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Szigeti B, Heifets BD. Expectancy Effects in Psychedelic Trials. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:512-521. [PMID: 38387698 DOI: 10.1016/j.bpsc.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
Clinical trials of psychedelic compounds like psilocybin, lysergic acid diethylamide (LSD), and N,N-dimethyltrptamine (DMT) have forced a reconsideration of how nondrug factors, such as participant expectations, are measured and controlled in mental health research. As doses of these profoundly psychoactive substances increase, so does the difficulty in concealing the treatment condition in the classic double-blind, placebo-controlled trial design. As widespread public enthusiasm for the promise of psychedelic therapy grows, so do questions regarding whether and how much trial results are biased by positive expectancy. First, we review the key concepts related to expectancy and its measurement. Then, we review expectancy effects that have been reported in both micro- and macrodose psychedelic trials from the modern era. Finally, we consider expectancy as a discrete physiological process that can be independent of, or even interact with, the drug effect. Expectancy effects can be harnessed to improve treatment outcomes and can also be actively managed in controlled studies to enhance the rigor and generalizability of future psychedelic trials.
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Affiliation(s)
- Balázs Szigeti
- Translational Psychedelic Research Program, University of California San Francisco, San Francisco, California; Centre for Psychedelic Research, Imperial College London, London, UK
| | - Boris D Heifets
- Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
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2
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Langford DJ, Lou R, Sheen S, Amtmann D, Colloca L, Edwards RR, Farrar JT, Katz NP, McDermott MP, Reeve BB, Wasan AD, Turk DC, Dworkin RH, Gewandter JS. Expectations for Improvement: A Neglected but Potentially Important Covariate or Moderator for Chronic Pain Clinical Trials. THE JOURNAL OF PAIN 2023; 24:575-581. [PMID: 36577461 PMCID: PMC10079631 DOI: 10.1016/j.jpain.2022.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/09/2022] [Accepted: 12/18/2022] [Indexed: 12/27/2022]
Abstract
Variability in pain-related outcomes can hamper assay sensitivity of chronic pain clinical trials. Expectations of outcome in such trials may account for some of this variability, and thereby impede development of novel pain treatments. Measurement of participants' expectations prior to initiating study treatment (active or placebo) is infrequent, variable, and often unvalidated. Efforts to optimize and standardize measurement, analysis, and management of expectations are needed. In this Focus Article, we provide an overview of research findings on the relationship between baseline expectations and pain-related outcomes in clinical trials of pharmacological and nonpharmacological pain treatments. We highlight the potential benefit of adjusting for participants' expectations in clinical trial analyses and draw on findings from patient interviews to discuss critical issues related to measurement of expectations. We conclude with suggestions regarding future studies focused on better understanding the utility of incorporating these measures into clinical trial analyses. PERSPECTIVE: This focus article provides an overview of the relationship between participants' baseline expectations and pain-related outcomes in the setting of clinical trials of chronic pain treatments. Systematic research focused on the measurement of expectations and the impact of adjusting for expectations in clinical trial analyses may improve assay sensitivity.
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Affiliation(s)
- Dale J Langford
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York; Department of Anesthesiology & Perioperative Medicine, University of Rochester, Rochester, New York; Department of Anesthesiology & Pain Medicine/Division of Pain Medicine, University of Washington, Seattle Washington.
