ReviewPain research & management2018
The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia.
Review in Pain research & management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Learning by observing: a systematic exploration of modulatory factors and the impact of observationally induced placebo and nocebo effects on treatment outcomes.Frontiers in psychology · 2024Pooled it
- The "Are You OK?" Paradox: A Scoping Review of Nocebo and Negative Suggestion in Healthcare Communication.Dentistry journal · 2026Review
- The High-Risk Model of Threat Perception Modulates Learning of Placebo and Nocebo Effects and Functional Somatic Disorders.Brain sciences · 2025Review
- Hereditary angioedema in children: Review and practical perspective for clinical management.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2024Review
- A randomized pharmacological fMRI trial investigating D-cycloserine and brain plasticity mechanisms in learned pain responses.Scientific reports · 2022Article
- [Results of a pilot study on the role of therapy expectation in interdisciplinary multimodal pain therapy for chronic back pain].Schmerz (Berlin, Germany) · 2022Observational
- Counterconditioning as Treatment to Reduce Nocebo Effects in Persistent Physical Symptoms: Treatment Protocol and Study Design.Frontiers in psychology · 2022Article
- How Negative Experience Influences the Brain: A Comprehensive Review of the Neurobiological Underpinnings of Nocebo Hyperalgesia.Frontiers in neuroscience · 2021Review
- Nocebo and the contribution of psychosocial factors to the generation of pain.Journal of neural transmission (Vienna, Austria : 1996) · 2020Review
- "Placebo by Proxy" and "Nocebo by Proxy" in Children: A Review of Parents' Role in Treatment Outcomes.Frontiers in psychiatry · 2020Review
- Pavlov's Pain: the Effect of Classical Conditioning on Pain Perception and its Clinical Implications.Current pain and headache reports · 2019Review
- Placebo Manipulations Reverse Pain Potentiation by Unpleasant Affective Stimuli.Frontiers in psychiatry · 2019Article
- The Other Side of the Coin: Nocebo Effects and Psychotherapy.Frontiers in psychiatry · 2019Article
- Placebo and Nocebo Effects Across Symptoms: From Pain to Fatigue, Dyspnea, Nausea, and Itch.Frontiers in psychiatry · 2019Review
- Classical Conditioning as a Distinct Mechanism of Placebo Effects.Frontiers in psychiatry · 2019Article
- Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain.International review of neurobiology · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can cause these effects. Especially studies using subliminal stimulus presentation and implicit conditioning (i.e., without contingency awareness) that bypass the development of explicit expectation suggest that conditioning without explicit expectation can lead to placebo and nocebo effects in pain perception. Because only few studies have investigated clinical samples, the picture seems less clear when it comes to patient populations with chronic pain. However, conditioning appears to be a promising means to optimize treatment. In order to get a better insight into the mechanisms of placebo and nocebo effects in pain and the possible benefits of conditioning compared to explicit expectation, future studies should carefully distinguish both methods of induction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.