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Bieniek H, Bąbel P. Placebo hypoalgesia induced by operant conditioning: a comparative study on the effects of verbal, token-based, and social rewards and punishers. Sci Rep 2023; 13:20346. [PMID: 37989856 PMCID: PMC10663593 DOI: 10.1038/s41598-023-47482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
Operant conditioning was shown to be a mechanism of placebo hypoalgesia; however, only verbal rewards and punishers were applied in the previous study. We aimed to induce placebo hypoalgesia using more clinically relevant consequences: token-based and social. Participants were divided into three experimental groups (with verbal, social, and token-based rewards and punishers); and two control groups (with and without placebo application). During operant conditioning, participants in the experimental groups received thermal stimuli of equal intensity and were rewarded for reporting lower pain and punished for reporting higher pain compared to their pretest pain levels. The control groups did not receive any consequences. Our results revealed placebo hypoalgesia was induced by operant conditioning only in the experimental groups with social and token-based reinforcement, compared to the control groups. The hypoalgesic effect found in the group that received verbal reinforcement did not differ significantly from the control group with the placebo application. Moreover, expectations about upcoming pain intensity were found to be a mediator, and the number of reinforcers received during conditioning was a predictor of placebo hypoalgesia. These findings highlight the potential benefits of incorporating token-based and social consequences for optimizing treatment outcomes in pain management.
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Affiliation(s)
- Helena Bieniek
- Institute of Psychology, Pain Research Group, Jagiellonian University, ul. Ingardena 6, 30-060, Kraków, Poland.
- Doctoral School in the Social Sciences, Jagiellonian University, Kraków, Poland.
| | - Przemysław Bąbel
- Institute of Psychology, Pain Research Group, Jagiellonian University, ul. Ingardena 6, 30-060, Kraków, Poland
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Meeuwis SH, Wasylewski MT, Bajcar EA, Bieniek H, Adamczyk WM, Honcharova S, Di Nardo M, Mazzoni G, Bąbel P. Learning pain from others: a systematic review and meta-analysis of studies on placebo hypoalgesia and nocebo hyperalgesia induced by observational learning. Pain 2023; 164:2383-2396. [PMID: 37326688 PMCID: PMC10578425 DOI: 10.1097/j.pain.0000000000002943] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 06/17/2023]
Abstract
ABSTRACT Observing someone experience pain relief or exacerbation after an intervention may induce placebo hypoalgesia or nocebo hyperalgesia. Understanding the factors that contribute to these effects could help in the development of strategies for optimizing treatment of chronic pain conditions. We systematically reviewed and meta-analyzed the literature on placebo hypoalgesia and nocebo hyperalgesia induced by observational learning (OL). A systematic literature search was conducted in the databases PubMed, PsycINFO, Web of Science, ScienceDirect, PsycARTICLES, Scopus, and Academic Search Ultimate. Twenty-one studies were included in the systematic review, 17 of which were suitable for meta-analysis (18 experiments; n = 764 healthy individuals). The primary end point was the standardized mean difference (SMD) for pain following placebo cues associated during OL with low vs high pain. Observational learning had a small-to-medium effect on pain ratings (SMD 0.44; 95% confidence interval [CI] 0.21-0.68; P < 0.01) and a large effect on pain expectancy (SMD 1.11; 95% CI 0.49-2.04; P < 0.01). The type of observation (in-person vs videotaped) modulated the magnitude of placebo hypoalgesia/nocebo hyperalgesia ( P < 0.01), whereas placebo type did not ( P = 0.23). Finally, OL was more effective when observers' empathic concern (but no other empathy-related factors) was higher ( r = 0.14; 95% CI 0.01-0.27; P = 0.03). Overall, the meta-analysis demonstrates that OL can shape placebo hypoalgesia and nocebo hyperalgesia. More research is needed to identify predictors of these effects and to study them in clinical populations. In the future, OL could be an important tool to help maximize placebo hypoalgesia in clinical settings.