| | - Raissa Lou
- Department of Anesthesiology & Perioperative Medicine, University of Rochester, Rochester, New York
| | - Soun Sheen
- Department of Anesthesiology & Perioperative Medicine, University of Rochester, Rochester, New York
| | - Dagmar Amtmann
- Department of Anesthesiology & Pain Medicine/Division of Pain Medicine, University of Washington, Seattle Washington
| | - Luana Colloca
- Department of Pain & Translational Symptom Science, University of Maryland, Baltimore, Maryland
| | - Robert R Edwards
- Department of Anesthesia, Harvard Medical School, Boston, Massachusetts
| | - John T Farrar
- Departments of Epidemiology, Neurology, and Anesthesia, Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nathaniel P Katz
- Department of Anesthesiology & Perioperative Medicine, Tufts University and Ein Sof Innovation, Boston, Massachusetts
| | - Michael P McDermott
- Department of Anesthesiology & Perioperative Medicine, University of Rochester, Rochester, New York
| | - Bryce B Reeve
- Department of Population Health Sciences, Center for Health Measurement, Duke University School of Medicine, Durham, North Carolina
| | - Ajay D Wasan
- Department of Anesthesiology & Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dennis C Turk
- Department of Anesthesiology & Pain Medicine/Division of Pain Medicine, University of Washington, Seattle Washington
| | - Robert H Dworkin
- Department of Anesthesiology & Perioperative Medicine, University of Rochester, Rochester, New York
| | - Jennifer S Gewandter
- Department of Anesthesiology & Perioperative Medicine, University of Rochester, Rochester, New York
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3
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Papetti L, Tarantino S, Ursitti F, Moavero R, Proietti MC, Sforza G, Monte G, Ferilli MAN, Balestri M, Vigevano F, Valeriani M. From the New Diagnostic Criteria to COVID-19 Pandemic Passing Through the Placebo Effect. What Have We Learned in the Management of Pediatric Migrane Over the Past 5 Years? Front Neurol 2022; 13:935803. [PMID: 35911893 PMCID: PMC9326104 DOI: 10.3389/fneur.2022.935803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
In 2018, the Food and Drug Administration (FDA) approval of anti-calcitonin gene-related peptide (CGRP) therapies for the treatment of migraine represented a milestone for the management of the disease in adults. On the contrary, the novelties in the field of pediatric migraine are inserted in a different scenario and still concern: (1) diagnostic criteria of the international classification of headache disorders-3 (ICHD-3) that show numerous limits of applicability in the developmental age; (2) the release of the results of the Childhood and Adolescent Migraine Prevention (CHAMP) study that raised doubts about the usefulness of traditional drugs for the treatment of pediatric migraine; (3) the Coronavirus disease 2019 (COVID-19) pandemic has put the spotlight on the importance of managing the psychological factors associated with the disease. In this mini review we discuss the most relevant news in pediatric migraine over the last 5 years.
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Affiliation(s)
- Laura Papetti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Samuela Tarantino
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Fabiana Ursitti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Romina Moavero
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Martina Checchi Proietti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Giorgia Sforza
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Gabriele Monte
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Martina Balestri
- Child Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Federico Vigevano
- Child Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Massimiliano Valeriani
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
- *Correspondence: Massimiliano Valeriani
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Knestrick KE, Gibler RC, Reidy BL, Powers SW. Psychological Interventions for Pediatric Headache Disorders: A 2021 Update on Research Progress and Needs. Curr Pain Headache Rep 2022; 26:85-91. [PMID: 35107711 PMCID: PMC8807374 DOI: 10.1007/s11916-022-01007-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW This review summarizes key findings from recent investigations of psychological interventions for pediatric headache disorders and discusses important avenues for future research. RECENT FINDINGS Cognitive Behavioral Therapy (CBT) is effective in reducing headache days among youth with chronic headache. There is mixed evidence for the benefit of CBT on reducing disability associated with migraine, suggesting that there is room to optimize CBT by leveraging complementary or alternative psychological interventions, such as Acceptance and Commitment Therapy (ACT) and mindfulness-based approaches. Tailoring CBT may be especially important for youth with more impairing or complex clinical presentations, such as those with continuous headache. Using eHealth and novel study designs to expand access to and dissemination of psychological interventions is promising. Although CBT is the gold standard psychological treatment for youth with migraine, we are only beginning to understand how and why it is effective. Other promising psychological treatments are available, and studies are beginning to examine how CBT can be optimized to fit the unique needs of each patient. Improving access and equitability of care for youth with migraine will require tailoring psychological treatments for patients with varying headache presentations and youth from a variety of cultural, racial, ethnic, and linguistic backgrounds.
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Affiliation(s)
- Kaelynn E Knestrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Robert C Gibler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Brooke L Reidy
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Scott W Powers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
- Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
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5
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Melis M, Di Giosia M, Colloca L. Ancillary factors in the treatment of orofacial pain: A topical narrative review. J Oral Rehabil 2018; 46:200-207. [PMID: 30326154 DOI: 10.1111/joor.12736] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/07/2018] [Accepted: 10/10/2018] [Indexed: 11/29/2022]
Abstract
Ancillary factors, not directly related to treatment, often play a significant role by affecting therapeutic outcome. A search of the literature was conducted including words related to the placebo phenomenon and orofacial diseases. Therefore, critical factors have been grouped into three major categories: (a) the natural course of the diseases; (b) the regression of the symptoms to their mean intensity; and (c) placebo response. This topical narrative review describes the elements mentioned above, provides an up-to-date overview of the hot topics and gaps in the field and indicates developing and future research direction of the orofacial pain field. Such a knowledge might be positively used during daily clinical practice to optimise the management of orofacial pain diseases, as well as in conducting future clinical trials for validating new interventions.
