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Placebo and Nocebo Effects in Itch and Pain

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Placebo

Abstract

Physical complaints, such as pain, can be effectively altered by placebo and nocebo effects due to induction of positive or negative expectations. While verbal suggestion and conditioning are recognized as playing a key role in placebo and nocebo effects on pain, these mechanisms have barely been investigated with regard to other somatosensory sensations, such as itch. Results on contagious itch in both animals and humans suggest that itch sensations might be even more susceptible for placebo and nocebo effects than pain. Research on placebo and nocebo effects on pain and itch can further deliver insight into the common and specific mechanisms underlying these effects in different physical complaints. Work of our research group on verbal suggestions inducing nocebo effects demonstrated an important role of verbal suggestions with regard to itch, with stronger nocebo effects on itch than a comparable procedure for pain. Recent work also demonstrated that placebo and nocebo effects on itch sensations were most effectively induced by procedures that consist of both conditioning and verbal suggestion principles. This work adds to previous prospective studies showing that expectation mechanisms, such as preservative worrying about negative consequences, are relatively consistent predictors of future disease outcomes, including itch, in chronic somatic conditions. Future studies should focus on the specific psychoneurobiological mechanisms of placebo and nocebo effects in various physical sensations, to get insight into the common and specific effects and to contribute to the long-term and clinically relevant use of placebo effects in clinical practice.

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References

  • Atlas LY, Wager TD (2012) How expectations shape pain. Neurosci Lett 520(2):140–148

    Article  PubMed  CAS  Google Scholar 

  • Bartels DJP, van Laarhoven AIM, Haerkamp EA, Wilder-Smith OH, Donderds ART, van Middendorp H, van de Kerkhof PCM, Evers AWM (2014) Role of conditioning and verbal suggestion in placebo and nocebo effects on itch. PLoS ONE 9:e91727

    Article  PubMed  PubMed Central  Google Scholar 

  • Benedetti F (2008) Mechanisms of placebo and placebo-related effects across diseases. Annu Rev Pharmacol 48:33–60

    Article  CAS  Google Scholar 

  • Benedetti F, Pollo A, Lopiano L, Lanotte M, Vighetti S, Rainero I (2003) Conscious expectation and unconscious conditioning in analgesic, motor, and hormonal placebo/nocebo responses. J Neurosci 23:4315–4323

    PubMed  CAS  Google Scholar 

  • Colloca L, Sigaudo M, Benedetti F (2008) The role of learning in nocebo and placebo effects. Pain 136(1–2):211–218

    Article  PubMed  CAS  Google Scholar 

  • Colloca L, Petrovic P, Wager TD, Ingvar M, Benedetti F (2010) How the number of learning trials affects placebo and nocebo responses. Pain 151(2):430–439

    Article  PubMed  PubMed Central  Google Scholar 

  • Colloca L, Klinger R, Flor H, Bingel U (2013) Placebo analgesia: psychological and neurobiological mechanisms. Pain 154(4):511–514

    Article  PubMed  PubMed Central  Google Scholar 

  • Curatolo M, Arendt-Nielsen L, Petersen-Felix S (2006) Central hypersensitivity in chronic pain: mechanisms and clinical implications. Phys Med Rehabil Clin N Am 17:287–302

    Article  PubMed  Google Scholar 

  • Evers AWM, Kraaimaat FW, Geenen R, Jacobs JWG, Bijlsma JWJ (2003) Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis. Behav Res Ther 41:1295–1310

    Article  PubMed  Google Scholar 

  • Evers AWM, Duller P, de Jong EMGJ, Otero ME, Verhaak CM, van der Valk PGM, van de Kerkhof PCM, Kraaimaat FW (2009) Effectiveness of a brief multidisciplinary itch-coping programme in adults with atopic dermatitis. Acta Derm-Venereol 89:57–63

    Article  PubMed  Google Scholar 

  • Evers AWM, Verhoeven EWM, Middendorp H, Sweep FGJ, Kraaimaat FW, Donders ART, Eijsbouts AE, van Laarhoven AIM, de Brouwer S, Wirken L, Radstake TRDJ, van Riel PLCM (2014) Daily stressors, stress vulnerability, immune and HPA-axis activity, and short-term fluctuations in rheumatoid arthritis activity. Ann Rheum Dis 73(9):1683–1688

