Department of Psychology and Behavioural Sciences

Testing a positive-affect induction to reduce verbally induced nocebo hyperalgesia in an experimental pain paradigm

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Andrew L. Geers, University of Toledo
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  • Shane Close, University of Toledo
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  • Fawn C. Caplandies, University of Toledo
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  • Charles L. Vogel, University of Toledo
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  • Ashley B. Murray, University of Toledo
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  • Yopina Pertiwi, University of Toledo
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  • Ian M. Handley, Montana State Univ, Montana State University, Montana State University System, Montana State University Bozeman, Dept Ecol
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  • Lene Vase

There is an ethical obligation to notify individuals about potential pain associated with diagnoses, treatments, and procedures; however, supplying this information risks inducing nocebo hyperalgesia. Currently, there are few empirically derived strategies for reducing nocebo hyperalgesia. Because nocebo effects are linked to negative affectivity, we tested the hypothesis that a positive-affect induction can disrupt nocebo hyperalgesia from verbal suggestion. Healthy volunteers (N = 147) were randomly assigned to conditions in a 2 (affect induction: positive vs neutral) by 2 (verbal suggestion: no suggestion vs suggestion of pain increase) between-subjects design. Participants were induced to experience positive or neutral affect by watching movie clips for 15 minutes. Next, participants had an inert cream applied to their nondominant hand, and suggestion was manipulated by telling only half the participants the cream could increase the pain of the upcoming cold pressor test. Subsequently, all participants underwent the cold pressor test (8 ± 0.04°C), wherein they submerged the nondominant hand and rated pain intensity on numerical rating scales every 20 seconds up to 2 minutes. In the neutral-affect conditions, there was evidence for the nocebo hyperalgesia effect: participants given the suggestion of pain displayed greater pain than participants not receiving this suggestion, P's < 0.05. Demonstrating a blockage effect, nocebo hyperalgesia did not occur in the positive-affect conditions, P's > 0.5. This is the first study to show that positive affect may disrupt nocebo hyperalgesia thereby pointing to a novel strategy for decreasing nocebo effects without compromising the communication of medical information to patients in clinical settings.

Original languageEnglish
Pages (from-to)2290-2297
Number of pages8
Publication statusPublished - Oct 2019

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