Open- and Closed-Label Placebo and Nocebo Suggestions About a Sham Transdermal Patch

Meeuwis, Stefanie H; Middendorp, Henriët van; Lavrijsen, A.P.M.; Veldhuijzen, Dieuwke S.; Evers, Andrea W M

doi:10.1097/psy.0000000000000862

Cited by 9 publications

(11 citation statements)

References 62 publications

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“…Contrary to our second hypothesis, the positive and negative suggestions about contagious itch failed to modulate participants' itch expectancies as well as their general itch experience. These findings are somewhat unexpected in light of previous work that shows that verbal suggestions can modulate expectancies about, and the experience of, cutaneous itch e.g., 12,33,34 On the contrary, in previous research catastrophizing information only influenced scratching responses and did not affect contagious itch. 20 These effects were moreover only found in patients with dermatological conditions, but not in healthy controls.…”

Section: Discussioncontrasting

confidence: 85%

Can contagious itch be affected by positive and negative suggestions?

Meeuwis

Skvortsova

Laarhoven

et al. 2022

Experimental Dermatology

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Contagious itch can be evoked by observing people scratching. Verbal suggestions about tobe-received itch can influence itch intensity, as shown by placebo research, but it is unknown whether this extends to contagious itch. The current study aimed to replicate prior findings that listening to scratching and rubbing sounds elicits contagious itch, and to investigate whether suggestions can modulate this process. Healthy participants (n=140) received positive or negative suggestions about itch in response to the sounds (aimed to decrease or increase expected itch, respectively), or no specific suggestions as a control. Participants listened to a number of audio fragments with scratching and rubbing sounds. The amount of expected itch as well as itch sensation after each audio fragment were measured by self-report. Suggestions had no effect on the expected itch. Both rubbing and scratching sounds significantly elicited itch in all groups. Scratching sounds induced more itch than rubbing sounds exclusively in the control group. These findings indicate that short suggestions might be not effective enough to modify the expectations of people regarding contagious itch. Furthermore, suggestions modulate contagious itch to some degree, but not in the hypothesized direction. Potential similarities and differences in the neurobiological mechanisms of contagious itch and nocebo effects are discussed.

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Section: Discussioncontrasting

confidence: 85%

Can contagious itch be affected by positive and negative suggestions?

Meeuwis

Skvortsova

Laarhoven

et al. 2022

Experimental Dermatology

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“…Mediation analysis demonstrated that positive VSs reduced expected itch compared to negative VSs (path a 1 : b X→M = -1.84, SE = 0.31, p < 0.001; findings of the separate studies are described in Meeuwis et al, 2019;Meeuwis et al, 2021). However, 3).…”

Section: Closed-label Positive Versus Negative Verbal Suggestions (Studies 2 and 3)mentioning

confidence: 88%

“…Mediation analysis demonstrated that positive VSs reduced expected itch compared to negative VSs (path a 1 : b X→M = -1.72, SE = 0.30, p < 0.001; findings of the separate studies are described in Meeuwis et al, 2019;Meeuwis et al, 2021). Lower post-VSs expected itch in turn was associated with lower post-VSs mean itch (path b 1 : b M→Y = 0.17, SE = 0.08, p = 0.032).…”

Section: Open-label Positive Versus Negative Verbal Suggestions (Studies 2 and 3)mentioning

confidence: 91%

“…Psychological traits and affective states that may be associated with placebo and nocebo responses to verbal suggestions (VSs) in histamine-induced itch were explored across three previously published experimental studies ( Meeuwis et al, 2018 ; Meeuwis et al, 2019 ; Meeuwis et al, 2021 ). This paper used the same data as these previous publications, but now aimed to examine interrelations between interindividual differences, expectations, and placebo and nocebo effects in itch in a larger participant sample.…”

Section: Methodsmentioning

confidence: 99%

“…Investigating how interindividual differences, expectations, placebo effects and nocebo effects are interrelated could further our understanding of the manner in which interindividual differences may contribute to placebo and nocebo responding. To this end, we exploratively analyzed data of three of our previous studies that investigated placebo and nocebo effects induced by (open- or closed-label) positive and negative verbal suggestions on itch ( Meeuwis et al, 2018 ; Meeuwis et al, 2019 ; Meeuwis et al, 2021 ). The objective was to explore the influence of interindividual differences across a mediation model of placebo and nocebo effects using conditional process analyses.…”