    Article  PubMed  Google Scholar 

  • Feneran AN, O'Donnell R, Press A, Yosipovitch G, Cline M, Dugan G, Papoiu ADP, Nattkemper LA, Chan YM, Shively CA (2013) Monkey see, monkey do: contagious itch in nonhuman primates. Acta Derm Venereol 93:27–29

    PubMed  Google Scholar 

  • Geers AL, Helfer SG, Kosbab K, Weiland PE, Landry SJ (2005) Reconsidering the role of personality in placebo effects: dispositional optimism, situational expectations, and the placebo response. J Psychosom Res 58(2):121–127

    Article  PubMed  Google Scholar 

  • Geers AL, Kosbab K, Helfer SG, Weiland PE, Wellman JA (2007) Further evidence for individual differences in placebo responding: an interactionist perspective. J Psychosom Res 62(5):563–570

    Article  PubMed  Google Scholar 

  • Holle H, Warne K, Seth AK, Critchley HD, Ward J (2012) Neural basis of contagious itch and why some people are more prone to it. Proc Natl Acad Sci USA 109(48):19816–19821

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Ikoma A, Handwerker H, Miyachi Y, Schmelz M (2005) Electrically evoked itch in humans. Pain 113(1):148–154

    Article  PubMed  Google Scholar 

  • Ikoma A, Steinhoff M, Stander S, Yosipovitch G, Schmelz M (2006) The neurobiology of itch. Nat Rev Neurosci 7(7):535–547

    Article  PubMed  CAS  Google Scholar 

  • Jensen KB, Kaptchuk TJ, Kirsch I, Raicek J, Lindstrom KM, Berna C, Gollub RL, Ingvar M, Kong J (2012) Nonconscious activation of placebo and nocebo pain responses. Proc Natl Acad Sci USA 109(39):15959–15964

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Klinger R, Soost S, Flor H, Worm M (2007) Classical conditioning and expectancy in placebo hypoalgesia: a randomized controlled study in patients with atopic dermatitis and persons with healthy skin. Pain 128(1–2):31–39

    Article  PubMed  Google Scholar 

  • Lloyd DM, Hal E, Hall S, McGlone FP (2011) Can itch-related visual stimuli alone provoke a scratch response in healthy individuals? Br J Dermatol 164(6):1299–1303

    Article  Google Scholar 

  • Martin-Pichora AL, Mankovsky-Arnold TD, Katz J (2011) Implicit versus explicit associative learning and experimentally induced placebo hypoalgesia. J Pain Res 4:67–77

    Article  PubMed  PubMed Central  Google Scholar 

  • Morton DL, Watson A, El-Deredy W, Jones AK (2009) Reproducibility of placebo analgesia: effect of dispositional optimism. Pain 146(1–2):194–198

    Article  PubMed  Google Scholar 

  • Niemeier V, Gieler U (2000) Observations during itch-inducing lecture. Dermatol Psychosom 1:15–18

    Article  Google Scholar 

  • Papoiu ADP, Wang H, Coghill RC, Chan Y-H, Yosipovitch G (2011) Contagious itch in humans. A study of visual “transmission” of itch in atopic dermatitis and healthy subjects. Br J Dermatol 164(6):1299–1303

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Pecina M, Azhar H, Love TM, Lu T, Fredrickson BL, Stohler CS, Zubieta JK (2013) Personality trait predictors of placebo analgesia and neurobiological correlates. Neuropsychopharmacology 38(4):639–646

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Price DD, Finniss DG, Benedetti F (2008) A comprehensive review of the placebo effect: recent advances and current thought. Annu Rev Psychol 59:565–590

    Article  PubMed  Google Scholar 

  • Scholz O, Hermanns N (1994) Illness behavior and cognitions influence the perception of itching of patients suffering from atopic dermatitis. Z Klin Psychol 23:127–135