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Affiliation(s)
- Stefanie H. Meeuwis
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Mateusz T. Wasylewski
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Elżbieta A. Bajcar
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Helena Bieniek
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Wacław M. Adamczyk
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
- The Jerzy Kukuczka Academy of Physical Education, Institute of Physiotherapy and Health Sciences, Katowice, Poland
| | - Sofiia Honcharova
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Marianna Di Nardo
- Department of Dynamic, Clinical Psychology and Health, Sapienza University of Rome, Rome, Italy
| | - Giuliana Mazzoni
- Department of Dynamic, Clinical Psychology and Health, Sapienza University of Rome, Rome, Italy
| | - Przemysław Bąbel
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
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Wiercioch-Kuzianik K, Brączyk J, Bieniek H, Bąbel P. Red induces hyperalgesia and white induces hypoalgesia regardless of pain modality. Sci Rep 2023; 13:6360. [PMID: 37076528 PMCID: PMC10115883 DOI: 10.1038/s41598-023-33313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
Colors are an important factor that influences different aspects of people's lives. However, little is known about the effects of colors on pain. This preregistered study aimed to investigate whether the type of pain affects the impact of colors on pain intensity. 74 participants were randomly divided into 2 groups according to the type of pain: electrical or thermal. In both groups, pain stimuli of the same intensity were preceded by different colors. Participants rated the pain intensity induced by each pain stimulus. Additionally, pain expectations related to each color were rated at the beginning and the end of the procedure. A significant effect of color on pain intensity ratings was found. Pain was most intense in both groups after red, whereas the lowest ratings were given after white. A similar pattern of results was observed for pain expectations. Expectations also correlated with and were found to be a predictor of experienced pain for white, blue, and green. The study shows that white can reduce, while red can alter the experienced pain. Moreover, it shows that the effect of colors is affected to a greater extent by the pain expectations rather than the pain modality. We conclude that the way colors influence pain broadens the current knowledge on effects of colors on human behavior and could help in the future both patients and practitioners.
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Affiliation(s)
- Karolina Wiercioch-Kuzianik
- Pain Research Group, Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060, Kraków, Poland.
| | - Justyna Brączyk
- Pain Research Group, Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060, Kraków, Poland
| | - Helena Bieniek
- Pain Research Group, Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060, Kraków, Poland
| | - Przemysław Bąbel
- Pain Research Group, Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060, Kraków, Poland
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Bajcar EA, Bieniek H, Brączyk J, Bąbel P. From past pain to future pain through the pain of others: Information about other people's pain ratings can alleviate our subsequent pain. Eur J Pain 2023; 27:378-389. [PMID: 36471639 DOI: 10.1002/ejp.2063] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/07/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies have shown that pain memories have a profound impact on subsequent pain experiences. This study investigated whether pain ratings derived from other people can modify an individual's memory of past pain. This study also examined whether pain memory modified by others' pain ratings determines subsequent pain experiences. METHODS Participants were divided into two groups: an experimental group and a control group. Participants in both groups were exposed to pain stimulation; then, they recalled its intensity twice over a period of time; after a break, they were again exposed to pain stimulation of the same intensity. The final sample consisted of 53 participants. The only difference between the experimental group and the control group was that in the former the pain ratings of other alleged participants were presented between the two consecutive pain recalls. These ratings suggested that other people experienced the same pain as less intense. RESULTS The pain ratings derived from other people did not alter the pain memory; nevertheless, they affected an individual's next pain experience even for a certain period of time after their presentation. This type of pain-related information shaped participants' subsequent pain experiences regardless of their empathy, conformity, and susceptibility to social influence. CONCLUSIONS Information on pain derived from other people not only shapes the response to a novel stimulation but also substantially modifies the subsequent experience of that stimulation. SIGNIFICANCE The study demonstrates the importance of social information on pain and provides evidence that this type of information substantially modifies the subsequent experience of the same pain. These results suggest that social information on pain can be used to alleviate pain associated with recurring medical procedures and thus increase patients' willingness to continue treatment.
