Skip to main content

Advertisement

SpringerLink
Log in

Choice and placebo expectation effects in the context of pain analgesia

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

An Erratum to this article was published on 11 October 2012

Abstract

The current experiment examined whether having choice over treatment options facilitates or inhibits the strength of placebo expectations in the context of pain perception. All participants were exposed to an aversive stimulus (i.e., the cold pressor task), and participants in some conditions were given expectations for two pain-relieving treatments (actually the same inert ointment mixture). Critically, participants in these expectation conditions were also given a choice or not about which of the two treatments they preferred to use. Participants in a control condition were not provided with a treatment expectation. Despite receiving the same inert treatment, participants who had a choice over treatments showed increased placebo analgesia as compared to participants not given a choice and participants in the control condition. Moreover, this effect was mediated by changes in anxiety. Explanations and implications for these results are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Given that we did not extensively prescreen for chronic pain or other health conditions in this college sample, the inclusion of a baseline pain measure allowed us to control for any pre-existing differences in our analyses. It is notable that mean baseline levels of pain did not differ across conditions (F [2, 38] = .05, P > .90) nor did they violate homogeneity of variance assumptions across conditions (Levene’s Statistic = .032, P > .90).

  2. Some readers may still wonder about potential interpretation problems when measuring expectations after the cold pressor task, as opposed to immediately after the manipulation of expectations. First, it should be noted that there is precedence for measuring expectations later in the study to avoid any possible contamination that explicitly thinking about expectations could have on a primary dependent variable (e.g., Geers et al., 2006; Geers et al., 2010). Moreover, although choice and no choice participants reported similar pain expectations on the manipulation-check item, their self-reported pain did differ from one another. This finding suggests that the manipulation-check responses, obtained near the end of the experiment, were not primarily determined by participants’ pain experiences and reports regarding the cold pressor task.

References

  • Benedetti, F. (2008). Mechanisms of placebo and placebo-related effects across diseases and treatments. Annual Review of Pharmacology and Toxicology, 48, 33–60.

    Article  CAS  PubMed  Google Scholar 

  • Bienenfeld, L., Frishman, W., & Glasser, S. P. (1996). The placebo effect in cardiovascular disease. American Heart Journal, 132, 1207–1221.

    Article  CAS  PubMed  Google Scholar 

  • Brehm, J. W. (1956). Post-decision changes in the desirability of choice alternatives. Journal of Abnormal and Social Psychology, 52, 384–389.

    Article  CAS  Google Scholar 

  • Burger, J. M. (1989). Negative reactions to increases in perceived personal control. Journal of Personality and Social Psychology, 35, 351–363.

    Google Scholar 

  • Chilvers, C., Dewey, M., Fielding, K., Gretton, V., Miller, P., Palmer, B., et al. (2001). Antidepressant drugs and generic counseling for treatment of major depression in primary care: Randomized trial with patient preference arms. British Medical Journal, 322, 722–775.

    Article  Google Scholar 

  • Devine, D. A., & Fernald, P. S. (1973). Outcome effects of receiving a preferred, randomized assigned, or nonpreferred therapy. Journal of Consulting and Clinical Psychology, 41, 104–107.

    Article  CAS  PubMed  Google Scholar 

  • Fallowfield, L. J., Hall, A., Maguire, G. P., & Baum, M. (1990). Psychological outcomes of different treatment policies in women with early stage breast cancer outside a clinical trial. British Medical Journal, 301, 575–580.

    Article  CAS  PubMed  Google Scholar 

  • Gattellari, M., Butow, P. N., & Tattersall, M. H. N. (2001). Sharing decisions in cancer care. Social Science and Medicine, 52, 1865–1878.

    Article  CAS  PubMed  Google Scholar 

  • Geers, A. L., Helfer, S. G., Kosbab, K., & Weiland, P. E. (2006). Expectations and placebo response: A laboratory investigation into the role of somatic focus. Journal of Behavioral Medicine, 29, 171–178.

    Article  PubMed  Google Scholar 

  • Geers, A. L., & Rose, J.P. (in press). Treatment choice and placebo expectation effects. Social and Personality Psychology Compass.

  • Geers, A. L., Rose, J. P., Fowler, S. L., & Rasinski, H. M. (2011a). Lay beliefs about treatment choice in the context of placebo effects. Toledo, OH: Unpublished raw data.

    Google Scholar 

  • Geers, A. L., Wellman, J. A., Fowler, S. L., Helfer, S. G., & France, C. R. (2010). Dispositional optimism predicts placebo analgesia. The Journal of Pain, 11, 1165–1171.

