Meijer Simone, van Middendorp Henriët, Peerdeman Kaya J, Evers Andrea W M
Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands.
Leiden Institute for Brain and Cognition, Leiden, Netherlands.
Front Psychol. 2022 Jun 13;13:806409. doi: 10.3389/fpsyg.2022.806409. eCollection 2022.
Persistent physical symptoms have a high prevalence and a large impact for patients and society. To date, treatment effects for these symptoms are often limited. Nocebo effects (i.e., negative outcomes that are not attributable to active treatment components) have a substantial influence on treatment success and can be established via learning through classical conditioning. Therefore, interventions aimed at reducing nocebo effects by means of counterconditioning, in which an alternative association (inhibiting the previous association) is learned, could be a promising method for improving physical symptoms. In experimental studies, counterconditioning has been shown promising in reducing experimentally-induced nocebo effects on pain and itch. Application of counterconditioning procedures to reduce nocebo effects on clinical symptoms has yet to be researched. This paper provides a protocol of a 6-week counterconditioning intervention aimed at reducing nocebo effects and clinical pain in patients with fibromyalgia. A study in patients with fibromyalgia is proposed to examine the feasibility and potential effectiveness of this counterconditioning intervention as a novel treatment method for reducing nocebo effects and generalization to clinical pain symptoms. Results can help design an optimized treatment protocol for reducing nocebo effects, based on the experiences of participants and the first indications of treatment efficacy.
持续性身体症状在患者和社会中具有高患病率和重大影响。迄今为止，针对这些症状的治疗效果往往有限。反安慰剂效应（即并非由积极治疗成分导致的负面结果）对治疗成功有着重大影响，并且可以通过经典条件作用学习而形成。因此，旨在通过对抗条件作用减少反安慰剂效应的干预措施（在这种干预中，学习一种替代关联（抑制先前的关联））可能是改善身体症状的一种有前景的方法。在实验研究中，对抗条件作用已被证明在减少实验诱导的对疼痛和瘙痒的反安慰剂效应方面很有前景。将对抗条件作用程序应用于减少对临床症状的反安慰剂效应尚未得到研究。本文提供了一个为期6周的对抗条件作用干预方案，旨在减少纤维肌痛患者的反安慰剂效应和临床疼痛。建议对纤维肌痛患者进行一项研究，以检验这种对抗条件作用干预作为一种减少反安慰剂效应并推广至临床疼痛症状的新治疗方法的可行性和潜在有效性。研究结果可根据参与者的经验和治疗效果的初步迹象，帮助设计一个优化的减少反安慰剂效应的治疗方案。
