I am delighted to announce the exciting news that we have received just under 900 abstracts for presentation in the scientific program of the VIth World Congress on Pain in Adelaide, April l-6, 1990. This 1s about a 50% increase in the number of abstracts submitted for the 1987 Congress in Hamburg and it represents by far the greatest number of scientific papers ever offered for the an IASP Congress. This surely reflects the healthy state of IASP and is also a very encouraging indlcator of the high level of activity in basic and clinical research in the field of pain throughout the world. Based upon our previous experience with the ratio of congress delegates to scientific abstracts, the Adelaide Congresses promises to be the largest world congress on pain we have so far held.

International association for the study of pain

Behavioral Methods for Chronic Pain and Illness

Placebo and Nocebo Effects Placebo and nocebo effects (effects of patients’ positive and negative expectations) are powerful and pervasive in clinical practice. Neurobiologic mechanisms, informatio...

https://www.nejm.org/doi/pdf/10.1056/NEJMra1907805

Placebo and Nocebo Effects

The biopsychosocial model of pain dominates the scientific community's understanding of chronic pain. Indeed, the biopsychosocial approach describes pain and disability as a multidimensional, dynamic integration among physiological, psychological, and social factors that reciprocally influence one another. In this article, we review two categories of studies that evaluate the contributions of psychosocial factors to the experience of chronic pain. First, we consider general psychosocial variables including distress, trauma, and interpersonal factors. Additionally, we discuss pain-specific psychosocial variables including catastrophizing, expectations, and pain-related coping. Together, we present a diverse array of psychological, social, and contextual factors and highlight the need to consider their roles in the development, maintenance, and treatment of chronic pain conditions.

/pdf/evaluating-psychosocial-contributions-to-chronic-pain-2luizh10ef.pdf

Evaluating Psychosocial Contributions to Chronic Pain Outcomes

https://www.cell.com/neuron/pdf/S0896-6273(14)00921-0.pdf

Placebo Effects: From the Neurobiological Paradigm to Translational Implications

Psychological correlates of acute postsurgical pain: A systematic review and meta-analysis.

Research shows that placebo analgesia can be induced through social observational learning. Our aim was to replicate and extend this result by studying the effect of the sex of both the model and the subject on the magnitude of placebo analgesia induced by social observational learning. Four experimental (1 through 4) and 2 control (5 and 6) groups were observed: groups 1, 3, and 5 were female; groups 2, 4, and 6 were male. All subjects received pain stimuli of the same intensity preceded by green and red lights. Before receiving pain stimuli, groups 1 and 4 observed a female model and groups 2 and 3 a male model; both models simulated responses to pain stimuli preceded by green lights as less painful than those preceded by red lights. Groups 1 through 4 also rated pain stimuli preceded by green lights as less painful. Further investigation revealed that in fact subjects in experimental groups rated red-associated stimuli as more painful than subjects from control groups who did not observe a model before receiving the same pain stimuli, indicating that nocebo hyperalgesia rather than placebo analgesia was induced. Empathy traits predicted the magnitude of nocebo hyperalgesia. Regardless of the sex of the subject, nocebo hyperalgesia was greater after the male model was observed. The results show that social observational learning is a mechanism that produces placebo effects. They also indicate that the sex of the model plays an important role in this process.

The effect of the sex of a model on nocebo hyperalgesia induced by social observational learning.

There is a growing body of evidence proving that observational learning, in addition to classical conditioning and verbal suggestions, may induce both placebo analgesia and nocebo hyperalgesia. However, much less is known about the mechanisms and factors influencing placebo effects induced by observational learning. The paper critically reviews the research findings in the field in the context of Bandura’s social learning theory. We apply Bandura’s taxonomy of the sources of social learning (behavioral, symbolic, and verbal modeling) and discuss the results of previous studies. Critical points in the placebo effects induced by observational learning are identified. We discuss aspects of behavior presented by the model (both verbal and non-verbal) involved in the formation of placebo effects induced by observational learning as well as the role of expectancies in this process. As a result, we propose a model that integrates the existing research findings. The model shows the main ways of transmission of pain-related information from the model to the observer. It highlights the role of expectancies and the individual characteristics of the observer in formation of placebo analgesia and nocebo hyperalgesia induced by observational learning. Finally, we propose future research directions based on our model.

/pdf/how-does-observational-learning-produce-placebo-effects-a-3299umzrow.pdf

How Does Observational Learning Produce Placebo Effects? A Model Integrating Research Findings.

Classical conditioning was suggested as a mechanism of placebo effects in the 1950s. It was then challenged by response expectancy theory, which proposed that classical conditioning is just one of the means by which expectancies are acquired and changed. According to that account, placebo effects induced by classical conditioning are mediated by expectancies. However, in most of the previous studies, either expectancies were not measured or classical conditioning was combined with verbal suggestions. Thus, on the basis of those studies, it is not possible to conclude whether expectancies are involved in placebo effects induced by pure classical conditioning. Two lines of recent studies have challenged the idea that placebo effects induced by classical conditioning are always mediated by expectancies. First, some recent studies have shown that a hidden conditioning procedure elicits both placebo analgesia and nocebo hyperalgesia, neither of which is predicted by expectancy. Second, there are studies showing that visual cues paired with pain stimuli of high or low intensity induce both placebo analgesia and nocebo hyperalgesia when they are presented subliminally without participants' awareness. The results of both lines of studies suggest that expectancy may not always be involved in placebo effects induced by classical conditioning and that conditioning may be a distinct mechanism of placebo effects. Thus, these results support the idea that placebo effects can be learned by classical conditioning either consciously or unconsciously. However, the existing body of evidence is limited to classically conditioned placebo effects in pain, that is, placebo analgesia and nocebo hyperalgesia.

Classical Conditioning as a Distinct Mechanism of Placebo Effects.

Research shows that placebo analgesia and nocebo hyperalgesia can be induced through observational learning. Our aim was to replicate and extend these results by studying the influence of the type and colour of stimuli used as placebos on the placebo effects induced by observational learning. Three experimental and two control groups were tested. All participants received pain stimuli of the same intensity preceded by colour lights (green and red) or geometric shapes (circles and squares). Before receiving pain stimuli, participants in the experimental groups, but not in the control groups, observed a model who rated pain stimuli that were preceded by either green lights (green placebo group), red lights (red placebo group), or circles (circle placebo group) as being less painful than those preceded by either red lights (green placebo group), green lights (red placebo group), or squares (circle placebo group). As a result participants in the experimental groups rated pain stimuli preceded by either green lights (green placebo group), red lights (red placebo group), or circles (circle placebo group) as being less painful than the participants in the control groups did, indicating that placebo effect was induced. No statistically significant differences were found in the magnitudes of the placebo effects between the three experimental groups (green placebo, red placebo, and circle placebo groups), indicating that neither the type nor the colour of placebo stimuli affected the placebo effects induced by observational learning. The placebo effects induced by observational learning were found to be unrelated to the individual differences in pain anxiety, fear of pain, and empathy.

/pdf/the-effect-of-the-type-and-colour-of-placebo-stimuli-on-47rb4ddyte.pdf

The Effect of the Type and Colour of Placebo Stimuli on Placebo Effects Induced by Observational Learning.

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