Nondeceptive placebo has demonstrated its efficiency in clinical practice. Although the underlying mechanisms are still unclear, nondeceptive placebo effect and nondeceptive nocebo effect may be mediated by expectation. To examine the extent to which expectation influences these effects, the present study compared nondeceptive placebo and nocebo effects with different expectation levels. Seventy-two healthy female participants underwent a standard conditioning procedure to establish placebo and nocebo effects. Sequentially, participants were randomized to one of the four experimental groups-baseline (BL), no expectation intervention (NoEI), expectation increasing (EI), and expectation decreasing (ED) groups, to receive either no intervention or interventions through different verbal suggestions that modulated their expectation. Placebo and nocebo effects were established in all four groups after the conditioning phase. However, after disclosing the placebo and nocebo, the analgesic and the hyperalgesic effects only persisted in the EI group, when compared with the BL group. Our results provide evidence highlighting the critical role of increased expectation in nondeceptive placebo and nocebo effects. The finding suggests that open-label placebo or nocebo per se might be insufficient to induce strong analgesic or hyperalgesic response and sheds insights into administrating open-label placebo and avoiding open-label nocebo in clinical practice.

译文

:非欺骗性安慰剂已在临床实践中证明了其有效性。尽管尚不清楚其基本机制,但预期可能介导了非欺骗性安慰剂作用和非欺骗性nocebo作用。为了检验预期影响这些影响的程度,本研究比较了不同预期水平的非欺骗性安慰剂和Nocebo的影响。 72名健康女性参与者接受了标准的调理程序以建立安慰剂和Nocebo的作用。随后,将参与者随机分为四个实验组之一:基线(BL),无期望干预(NoEI),期望增加(EI)和期望减少(ED)组,以不接受干预或通过不同的口头建议进行干预改变了他们的期望。调理阶段后,在所有四个组中均建立了安慰剂和Nocebo效应。但是,与BL组相比,在公开安慰剂和Nocebo之后,镇痛和镇痛作用仅在EI组中持续存在。我们的结果提供了证据,证明了期望值在非欺骗性安慰剂和Nocebo效应中的关键作用。该发现表明,开放标签的安慰剂或Nocebo本身可能不足以引起强烈的止痛或痛觉过敏反应,并为在临床实践中使用开放标签的安慰剂和避免使用开放标签的Nocebo提供了见识。

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