    Google Scholar 

  • Scott DJ, Stohler CS, Egnatuk CM, Wang H, Koeppe RA, Zubieta JK (2007) Individual differences in reward responding explain placebo-induced expectations and effects. Neuron 55(2):325–336

    Article  PubMed  CAS  Google Scholar 

  • Scott DJ, Stohler CS, Egnatuk CM, Wang H, Koeppe RA, Zubieta JK (2008) Placebo and nocebo effects are defined by opposite opioid and dopaminergic responses. Arch Gen Psychiatry 65(2):220–231

    Article  PubMed  Google Scholar 

  • Smith BW, Tooley EM, Montague EQ, Robinson AE, Cosper CJ, Mullins PG (2008) Habituation and sensitization to heat and cold pain in women with fibromyalgia and healthy controls. Pain 140:420–428

    Article  PubMed  Google Scholar 

  • Stewart-Williams S, Podd J (2004) The placebo effect: dissolving the expectancy versus conditioning debate. Psychol Bull 130(2):324–340

    Article  PubMed  Google Scholar 

  • van Laarhoven AI, Kraaimaat FW, Wilder-Smith OH, van de Kerkhof PC, Cats H, van Riel PL, Evers AW (2007) Generalized and symptom-specific sensitization of chronic itch and pain. J Eur Acad Dermatol Venereol 21:1187–1192

    PubMed  Google Scholar 

  • van Laarhoven AIM, Kraaimaat FW, Wilder-Smith OH, Kerkhof PCM, Evers AWM (2010) Heterotopic pruritic conditioning and itch - analogous to DNIC in pain? Pain 149:332–337

    Article  PubMed  Google Scholar 

  • van Laarhoven AI, Vogelaar ML, Wilder-Smith OH, van Riel PL, van de Kerkhof PC, Kraaimaat FW, Evers AW (2011) Induction of nocebo and placebo effects on itch and pain by verbal suggestions. Pain 152(7):1486–1494

    Article  PubMed  Google Scholar 

  • van Laarhoven AI, Walker AL, Wilder-Smith OH, Kroeze S, van Riel PL, van de Kerkhof PC, Kraaimaat FW, Evers AW (2012) Role of induced negative and positive emotions in sensitivity to itch and pain in women. Br J Dermatol 167(2):262–269

    Article  PubMed  Google Scholar 

  • Van Laarhoven AIM, Kraaimaat FW, Wilder-Smith OH, van Riel PLCM, van de Kerkhof PCM, Evers AWM (2013) Sensitivity to itch and pain in patients with psoriasis and rheumatoid arthritis. Exp Dermatol 22:530–534

    Article  PubMed  Google Scholar 

  • Verhoeven EW, Kraaimaat FW, van de Kerkhof PC, van Weel C, Duller P, van der Valk PG, van den Hoogen HJ, Bor JH, Schers HJ, Evers AW (2007) Prevalence of physical symptoms of itch, pain and fatigue in patients with skin diseases in general practice. Br J Dermatol 156:1346–1349

    Article  PubMed  CAS  Google Scholar 

  • Verhoeven EWM, de Klerk S, Kraaimaat FW, van de Kerkhof PCM, de Jong EMGJ, Evers AWM (2008) Biopsychosocial mechanisms of chronic itch in patients with skin diseases: a review. Acta Derm-Venereol 88:211–218

    PubMed  Google Scholar 

  • Verhoeven EWM, Kraaimaat FW, de Jong EMGJ, Schalkwijk J, van de Kerkhof PCM, Evers AWM (2009) Individual differences in the effect of daily stressors on psoriasis: a prospective study. Br J Dermatol 161:295–299

    Article  PubMed  CAS  Google Scholar 

  • Yosipovitch G, Greaves MW, Schmelz M (2003) Itch. Lancet 361(9358):690–694

    Article  PubMed  Google Scholar 

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Correspondence to Andrea W. M. Evers .

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Evers, A.W.M., Bartels, D.J.P., van Laarhoven, A.I.M. (2014). Placebo and Nocebo Effects in Itch and Pain. In: Benedetti, F., Enck, P., Frisaldi, E., Schedlowski, M. (eds) Placebo. Handbook of Experimental Pharmacology, vol 225. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44519-8_12

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