Conditioned placebo responses.

Following earlier animal research, we attempt to condition placebo effects in human subjects. Four groups of 8 voluntary subjects were told that the experimenters would test a powerful new analgesic cream over three sessions by assessing its ability to reduce experimentally induced pain. The analgesic cream was, in fact, a placebo. In the first session all subjects were tested with and without the cream to assess their placebo response. In the second session, to condition two groups (with differing stimulation levels) to experience pain relief in response to the placebo, we repeatedly paired a reduction in nocioceptive stimulation with placebo administration. (Subjects were unaware that stimulation levels were manipulated). To condition the other two groups (with different stimulation levels) to experience an exacerbation of the pain, we paired an increase in nocioceptive stimulation with placebo administration. In the third session, all subjects were again tested for placebo response. Results suggested that placebo responses are conditionable in the laboratory in both a positive and negative direction. The clinical implications of a learning theory of placebo behavior are discussed.