    Article  PubMed  Google Scholar 

  • Geers, A. L., Wellman, J. A., Fowler, S. L., Rasinski, H. M., & Helfer, S. G. (2011b). Placebo expectations and the detection of somatic information. Journal of Behavioral Medicine, 34, 208–217.

    Article  PubMed  Google Scholar 

  • Geers, A. L., Wellman, J. A., Helfer, S. G., Fowler, S. L., & France, C. R. (2008). Dispositional optimism and thoughts of well-being determine sensitivity to an experimental pain task. Annals of Behavioral Medicine, 36, 304–313.

    Article  PubMed  Google Scholar 

  • Gordon, R. B. (1976). Effects of volunteering and responsibility on the perceived value and effectiveness of a clinical treatment. Journal of Consulting and Clinical Psychology, 44, 799–801.

    Article  CAS  PubMed  Google Scholar 

  • Hack, T. F., Degner, L. F., Watson, P., & Sinha, L. (2006). Do patients benefit from participating in medical decision making? Longitudinal follow-up of women with breast cancer. Psycho-Oncology, 15, 9–19.

    Article  PubMed  Google Scholar 

  • Hammersley, R., Finnigan, F., & Millar, K. (1998). Verbal expectancies and performance after alcohol. Addictive Behaviors, 23, 489–496.

    Article  CAS  PubMed  Google Scholar 

  • Handelzalts, J. E., & Keinan, G. (2010). The effect of choice between test anxiety options on treatment outcomes. Psychotherapy Research, 20, 100–112.

    Article  PubMed  Google Scholar 

  • Harmon-Jones, E., & Mills, J. (Eds.). (1999). Cognitive dissonance: Progress on a pivotal theory in social psychology. Washington, DC: American Psychological Association.

    Google Scholar 

  • Harrington, A. (1999). The placebo effect: An interdisciplinary phenomenon. Cambridge: Harvard University Press.

    Google Scholar 

  • Hart, W., Albarracín, D., Eagly, A. H., Brechan, I., Lindberg, M. J., & Merrill, L. (2009). Feeling validated versus being correct: A meta-analysis of selective exposure to information. Psychological Bulletin, 135, 555–588.

    Article  PubMed  Google Scholar 

  • Hróbjartsson, A., & Gotzsche, P. C. (2001). Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. New England Journal of Medicine, 344, 1594–1601.

    Article  PubMed  Google Scholar 

  • Hróbjartsson, A., & Gotzsche, P. C. (2004). Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no-treatment. Journal of International Medicine, 256, 91–100.

    Google Scholar 

  • Hyland, M. E. (2011). Motivation and placebos: do different mechanisms occur in different contexts? Philosophical Transactions B, 366, 1828–1837.

    Article  Google Scholar 

  • Iyengar, S., & Lepper, M. (2000). When choice is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology, 79, 995–1006.

    Article  CAS  PubMed  Google Scholar 

  • Kahneman, D., & Tversky, A. (1984). Choices, values, and frames. American Psychologist, 39, 341–350.

    Article  Google Scholar 

  • Kanfer, F. H., & Grimm, L. G. (1978). Freedom of choice and behavioral change. Journal of Consulting and Clinical Psychology, 46, 873–878.

    Article  CAS  PubMed  Google Scholar 

  • Kenny, D. A., Kashy, D. A., & Bolger, N. (1998). Data analysis in social psychology. In D. Gilbert, S. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (Vol. 1, pp. 233–265). Boston, MA: McGraw-Hill.

    Google Scholar 

  • Kirsch, I. (1999). How Expectancies Shape Experience. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Kirsch, L., & Sapierstein, G. (1998, June). Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention and Treatment, 1, Article 0002a. Retrieved April 1, 2002, from http://journals.apa.org/prevention/volume1/pre00100002a.html

  • Langer, E. J. (1975). The illusion of control. Journal of Personality and Social Psychology, 32, 311–328.

    Article  Google Scholar 

  • Langer, E. J., & Rodin, J. (1976). The effects of choice and enhanced personal responsibility for the aged: A field experiment in an institutional setting. Journal of Personality and Social Psychology, 34, 191–198.

    Article  CAS  PubMed  Google Scholar 

  • Laska, E., & Sunshine, A. (1977). Anticipation of analgesia: A placebo effect. Headache, 1, 1–11.

