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Beliefs about pharmaceutical medicines and natural remedies explain individual variation in placebo analgesia

Watkinson, A; Chapman, SCE; Horne, R; (2017) Beliefs about pharmaceutical medicines and natural remedies explain individual variation in placebo analgesia. The Journal of Pain , 18 (8) pp. 908-922. 10.1016/j.jpain.2017.02.435. Green open access

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Abstract

This study examined whether placebo responses were predicted by a theoretical model of specific and general treatment beliefs. Using a randomised cross-over, experimental design (168 healthy individuals) we assessed whether responses to a cold pressor task were influenced by two placebo creams described as Pharmaceutical vs Natural origin. We assessed whether placebo responses were predicted by pre-treatment beliefs about the treatments (placebo) and by beliefs about the pain. The efficacy of both Pharmaceutical and Natural Placebos in reducing Pain Intensity was predicted by aspects of pain catastrophizing including Feelings of Helplessness (Pharmaceutical: B=0.03, p<0.01, Natural: B=0.02, p<0.05) and Magnification of Pain (Pharmaceutical: B=0.04, p<0.05, Natural: B=0.05, p<0.05) but also by pre-treatment Necessity beliefs (Pharmaceutical: B=0.21, p<0.01, Natural: B=0.16, p<0.05) and, for the Pharmaceutical condition, by more general beliefs in personal sensitivity to pharmaceuticals (B=0.14, p<0.05). Treatment Necessity beliefs also partially mediated the effects of Helplessness on placebo responses. Treatment Necessity beliefs for the Pharmaceutical Placebo were influenced by general pharmaceutical beliefs whereas Necessity beliefs for the Natural Placebo were informed by general background beliefs about holistic treatments. Our findings demonstrate that treatment beliefs influence the placebo effect suggesting that they may offer an additional approach for understanding the placebo effect. PERSPECTIVE: Placebo effects contribute to responses to active analgesics. Understanding how beliefs about different types of medicines influence placebo analgesia may be useful in understanding variations in treatment response. Using the cold-pressor paradigm we found that placebo analgesia is influenced by beliefs about natural remedies, pharmaceutical medicines and about pain.

Type: Article
Title: Beliefs about pharmaceutical medicines and natural remedies explain individual variation in placebo analgesia
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jpain.2017.02.435
Publisher version: http://dx.doi.org/10.1016/j.jpain.2017.02.435
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Analgesia, Natural remedies, Pharmaceutical medicines, Placebo effect, Treatment beliefs
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/1546802
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