Highlights
- •The study documents the first experimental evidence for a substantial expectancy-induced placebo analgesia response in healthy children aged 6 to 9 years.
- •The placebo responses were 5.6 times larger for pain tolerance and 3.6 times larger for pain threshold than those found in adults in a recently published study using a similar heat pain paradigm.
- •Girls were more placebo responsive for pain threshold than boys.
- •Pain perception in boys was modulated by magical thinking and it was differentially so for the left and right forearms.
Abstract
Expectations and beliefs shape the experience of pain. This is most evident in context-induced,
placebo analgesia, which has recently been shown to interact with the trait of magical
thinking (MT) in adults. In children, placebo analgesia and the possible roles that
MT and gender might play as modulators of placebo analgesia have remained unexplored.
Using a paradigm in which heat pain stimuli were applied to both forearms, we investigated
whether MT and gender can influence the magnitude of placebo analgesia in children.
Participants were 49 right-handed children (aged 6–9 years) who were randomly assigned—stratified
for MT and gender—to either an analgesia-expectation or a control-expectation condition.
For both conditions, the placebo was a blue-colored hand disinfectant that was applied
to the children's forearms. Independent of MT, the placebo treatment significantly
increased both heat pain threshold and tolerance. The threshold placebo effect was
more pronounced for girls than boys. In addition, independent of the expectation treatment,
low-MT boys showed a lower tolerance increase on the left compared to the right side.
Finally, MT specifically modulated tolerance on the right forearm side: Low-MT boys
showed an increase, whereas high-MT boys showed a decrease in heat pain tolerance.
This study documented a substantial expectation-induced placebo analgesia response
in children (girls > boys) and demonstrated MT and gender-dependent laterality effects
in pain perception. The findings may help improve individualized pain management for
children.
Perspective
The study documents the first experimental evidence for a substantial expectancy-induced
placebo analgesia response in healthy children aged 6 to 9 years (girls > boys). Moreover,
the effect was substantially higher than the placebo response typically found in adults.
The findings may help improve individualized pain management for children.
Key words
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Article info
Publication history
Published online: September 24, 2014
Accepted:
September 12,
2014
Received in revised form:
August 23,
2014
Received:
May 10,
2014
Footnotes
J.K. and C.S. contributed equally to this work.
This research was supported by the University of Basel. P.K. was also supported by brainability LLC. J.K.'s contributions to this study were supported by the Swiss National Science Foundation, grant project (P2BSP1_148628).
The authors declare that there is no conflict of interest.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