Section: Introductionmentioning

confidence: 99%

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Associations Between Interindividual Differences, Expectations and Placebo and Nocebo Effects in Itch

et al. 2021

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Introduction: Placebo and nocebo effects are positive and negative health outcomes that can be elicited by the psychosocial context. They can be mediated by expectations, and may emerge in somatic symptoms even when people are aware of these effects. Interindividual differences (e.g., in personality, affective states) could impact placebo and nocebo responding, but findings are inconsistent.Methods: The current work examined expectation as a mediator of the association between verbal placebo and nocebo suggestions (VSs) and histamine-induced itch across three experimental studies. Moreover, we examined whether interindividual differences (e.g., in optimism, neuroticism, behavioral activation system (BAS), body ignorance) modulated: (1) the direct association between VSs and itch (direct moderation), and (2) the indirect, expectation-mediated association between VSs and itch (moderated mediation). Positive VSs were compared to neutral instructions (Study 1; n = 92) or negative VSs (Studies 2+3; n = 203) in an open-label (i.e., explaining placebo and nocebo effects) or closed-label (concealed) context using PROCESS. First, mediation of VSs effects on itch by expectations was tested. Next, moderation by individual traits was explored using conditional process analyses.Results: The effects of VSs on itch were significantly mediated by expectation in Study 1 and in the open-label (but not closed-label) contexts of Studies 2 and 3. Ignorance of bodily signals marginally moderated the direct effects of VSs on itch when closed-label suggestions were given: at low levels of body ignorance, effects of positive and negative VSs were stronger. Moreover, moderated mediation was observed in the open-label groups of Studies 2 and 3: The expectation-mediated effects of VSs on itch were stronger when BAS drive was lower.Conclusion: Overall, the effects of VSs on itch were mediated by expectations in the open-label, but not the closed-label context. Moreover, the current work suggests that placebo and nocebo effects may be moderated by ignorance of bodily signals and the BAS. There was limited evidence that other interindividual differences modulated placebo and nocebo responding in itch.

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Mitigating the Nocebo Effect in Biosimilar Use and Switching: A Systematic Review

Car,

Vandenplas,

Lacosta

et al. 2024

Pharm Med

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Background In the context of biosimilar use and switching, a patient’s negative perception of a biosimilar might trigger a nocebo effect, where negative expectations unrelated to its pharmacologic action may lead to worsened symptoms, resulting in less perceived therapeutic benefit or worsened adverse events. Considering the crucial role biosimilars have in reducing health care costs and expanding access to safe biologics globally, it is essential to develop and implement effective strategies to mitigate the possible occurrence of such nocebo effects. Objective The aim of this systematic literature review was two-fold: (i) to review strategies that have been applied and/or tested for minimising the nocebo effect in clinical practice, within and outside the context of biosimilar switching, and (ii) to propose recommendations on useful mitigation strategies to minimise the occurrence of the nocebo effect in the context of biosimilar switching. Methods Biomedical databases PubMed and Embase were screened up until the end of April 2023 with a search string consisting of the following search terms “nocebo”, “biosimilar”, “mitigation”, “strategy”, and “prevention” and related synonyms. The search strategy was supplemented by snowballing of the included studies. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, the Scale for the Assessment of Narrative Review Articles, and the Mixed Methods Appraisal Tool. Results Of the 1617 identified and screened records, 60 met the inclusion criteria. Among these, 10 (17%) were conducted within the context of biosimilar switching, 7 of which specifically tested strategies to mitigate the nocebo effect. Among the remaining 50 studies conducted outside the biosimilar switching context, 46 tested mitigation strategies. Across the included studies, 13 distinct mitigation strategies were identified, which can be employed within the context of biosimilar switching: (i) open non-verbal communication, (ii) positive framing, (iii) empathic communication, (iv) validating communication, (v) shared decision making, (vi) self-affirmation, (vii) education of patients and health care professionals about the nocebo effect, (viii) education of patients and health care professionals about biosimilars, (ix) soft-skills training for health care professionals, (x) personalised information, (xi) supporting information, (xii) multidisciplinary approach, (xiii) organisation of the switch. Conclusion This review has identified a set of strategies that have been tested to mitigate the nocebo effect, which can be applied by health care professionals in the context of biosimilar switching with the aim of mitigating the occurrence of a nocebo effect. We recommend implementing a combination of mitigation strategies for patients and health care professionals to utilise before, during,...

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Open- and Closed-Label Placebo and Nocebo Suggestions About a Sham Transdermal Patch

Abstract: Supplemental digital content is available in the text.

Cited by 9 publications

References 62 publications

Can contagious itch be affected by positive and negative suggestions?

Can contagious itch be affected by positive and negative suggestions?

Associations Between Interindividual Differences, Expectations and Placebo and Nocebo Effects in Itch

Mitigating the Nocebo Effect in Biosimilar Use and Switching: A Systematic Review

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