Stephanie L. Fowler

Dispositional Optimism Predicts Placebo Analgesia

UNLABELLED Based on prior research identifying dispositional optimism as a predictor of placebo responding, the present study tested the hypothesis that individuals high in optimism would be more likely to respond to a placebo analgesic. Optimists and pessimists were randomly assigned to a placebo expectation condition or a no expectation condition before a cold pressor task. Blood pressure and heart rate were recorded before and during the cold pressor task, and participant ratings of pain and expectations were obtained immediately after the task. Analysis of the expectation manipulation revealed that the placebo instruction was successful in altering participant expectancy during the cold pressor. Supporting the main hypothesis, dispositional optimism was associated with lower pain ratings in the placebo condition but not in the control condition. Because dispositional optimism can alter placebo responding to laboratory pain, future studies should examine the potential role that this individual difference factor may play in patient responsivity to pharmacological and nonpharmacological treatments for clinical pain. PERSPECTIVE This study examined the possibility that individual differences can predict placebo analgesia. Participants were randomly assigned to receive either a placebo expectation or no expectation before a cold pressor task. Dispositional optimism was related to less cold pressor pain in the placebo condition as compared with the control condition.

Dispositional Optimism and Thoughts of Well-Being Determine Sensitivity to an Experimental Pain Task

BackgroundPrior studies with patient samples have found dispositional optimism to be associated with less pain.PurposeWe examined the relationship between optimism and experimental pain. It was hypothesized that optimists generally cope with a painful stimulus by mentally disengaging from the pain. However, if optimists are prompted to think about health and well-being prior to the painful event, they are more responsive to the pain.MethodsOptimists and pessimists were primed with words related to health or with neutral words prior to the cold pressor task. Pain, distress, and cardiovascular reactivity to the cold pressor task were assessed.ResultsDispositional optimism was associated with lower pain sensitivity, distress, and cardiovascular reactivity in the neutral prime condition. In the health prime condition, optimists and pessimists did not differ on any of the dependent measures.ConclusionsDispositional optimism is associated with reduced pain for healthy adults encountering a brief pain stimulus. This relationship is eliminated, however, when individuals are primed with thoughts of health and well-being. The results are interpreted as evidence for the use of differential coping strategies by optimists in response to pain.

Why does choice enhance treatment effectiveness? Using placebo treatments to demonstrate the role of personal control

In modern health care, individuals frequently exercise choice over health treatment alternatives. A growing body of research suggests that when individuals choose between treatment options, treatment effectiveness can increase, although little experimental evidence exists clarifying this effect. Four studies were conducted to test the hypothesis that exercising choice over treatment alternatives enhances outcomes by providing greater personal control. Consistent with this possibility, in Study 1 individuals who chronically desired control reported less pain from a laboratory pain task when they were able to select between placebo analgesic treatments. Study 2 replicated this finding with an auditory discomfort paradigm. In Study 3, the desire for control was experimentally induced, and participants with high desire for control benefited more from a placebo treatment when they were able to choose their treatment. Study 4 revealed that the benefit of choice on treatment efficacy was partially mediated by thoughts of personal control. This research suggests that when individuals desire control, choice over treatment alternatives improves treatment effectiveness by enhancing personal control.

Choice and placebo expectation effects in the context of pain analgesia

The current experiment examined whether having choice over treatment options facilitates or inhibits the strength of placebo expectations in the context of pain perception. All participants were exposed to an aversive stimulus (i.e., the cold pressor task), and participants in some conditions were given expectations for two pain-relieving treatments (actually the same inert ointment mixture). Critically, participants in these expectation conditions were also given a choice or not about which of the two treatments they preferred to use. Participants in a control condition were not provided with a treatment expectation. Despite receiving the same inert treatment, participants who had a choice over treatments showed increased placebo analgesia as compared to participants not given a choice and participants in the control condition. Moreover, this effect was mediated by changes in anxiety. Explanations and implications for these results are discussed.