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Affiliation(s)
- Elżbieta A Bajcar
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Helena Bieniek
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Justyna Brączyk
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Przemysław Bąbel
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
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Kłosowska J, Bajcar EA, Bieniek H, Brączyk J, Joshanloo M, Mattarozzi K, Bagnis A, Pontén M, Lalouni M, Geers AL, Clemens KS, Park J, Choi G, Choi YK, Jung W, Son E, Yoon HY, Bąbel P. Development and cross-national investigation of a model explaining participation in WHO-recommended and placebo behaviours to prevent COVID-19 infection. Sci Rep 2022; 12:17704. [PMID: 36271008 PMCID: PMC9586969 DOI: 10.1038/s41598-022-17303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/22/2022] [Indexed: 01/18/2023] Open
Abstract
To protect themselves from COVID-19, people follow the recommendations of the authorities, but they also resort to placebos. To stop the virus, it is important to understand the factors underlying both types of preventive behaviour. This study examined whether our model (developed based on the Health Belief Model and the Transactional Model of Stress) can explain participation in WHO-recommended and placebo actions during the pandemic. Model was tested on a sample of 3346 participants from Italy, Japan, Poland, Korea, Sweden, and the US. It was broadly supported: objective risk and cues to action showed both direct and indirect (through perceived threat) associations with preventive behaviours. Moreover, locus of control, decision balance, health anxiety and preventive coping moderated these relationships. Numerous differences were also found between countries. We conclude that beliefs about control over health and perceived benefits of actions are critical to the development of interventions to improve adherence to recommendations.
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Affiliation(s)
- Joanna Kłosowska
- grid.5522.00000 0001 2162 9631Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060 Kraków, Poland
| | - Elżbieta A. Bajcar
- grid.5522.00000 0001 2162 9631Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060 Kraków, Poland
| | - Helena Bieniek
- grid.5522.00000 0001 2162 9631Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060 Kraków, Poland
| | - Justyna Brączyk
- grid.5522.00000 0001 2162 9631Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060 Kraków, Poland
| | - Mohsen Joshanloo
- grid.412091.f0000 0001 0669 3109Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Katia Mattarozzi
- grid.6292.f0000 0004 1757 1758Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Arianna Bagnis
- grid.6292.f0000 0004 1757 1758Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Moa Pontén
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria Lalouni
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andrew L. Geers
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, USA
| | - Kelly S. Clemens
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, USA
| | | | - Gahee Choi
- grid.412091.f0000 0001 0669 3109Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Yun-Kyeung Choi
- grid.412091.f0000 0001 0669 3109Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Wookyoung Jung
- grid.412091.f0000 0001 0669 3109Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Eunjung Son
- grid.412091.f0000 0001 0669 3109Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Hyae Young Yoon
- grid.412091.f0000 0001 0669 3109Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Przemysław Bąbel
- grid.5522.00000 0001 2162 9631Institute of Psychology, Jagiellonian University, ul. Ingardena 6, 30-060 Kraków, Poland
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Bieniek H, Bąbel P. The effect of the model's social status on placebo analgesia induced by social observational learning. Pain Med 2021; 23:81-88. [PMID: 34633464 PMCID: PMC8723154 DOI: 10.1093/pm/pnab299] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/13/2021] [Accepted: 10/03/2021] [Indexed: 11/24/2022]
Abstract
Background Placebo analgesia can be induced by social observational learning. The aim of this study was to determine whether this effect can be influenced by the social status of a model. Methods Healthy volunteers were randomly assigned to three groups: a group that observed a video featuring a high-status model (introduced as a professor), a group that observed a video featuring a low-status model (introduced as a janitor), and a control group. Participants observed videos showing a model (of high or low status) undergoing the experimental procedure, during which he received pain stimuli. In each group, half of participants watched a video in which the model rated blue stimuli as more painful (6–8 on the numeric rating scale) and orange stimuli as less painful (1–3 on the numeric rating scale), whereas the other half of participants watched a video in which the model rated orange stimuli as more painful and blue stimuli as less painful. Participants in the control group did not watch any video. Then, all participants received 16 electrocutaneous pain stimuli of the same intensity, preceded by either blue or orange colors. The perceived social status of the model and the trait empathy of participants were measured. Results Placebo analgesia was induced in both experimental groups, yet no difference in the magnitude of the effect was found. However, we found that the participants’ individual ratings of the model’s social status predicted the magnitude of placebo analgesia. Conclusion This is the first study to show that the perception of a model’s social status is related to the magnitude of placebo analgesia induced by observational learning.