    Google Scholar 

  • Leotti, L. A., Iyengar, S. S., & Ochsner, K. N. (2010). Born to choose: The origins and value of the need for control. Trends in Cognitive Sciences, 14, 457–463.

    Article  PubMed  Google Scholar 

  • Mendonca, P. J., & Brehm, S. S. (1983). Effects of choice on behavioral treatment of overweight children. Journal of Social and Clinical Psychology, 1, 343–358.

    Article  Google Scholar 

  • Montgomery, G. H., & Kirsch, I. (1996). Mechanisms of placebo pain reduction: An empirical investigation. Psychological Science, 7, 174–176.

    Article  Google Scholar 

  • Montgomery, G. H., & Kirsch, I. (1997). Classical condition and the placebo effect. Pain, 72, 107–113.

    Article  CAS  PubMed  Google Scholar 

  • Morris, J., & Royle, G. T. (1988). Offering patients a choice of surgery for early breast cancer: A reduction in anxiety and depression in patients and their husbands. Social Science and Medicine, 26, 583–585.

    Article  CAS  PubMed  Google Scholar 

  • Moyer, A., & Salovey, P. (1998). Patient participation in treatment decision making and the psychological consequences of breast cancer surgery. Women’s Health: Research on Gender, Behavior, and Policy, 4, 103–116.

    CAS  Google Scholar 

  • Myers, E. D., & Branthwaite, A. (1992). Out-patient compliance with antidepressant medication. British Journal of Psychiatry, 160, 83–86.

    Article  CAS  PubMed  Google Scholar 

  • Myers, C. D., Tsao, J. C. I., Glover, D. A., Kim, S. C., Turk, N., & Zelter, L. K. (2006). Sex, gender, and age: Contributions to laboratory pain responding in children and adolescence. The Journal of Pain, 7, 556–564.

    Article  PubMed  Google Scholar 

  • Nickerson, R. S. (1998). Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology, 2, 175–220.

    Article  Google Scholar 

  • Petrovic, P., Dietrich, T., Fransson, P., Andersson, J., & Carlsson, K. (2005). Placebo in emotional processing-induced expectations of anxiety relief activate a generalized modulatory network. Neuron, 46, 957–969.

    Article  CAS  PubMed  Google Scholar 

  • Presson, P. K., & Benassi, V. A. (1996). Illusion of control: A meta-analytic review. Journal of Social Behavior and Personality, 11, 493–510.

    Google Scholar 

  • Price, D. D., & Fields, H. L. (1997). The contribution of desire and expectation to placebo analgesia: Implications for new research strategies. In A. Harrington (Ed.), The placebo effect: an interdisciplinary exploration (pp. 93–116). Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Price, D. D., Finniss, D. G., & Benedetti, F. (2008). A comprehensive review of the placebo effect: Recent advances and current thought. Annual Review of Psychology, 59, 565–590.

    Article  PubMed  Google Scholar 

  • Rief, W., Hofmann, S. G., & Nestoriuc, Y. (2008). The power of expectation—Understanding the placebo and nocebo phenomenon. Social and Personality Psychology Compass, 2, 1624–1637.

    Article  Google Scholar 

  • Riley, J. L., I. I. I., Robinson, M. E., Wise, E. A., Myers, C. D., & Fillingim, R. B. (1998). Sex differences in the perception of noxious experimental stimuli: A meta-analysis. Pain, 74, 181–188.

    Article  PubMed  Google Scholar 

  • Rokke, P. D., & al’Absi, M. (1992). Matching pain coping strategies to the individual: A prospective validation of the cognitive coping strategy inventory. Journal of Behavioral Medicine, 15, 611–625.

    Article  CAS  PubMed  Google Scholar 

  • Rokke, P. D., Fleming-Ficek, S., Siemens, N. M., & Hegstad, H. J. (2004). Self-efficacy and choice of coping strategies for tolerating acute pain. Journal of Behavioral Medicine, 27, 343–360.

    Article  PubMed  Google Scholar 

  • Rokke, P. D., & Lall, R. (1992). The role of choice in enhancing tolerance to acute pain. Cognitive Therapy and Research, 16, 53–65.

    Article  Google Scholar 

  • Schulz, R. (1976). Effects of control and predictability on the physical and psychological well-being of the institutionalized aged. Journal of Personality and Social Psychology, 33, 563–573.

    Article  CAS  PubMed  Google Scholar 

  • Shafir, E., Simonson, I., & Tversky, A. (1993). Reason-based choice. Cognition, 49, 11–36.