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Affiliation(s)
- Marcello Melis
- Private practice, Cagliari, Italy.,School of Dentistry, University of Cagliari, Cagliari, Italy
| | - Massimiliano Di Giosia
- Orofacial Pain Clinic, Department of Endodontics, Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Luana Colloca
- Department of Pain and Translational Symptom Science & Department of Anesthesiology, School of Nursing/School of Medicine, University of Maryland, Baltimore, Maryland
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Abstract
Pharmacological strategies for pain management have primarily focused on dampening ascending neurotransmission and on opioid receptor-mediated therapies. Little is known about the contribution of endogenous descending modulatory systems to clinical pain outcomes and why some patients are mildly affected while others suffer debilitating pain-induced dysfunctions. Placebo effects that arise from patients' positive expectancies and the underlying endogenous modulatory mechanisms may in part account for the variability in pain experience and severity, adherence to treatment, distinct coping strategies, and chronicity. Expectancy-induced analgesia and placebo effects in general have emerged as useful models to assess individual endogenous pain modulatory systems. Different systems and mechanisms trigger placebo effects that highly impact pain processing, clinical outcomes, and sense of well-being. This review illustrates critical elements of placebo mechanisms that inform the methodology of clinical trials, the discovery of new therapeutic targets, and the advancement of personalized pain management.
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Affiliation(s)
- Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing; Department of Anesthesiology, School of Medicine; and Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland 21201, USA;
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7
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Evers AW, Colloca L, Blease C, Annoni M, Atlas LY, Benedetti F, Bingel U, Büchel C, Carvalho C, Colagiuri B, Crum AJ, Enck P, Gaab J, Geers AL, Howick J, Jensen KB, Kirsch I, Meissner K, Napadow V, Peerdeman KJ, Raz A, Rief W, Vase L, Wager TD, Wampold BE, Weimer K, Wiech K, Kaptchuk TJ, Klinger R, Kelley JM. Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus. PSYCHOTHERAPY AND PSYCHOSOMATICS 2018; 87:204-210. [PMID: 29895014 PMCID: PMC6191882 DOI: 10.1159/000490354] [Citation(s) in RCA: 290] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice. METHODS A survey and interdisciplinary expert meeting by invitation was organized as part of the 1st Society for Interdisciplinary Placebo Studies (SIPS) conference in 2017. Twenty-nine internationally recognized placebo researchers participated. RESULTS There was consensus that maximizing placebo effects and minimizing nocebo effects should lead to better treatment outcomes with fewer side effects. Experts particularly agreed on the importance of informing patients about placebo and nocebo effects and training health professionals in patient-clinician communication to maximize placebo and minimize nocebo effects. CONCLUSIONS The current paper forms a first step towards developing evidence-based and ethical recommendations about the implications of placebo and nocebo research for medical practice, based on the current state of evidence and the consensus of experts. Future research might focus on how to implement these recommendations, including how to optimize conditions for educating patients about placebo and nocebo effects and providing training for the implementation in clinical practice.
