Introduction
pain
SHOCKS
When thinking about the power of the mind in shaping people’s experiences, the placebo effect often comes to mind. The placebo effect is perhaps one of the most outstanding manifestations of the link between individuals’ positive expectancies and actual improvement in outcomes. It demonstrates how treatments inherently inert become beneficial by forming positive expectancies regarding their impactOver the last decades, a large portion of placebo research has been focused on pain, a complex experience that includes both physiological and psychological dimensions and is highly influenced by emotions and expectanciesInterestingly, a common feature that appears to be present across placebo studies is the focus on enhancing individuals’ positive expectancies exclusively regarding the effectiveness of To answer this question, we turned to emotion regulation (ER), defined as individuals’ attempts to influence their emotional conditionHence, the first goal of the present study was to test for the first time whether placebo-induced expectancies could be built around an ER strategy, namely, distraction, instead of around a placebo intervention. To that end, we adopted the typical abovementioned conditioning paradigm. Participants were experiencing fear of possible painful shockImportantly, beyond measuring self-reported fear under the two distraction conditions, we included a robust behavioral measure of individuals’ preferences between the two distractions. Specifically, we asked whether placebo-response expectancies would increase individuals’ behavioral choice for the placebo-distraction over the control distraction, when regulating fear of pain. Choice measures are prevalent in ER research seeking to understand individuals’ behavioral preferences for different ER strategies in varying emotional contextsThe second goal of this study was to explore whether the effects of placebo-induced expectancies can be transferred from one domain to another. Specifically, we tested whether the increased effectiveness of, and preference for the placebo-distraction compared to the control-distraction, would generalize to a different emotional context of regulating fear of unpleasant pictures. Notably, as opposed to fear of shocks, which are aversive tactile stimulations, fear of unpleasant pictures involves a different domain of aversive visual stimulations.There is evidence showing that placebo analgesics can be effective in contexts unrelated to pain, particularly when a conditioning (but not only verbal suggestion) manipulation was utilized to reinforce the expectancies for pain relief. For example, studies have found that placebo analgesics were also effective in attenuating negative emotions