Nocebo and the contribution of psychosocial factors to the generation of pain, 2019, Benedetti et al

[Andy]

The biopsychosocial model claims that illness is generated by biological, psychological, and social factors. The nocebo response, particularly nocebo hyperalgesia, is an excellent model and approach to understand these effects and their psychophysiological underpinnings, as nocebos are made of negative psychological and social factors, such as negative expectations and social interactions.

There is today experimental evidence that nocebos can create symptoms and illness from nothing, in particular pain, whereby a combination of biological, psychological and social factors interact with each other in the generation of the global painful experience. Several biochemical pathways have been identified, e.g. cholecystokinin and cyclooxygenase, and the activation of these mechanisms has been specifically investigated in the field of pain, analgesia and hyperalgesia.

The study of placebo and nocebo oxygen at high-altitude has been crucial to unravel these mechanisms, as reduction of oxygen pressure (hypoxia) leads to headache pain. Indeed, the investigation of oxygen-related conditions, such as hypoxia, represents today an excellent approach to understand how nocebos can contribute to generate illness and pain. In this review we discuss old and new findings that help us better understand the interplay between biology and psychology.

Paywall, https://link.springer.com/article/10.1007/s00702-019-02104-x
Not available via Scihub at time of posting.

 

[Hoopoe]

There is today experimental evidence that nocebos can create symptoms and illness from nothing

I am very skeptical and would like to see some evidence that isn't affected by biased reporting, and then some evidence that these symptoms are actually comparable in their characteristics to the symptoms of real patients who are told they have a psychogenic illness.

 

[lansbergen]

There is today experimental evidence that nocebos can create symptoms and illness from nothing

How can they know there is nothing??????

 

[TiredSam]

When I read the title I thought "generation of pain" was a label like "millenial generation", and wondered which generation they were about to brand for complaining too much about pain.

 

[Arnie Pye]

There is today experimental evidence that nocebos can create symptoms and illness from nothing, in particular pain, whereby a combination of biological, psychological and social factors interact with each other in the generation of the global painful experience. Several biochemical pathways have been identified, e.g. cholecystokinin and cyclooxygenase, and the activation of these mechanisms has been specifically investigated in the field of pain, analgesia and hyperalgesia.The study of placebo and nocebo oxygen at high-altitude has been crucial to unravel these mechanisms, as reduction of oxygen pressure (hypoxia) leads to headache pain. Indeed, the investigation of oxygen-related conditions, such as hypoxia, represents today an excellent approach to understand how nocebos can contribute to generate illness and pain.

Are the authors saying that having lower than normal oxygen levels doesn't cause real pain because there is no obvious physical damage? Could we lower theirs for an hour or two, please, and see how they feel? Or have I missed the point or misunderstood?

 

[Jonathan Edwards]

Or have I missed the point or misunderstood?

The abstract seems to imply that the authors have no idea what they are talking about. Not that that is new but it is unusual fort to be so egregious.

 

[Snowdrop]

I don't see any online presence for the "Innovative clinical training and trials healthcare worldwide initiative" that funded the 'research'. Certainly worth wondering what this initiative is about.

 

[Wonko]

To be fair they don't say which world, I am lead to believe that there may be several, many of which may not have affordable internet access

 

[rvallee]

Are the authors saying that having lower than normal oxygen levels doesn't cause real pain because there is no obvious physical damage? Could we lower theirs for an hour or two, please, and see how they feel? Or have I missed the point or misunderstood?

Suffers of headaches everywhere (i.e. everyone) rejoice: headaches aren't real we can all stop pretending now.

Also spicy food is purely psychogenic. Because, you know, no actual damage. Ghost peppers for everyone!

 

[Jonathan Edwards]

It is quite an interesting concept though - that illness can be caused by nothing.

Headaches can be caused by the nothingness of no oxygen
Malnutrition can be caused by nothing - now get that!
Broken legs can because by an absence of an intact plank in a boardwalk
Glandular fever can be caused by the nothingness of not meeting the virus in kindergarten

How can nothingness be so powerful?

Of course Aristotle gives the answer - nothingness, here and there, is a formal cause rather than an efficient cause. But don't let that stop people producing nocebobabble.

 

[Barry]

It is quite an interesting concept though - that illness can be caused by nothing.

I suppose in the case of IBS they may have discovered perpetual motion ...

 

[Jonathan Edwards]

That may not bear thinking about.

 

[Milo]

And labor pains, a construct too? True hysteria ?

 

[ladycatlover]

Toothache? Caused by the nothingness where there should be somethingness in the tooth? (A hole in other words)

 

[rvallee]

And labor pains, a construct too? True hysteria ?

Food poisoning. Those gut-wrenching twists in the bowels? No damage? All an illusion. There is no spoonpain. How fortunate it is to know that.