Concept priming and pain: an experimental approach to understanding gender roles in sex-related pain differences

Prior research has found that sex differences in pain are partially due to individual variations in gender roles. In a laboratory study, we tested the hypothesis that the presence of covert gender role cues can also moderate the extent to which women and men experience pain. Specifically, we varied gender role cues by asking male and female participants to write about instances in which they behaved in a stereotypically feminine, masculine, or neutral manner. Pain and cardiovascular reactivity to the cold pressor task were then assessed. Results revealed that, when primed with femininity, men reported less pain and anxiety from the cold pressor task than women. However, no differences existed between the sexes in the masculine or neutral prime conditions. The results indicate that covert gender cues can alter pain reports. Further, at least in some situations, feminine role cues may be more influential on pain reports than masculine role cues.

Comparative and dispositional optimism as separate and interactive predictors

Comparative optimism and dispositional optimism are typically studied separately and little is known regarding their unique and combined predictive abilities. We examined how these two types of optimism predict cognitive and affective reactions following unpleasant dental health feedback (Studies 1 and 2) and neutral feedback (Study 2). In Study 1, dispositional optimism and a measure of dental health comparative optimism interacted to predict appraisals of dental health feedback. In Study 2, dispositional optimism and dental health comparative optimism interacted to predict appraisals of new dental health information following negative dental health feedback – but not following neutral feedback. Individuals scoring high in dispositional optimism and low in dental health comparative optimism were more interested in and receptive to the dental health feedback than those scoring high in both types of optimism. Finally, greater dental health comparative optimism was associated with less negative affect following the dental health feedback, whereas dispositional optimism was associated with greater positive affect under all conditions. The results indicate that comparative and dispositional optimism are unique as well as interactive predictors.

Choice as a Moderator of Placebo Expectation Effects: Additional Support From Two Experiments

Two experiments investigated the hypothesis that treatment choice enhances placebo treatment efficacy. In Experiment 1, prior to a pain task, participants were given either an expectation that two (inert) products could reduce pain or no expectation. In addition, participants either selected between the two products or were assigned a product to use. Participants given both the placebo expectation and treatment choice reported the lowest pain. Experiment 2 conceptually replicated this finding using a placebo paradigm with aversive auditory stimuli. Additional control conditions indicated that a choice availability (rather than choice restriction) explanation best accounted for these results.

Does trait masculinity relate to expressing toughness? The effects of masculinity threat and self-affirmation in college men.

Men have higher morbidity and mortality rates than women across the life span. One potential explanation for this gap is greater pressure for men to express their masculine toughness. Situations that threaten masculinity often result in compensatory behaviors (e.g., binge drinking) geared toward proving toughness. The present research tested the hypothesis that threats to masculinity would lead men to behave in ways that express toughness to a greater extent if they were highly masculine, as measured by the Bem Sex-Role Inventory. Further, we anticipated that self-affirmation would ameliorate the compensatory responding exhibited by higher masculine men under threat. Participants were randomly assigned to 1 of 4 experimental cells in a 2 (Masculine Identity Threat: yes, no) × 2 (Self-Affirmation: yes, no) between-subjects factorial design. Results indicated that men expressed masculine toughness to a greater extent when facing a masculinity threat than when under no threat. Further, higher masculinity amplified the effect of threat in expressing toughness. Results also showed that the opportunity to self-affirm reduced expression of toughness among higher masculine men facing a masculinity threat. Theoretical contributions, implications, and future directions for this line of research are discussed.

Erratum to: Choice and placebo expectation effects in the context of pain analgesia

Concurrent pain ratings were made on an 11point scale (0 = no pain; 10 = worst possible pain) at four time points during the task (after 15, 30, 45, and 60 s). VAS (visual analogue scale) post-task pain ratings were made by marking 100-mm lines, anchored with no pain/not bad at all on the left side and worst pain possible/most unpleasant feeling possible on the right side. Anxiety ratings were made on a 7-point scale (1 = not at all anxious; 7 = very anxious). The reported means control for participant age, gender, and baseline pain ratings