructions (control, N = 15). Perceived pain intensity, unpleasantness/aversion and urge‐to‐defecate, state anxiety and serum cortisol were determined at baseline, immediately following group‐specific instructions and on a second study day after the same instructions (test day). Rectal pain thresholds were determined at baseline and on the test day. Key Results  Whereas perceived pain intensity was significantly decreased in the placebo group, the nocebo group revealed significantly increased pain intensity ratings, along with significantly greater anticipatory anxiety on the test day (all P 
ISSN:1350-1925
1365-2982
DOI:10.1111/j.1365-2982.2012.01950.x