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Affiliation(s)
- Andrea W.M. Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands,*Andrea W.M. Evers, Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, PO Box 9555, NL–2300 RB Leiden (The Netherlands), E-Mail
| | - Luana Colloca
- Department of Pain Translational Symptoms Science and Anaesthesiology, School of Nursing and Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Charlotte Blease
- Department of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Marco Annoni
- Department of Institute of Biomedical Technologies, National Research Council, Rome, Italy
| | - Lauren Y. Atlas
- Department of Section on Affective Neuroscience and Pain, NIH, Bethesda, Massachusetts, USA
| | - Fabrizio Benedetti
- Department of Physiology and Neuroscience, University of Turin Medical School, Turin, Italy
| | - Ulrike Bingel
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Carvalho
- Department of Clinical and Health Psychology, Instituto Universitário de Ciências Psicológicas, Lisbon, Portugal
| | - Ben Colagiuri
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Alia J. Crum
- Department of Psychology, Stanford University, Stanford, California, USA
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Jens Gaab
- Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Andrew L. Geers
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Jeremy Howick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Karin B. Jensen
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Irving Kirsch
- Beth Israel Deaconess Medical Center, Program in Placebo Studies, Boston, Massachusetts, USA
| | - Karin Meissner
- Division of Health Promotion, University of Applied Sciences, Coburg, Germany
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, USA
| | - Kaya J. Peerdeman
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Amir Raz
- Departments of Psychiatry, Neurology and Neurosurgery, McGill University, Montreal, Québec, Canada
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Tor D. Wager
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado, USA
| | - Bruce E. Wampold
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA,Modum Bad Psychiatric Center, Vikersund, Norway
| | - Katja Weimer
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Katja Wiech
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Ted J. Kaptchuk
- Beth Israel Deaconess Medical Center, Program in Placebo Studies, Boston, Massachusetts, USA
| | - Regine Klinger
- Department of Pain Translational Symptoms Science and Anaesthesiology, School of Nursing and Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - John M. Kelley
- Beth Israel Deaconess Medical Center, Program in Placebo Studies, Boston, Massachusetts, USA
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Blasini M, Movsas S, Colloca L. Placebo hypoalgesic effects in pain: Potential applications in dental and orofacial pain management. Semin Orthod 2018; 24:259-268. [PMID: 31354227 PMCID: PMC6660159 DOI: 10.1053/j.sodo.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Placebo and nocebo effects are present within every treatment and intervention, and can be purposefully enhanced and reduced, respectively, in order to improve patients' clinical outcomes. A plethora of research has been conducted on the mechanisms of placebo hypoalgesia and nocebo hyperalgesia in experimental and clinical settings. However, its implications in particular clinical settings such as orthodontic pain management remain underexplored. We conducted a search of the literature regarding placebo analgesia, orthodontic pain management, and orofacial and dental pain. Articles were qualitatively assessed and selected based on the scope of this narrative review. Although no studies investigating the extent of the implications of the placebo and nocebo phenomena in the orthodontic clinical setting were found, we herein present a comprehensive review on the influences of placebo and nocebo effects in experimental and clinical pain management, as well as on the potential for engaging placebo-related endogenous pain modulation for orthodontic pain management. Ethical considerations for the clinical application of placebos are discussed, and future research directions are presented.
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Affiliation(s)
- Maxie Blasini
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA; Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, University of Maryland, Baltimore, USA; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
| | - Shira Movsas
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA; Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, University of Maryland, Baltimore, USA; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
| | - Luana Colloca
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA; Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, University of Maryland, Baltimore, USA; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
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9
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Peiris N, Blasini M, Wright T, Colloca L. The Placebo Phenomenon: A Narrow Focus on Psychological Models. PERSPECTIVES IN BIOLOGY AND MEDICINE 2018; 61:388-400. [PMID: 30293977 PMCID: PMC6195310 DOI: 10.1353/pbm.2018.0051] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The placebo effect is a complex phenomenon that can be described from neurobiological, psychosocial, and epistemological perspectives. Different leaders in the field have proposed multiple theories and models that attempt to describe both the nature and the mechanisms of action underlying placebo effects. This article focuses on the most relevant psychological models that have been suggested for characterizing the different mechanisms underlying the placebo effect. We outline how the dynamic psychoneurobiological aspects of the placebo phenomenon can be a potential reliable and useful tool in daily clinical practice for illness and symptom management within a wide variety of specialties and health-care practices.
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Affiliation(s)
- Nathalie Peiris
- Department of Anesthesiology School of Medicine, University
of Maryland, Baltimore
| | - Maxie Blasini
- Department of Pain Translational Symptom Science,
School of Nursing, University of Maryland, Baltimore
| | - Thelma Wright
- Department of Anesthesiology School of Medicine, University
of Maryland, Baltimore
| | - Luana Colloca
- Departments of Anesthesiology and Psychiatry, School
of Medicine; Department of Pain Translational Symptom Science, School of Nursing;
and Center to Advance Chronic Pain Research, University of Maryland,
Baltimore
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