Accumulating evidence reveal important applications of endogenous pain modulation assessment in healthy controls and in patients in clinical settings, as dysregulations in the balance of pain modulatory circuits may facilitate pain and promote chronification of pain. This article reviews data on pain modulation, focusing on the mechanisms and translational aspects of pain modulation from conditioned pain modulation (CPM) to placebo and nocebo effects in experimental and clinical pain. The specific roles of expectations, learning, neural and neurophysiological mechanisms of the central nervous system are briefly reviewed herein. The interaction between CPM and placebo systems in pain inhibitory pathways is highly relevant in the clinic and in randomized controlled trials yet remains to be clarified. Examples of clinical implications of CPM and its relationship to placebo and nocebo effects are provided. A greater understanding of the role of pain modulation in various pain states can help characterize the manifestation and development of chronic pain and assist in predicting the response to pain-relieving treatments. Placebo and nocebo effects, intrinsic to every treatment, can be used to develop personalized therapeutic approaches that improve clinical outcomes while limiting unwanted effects.
Quebec has the highest non graduation rate in Canada. The personal and social consequences are numerous, with long term repercussions. Even if a low intelligence quotient (IQ) is an important risk factor of school dropout, some factors may influence this association. The purpose of this study is to investigate the moderating effect of the student-teacher relationship on the association between the IQ and school dropout using the data of the SIAA (Stratégie d'Intervention Agir Autrement) study. The logistic regression analyzes confirmed that the IQ score contributes in predicting school dropout. However, the results suggest that warm or conflicting student-teacher relationships have no contribution to the prediction model and do not moderate the link between IQ and school dropout.
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