    Article  CAS  PubMed  Google Scholar 

  • Sharot, T., Shiner, T., & Dolan, R. J. (2010). Experience and choice shape expected aversive outcomes. The Journal of Neuroscience, 30, 9209–9215.

    CAS  PubMed  Google Scholar 

  • Shelke, A. R., Roscoe, J. A., Morrow, G. R., Colman, L. K., Banerjee, T. K., & Kirshner, J. J. (2008). Effect of a nausea expectancy manipulation on chemotherapy-induced nausea: A University of Rochester cancer center community clinical oncology program study. Journal of Pain and Symptom Management, 35, 381–387.

    Article  PubMed  Google Scholar 

  • Smith, S. M., Fabrigar, L. R., & Norris, M. E. (2008). Reflecting on six decades of selective exposure research: Progress, challenges, and opportunities. Social and Personality Psychology Compass, 2, 464–493.

    Article  Google Scholar 

  • Sobel, M. E. (1982). Asymptotic intervals for indirect effects in structural equations models. In S. Leinhart (Ed.), Sociological methodology (pp. 290–312). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Stewart, M., Brown, J. B., Weston, W. W., McWhinney, I. R., McWilliam, C. L., & Freeman, T. R. (2003). Patient-centered medicine: transforming the clinical method (2nd ed.). Abingdon, UK: Radcliffe Medical Press Ltd.

    Google Scholar 

  • Stewart-Williams, S. (2004). The placebo puzzle: Putting together the pieces. Health Psychology, 23, 198–206.

    Article  PubMed  Google Scholar 

  • Stewart-Williams, S., & Podd, J. (2004). The placebo effect: Dissolving the expectancy versus condition debate. Psychological Bulletin, 130, 324–340.

    Article  PubMed  Google Scholar 

  • Street, R. L., & Voigt, B. (1997). Patient participation in deciding breast cancer treatment and subsequent quality of life. Medical Decision Making, 17, 298–306.

    Article  PubMed  Google Scholar 

  • Turner, J. A., Deyo, R. A., Loeser, J. D., Von Korff, M., & Fordyce, W. E. (1994). The importance of placebo effects in pain treatment and research. Journal of the American Medical Association, 271, 1609–1614.

    Article  CAS  PubMed  Google Scholar 

  • Vandereycken, W., & Vansteenkiste, M. (2009). Let eating disorder patients decide: Providing choice may reduce early drop-out from impatient treatment. European Eating Disorders Review, 17, 177–183.

    Article  PubMed  Google Scholar 

  • Vogel, B. A., Leonhart, R., & Helmes, A. W. (2009). Communication matters: The impact of communication and participation in decision making on breast cancer patients’ depression and quality of life. Patient Education and Counseling, 77, 391–397.

    Article  PubMed  Google Scholar 

  • Vohs, K. D., Baumeister, R. F., Schmeichel, B. J., Twenge, J. M., Nelson, N. M., & Tice, D. M. (2008). Making choices impairs subsequent self-control: A limited-resource account of decision making, self-regulation, and active initiative. Journal of Personality and Social Psychology, 94, 883–898.

    Article  PubMed  Google Scholar 

  • Voudouris, N. J., Peck, C. L., & Coleman, G. (1990). The role of conditioning and expectancy in the placebo response. Pain, 43, 121–128.

    Article  CAS  PubMed  Google Scholar 

  • Walach, H., Schmidt, S., Dirhold, T., & Nosch, S. (2002). The effects of a caffeine placebo and suggestion on blood pressure, heart rate, well-being, and cognitive performance. International Journal of Psychophysiology, 43, 247–260.

    Article  PubMed  Google Scholar 

  • Worthington, E. L. (1978). The effects of imagery content, choice of imagery content, and self-verbalization on the self-control of pain. Cognitive therapy and Research, 2, 225–240.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Toledo, Mail Stop #948, 2801 Bancroft St., Toledo, OH, 43606-3390, USA

    Jason P. Rose, Andrew L. Geers, Heather M. Rasinski & Stephanie L. Fowler

Authors
  1. Jason P. Rose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew L. Geers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heather M. Rasinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephanie L. Fowler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jason P. Rose.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rose, J.P., Geers, A.L., Rasinski, H.M. et al. Choice and placebo expectation effects in the context of pain analgesia. J Behav Med 35, 462–470 (2012). https://doi.org/10.1007/s10865-011-9374-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-011-9374-0

Keywords

Search

Navigation