Enhancing placebo analgesia : Unravelling the powerful interplay of ownership and verbal suggestion

Victoria Wai Lan YEUNG*

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

Abstract

Background
Placebo analgesic research demonstrates pain reduction after using a placebo analgesic. Recent studies have documented that sometimes possessing a placebo analgesic induces placebo analgesia. These prior studies used a ‘cream’ as the stimulus and proposed that the effect is driven by an expectancy of obtaining benefits from the owned analgesic. This paper examines three pivotal components of placebo analgesia: placebo form, ownership and expectancy induced by verbal suggestion. We investigate analgesic expectancy between cream versus oil form of placebo stimulus and systematically isolate the effects of ownership, verbal suggestion and their interaction, comparing with the effect of use, to decipher the dynamics of placebo analgesia.

Methods
Study 1 (N = 46) evaluated analgesic expectancy between cream and oil. Study 2 (N = 119) exposed participants to a placebo analgesic oil and randomized them into PU (possess and use), PA (possess and anticipate), P (possess-only) or A (anticipate-only) conditions. Pain outcomes were assessed using a cold pressor test. Comparing PA and P conditions assessed the verbal suggestion effect, comparing PA and A conditions evaluated the possession effect, while comparing PU and PA conditions shed light on the use effect.

Results
In Study 1, participants showed comparable analgesic expectancy for cream and oil. In Study 2, both PA and PU groups performed equally well, reporting higher pain threshold, F(3, 115) = 5.14, p = 0.002,
 = 0.12; and a greater probability of persistent hand submersion than P and A groups, X2(3) = 8.06, p = 0.045.

Conclusion
The findings highlight the significance of integrating possession with expectancy to induce placebo analgesia, which has clinical implications.

Significance
This study delves into the intricate dynamics of placebo analgesia, shedding light on the significant influence of ownership and verbal suggestion. Through a meticulous exploration of the relationship between ownership and expectancy induced by verbal suggestion, we propose novel avenues for enhancing placebo responses. This research has implications for clinical practice and pain management strategies, potentially revolutionizing approaches to pain relief and therapeutic outcomes. Our findings contribute to a paradigm shift in understanding placebo analgesia, emphasizing the pivotal interaction between ownership and verbal suggestion.
Original languageEnglish
Article numberEJP2303
JournalEuropean Journal of Pain
Early online date24 Jun 2024
DOIs
Publication statusE-pub ahead of print - 24 Jun 2024

Bibliographical note

The author expresses gratitude to Eric Kenson Yau for his assistance with data collection for Study 1 and designing the stimulus for Studies 1 and 2. Pui Chuen Tam for data collection for Study 2. Teresa Hou Yichen, Winnie Poon Ki, Frank Guo Pengju, Hason Fong Hoi Chun, Elvin Chung Long Yin and Billy Lam Yu Ki for their assistance in preparing this manuscript.

Publisher Copyright: © 2024 The Author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®.

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