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Affiliation(s)
- Helena Bieniek
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Przemysław Bąbel
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
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Bajcar EA, Wiercioch-Kuzianik K, Brączyk J, Farley D, Bieniek H, Bąbel P. When one suffers less, all suffer less: Individual pain ratings are more effective than group ratings in producing placebo hypoalgesia. Eur J Pain 2021; 26:207-218. [PMID: 34399009 PMCID: PMC9290059 DOI: 10.1002/ejp.1855] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/10/2021] [Accepted: 08/14/2021] [Indexed: 12/19/2022]
Abstract
Background Placebo hypoalgesia can be induced by observing a person (model) whose pain relief is the result of the use of an inert substance or procedure. This study examined whether verbal modelling, that is, showing pain ratings provided by other people, is sufficient to induce placebo hypoalgesia. Methods Participants from the experimental groups were acquainted with pain ratings (presented on VASs) derived from a single person (groups 1 and 3) or a group of people (groups 2 and 4) that were allegedly subjected to the same painful procedure. The ratings of pain stimuli that were allegedly applied with placebo were lower than the ratings of stimuli applied without placebo. In two of the experimental groups (group 3 and 4), participants also watched a video recording showing individuals who allegedly provided pain ratings; however, they did not observe them undergoing pain stimulation. The control group did not undergo any manipulation. Then, the participants received a series of the same thermal pain stimuli that were applied either with or without placebo and rated their intensity. Results Placebo hypoalgesia was induced only in participants presented with pain ratings provided by a single person, regardless of whether this person was previously seen. However, the pain ratings presented to the participants generally decreased individual pain sensations, regardless of whether they came from a group of people or a single person. Conclusions Verbal modelling can produce placebo hypoalgesia and reduce pain sensations. It may be effectively used in clinical practice to modify patients' responses to pain treatment. Significance This study shows that knowledge about pain ratings provided by another person is sufficient to induce placebo hypoalgesia; thus, neither direct nor indirect observation of a person experiencing pain is necessary to induce this effect. Pain ratings derived from a group of people can decrease pain sensations but they do not produce placebo hypoalgesia.
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Affiliation(s)
- Elżbieta Anita Bajcar
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | | | - Justyna Brączyk
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Dominika Farley
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Helena Bieniek
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Przemysław Bąbel
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
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Remmers C, Bieniek H. [Acinetobacter calcoaceticus var. Iwoffi as the cause of abscess formation in Han:NMRI nude mice]. Berl Munch Tierarztl Wochenschr 1988; 101:296-302. [PMID: 2973310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
The endocrine testicular function in mink (Mustela vison) was investigated during the first year of life encompassing puberty, the first mating season and the phase of regression thereafter. The mink, relatively easily accessible as a semi-domesticated animal, was chosen as an example of a mammalian seasonal breeder. In plasma samples from 7 to 17 animals collected on 10 occasions between July and April testosterone and delta4-androstenedione were determined by simultaneous radioimmunoassay. A steady increase of both androgens from November to early March, when the mating season occurs, and a rapid decline to pre-pubertal levels thereafter was observed. The ratio of testosterone to delta4-androstenedione was 1:1 from November to April. These findings parallel the known morphological transitions of the testes.
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