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The perception of pain can be modulated by a variety of factors such as biological/pharmacological treatments as well as potent cognitive and emotional manipulations. Placebo and nocebo effects are among the most prominent examples for such manipulations. Placebo and nocebo manipulations cause reliable psychological and physiological changes, although the administered agent or treatment is inert. The present dissertation aimed at investigating the role of cognitive and emotional influences in the generation of placebo and nocebo effects on pain perception. In addition, the feasibility of solely psychological placebo manipulations to alter the perception of pain was tested.
Two commonly discussed preconditions for the generation of placebo and nocebo effects are prior experiences (i.e., past encounter of drug effects) and expectations (i.e., positive or negative attitudes towards an intervention). So far, research on placebo and nocebo effects relied on the administration of sham interventions, which resembled medical treatments like inert pills, creams or injections. However, such experimental procedures deal with confounds due to earlier experiences and expectations resulting from the individual’s history with medical interventions. Accordingly, the implementation of a placebo manipulation that is completely new to an individual, seems necessary to disentangle the contribution of experience and expectation for the induction of placebo and nocebo effects.
To this end, in Experiment 1 the level of experience and expectation regarding a placebo-nocebo treatment was stepwise manipulated across three different experimental groups. To avoid any resemblances to earlier experiences and individual expectations, a mere psychological placebo-nocebo treatment was chosen that was new to all participants. They were instructed that visual black and white stripe patterns had been found to reliably alter the perception of pain. One group of participants received only the placebo-nocebo instruction (expectation), a second group experienced a placebo-nocebo treatment within a conditioning phase (experience) but no instruction, and a third group received the combination of both that is a placebo-nocebo instruction and a placebo-nocebo conditioning (experience + expectation).
It was shown that only the experience + expectation group revealed significantly higher pain ratings and physiological responses during nocebo, compared to placebo trials of the succeeding test phase. These findings demonstrate that the induction of a mere psychological placebo-nocebo effect on pain is in principle possible. Most important, results indicate that such effects most likely rely on both, a positive treatment experience, due to the encounter of an effective intervention (placebo conditioning), and a positive expectation about the intervention (placebo instruction).Besides experience and expectation, the current mood state has been shown to modulate pain and to impact the induction of placebo and nocebo effects. In this vein it has been demonstrated that placebo effects come along with positive affect, while nocebo effects often occur together with elevated feelings of anxiety. To clarify the interaction of emotions and placebo-nocebo manipulations on pain perception, in Experiment 2 the paradigm of Experiment 1 was modified. Instead of black and white stripe patterns, positive and negative emotional pictures were presented, which either cued pain increase (nocebo) or pain decrease (placebo). Two experimental groups were compared, which differed with regard to the instructed contingency of positive pictures serving as placebo and negative pictures serving as nocebo cues or vice versa (congruent vs. incongruent). Results indicate that the differentiation of placebo and nocebo trials (behaviorally and physiologically) was more pronounced for the congruent compared to the incongruent group. However, in the incongruent group, affective pain ratings were also significantly higher for nocebo (positive pictures) than placebo (negative pictures) trials, similar to the congruent group. These findings demonstrate that a placebo-nocebo manipulation is capable to dampen and even reverse the originally pain augmenting effect of negative emotions.
The results of Experiment 2 were further corroborated in Experiment 3, when the design was adapted to the fMRI scanner, and again a congruent and an incongruent experimental group were compared. Behavioral, physiological and neurophysiological markers of pain processing revealed a differentiation between nocebo and placebo conditions that was present irrespective of the experimental group. In addition, the fMRI analysis revealed an increased engagement of prefrontal areas for the incongruent group only, supposedly reflecting the reinterpretation or appraisal process when positive pictures were cueing negative outcomes.
Taken together, the results of the present studies showed (a) that it is possible to induce a placebo-nocebo effect on pain solely by a psychological manipulation, (b) that both, prior experiences and positive expectation, are necessary preconditions for this placebo-nocebo effect, (c) that the impact of negative emotion on pain can be dampened and even reversed by placebo-nocebo manipulations, and (d) that most likely a cognitive top-down process is crucial for the induction of (psychological) placebo-nocebo effects.
These results significantly enhance our understanding of psychological mechanisms involved in the induction of placebo-nocebo effects. Further, a fruitful foundation for future studies is provided, which will need to determine the contributions of primarily nocebo or placebo responses mediating the effects as demonstrated in the present studies. In a long-term perspective, the present findings may also help to exploit placebo effects and prevent from nocebo effect in clinical contexts by further elucidating crucial psychological factors that contribute to the placebo and nocebo response.
We examined whether movement costs as defined by movement magnitude have an impact on distance perception in near space. In Experiment 1, participants were given a numerical cue regarding the amplitude of a hand movement to be carried out. Before the movement execution, the length of a visual distance had to be judged. These visual distances were judged to be larger, the larger the amplitude of the concurrently prepared hand movement was. In Experiment 2, in which numerical cues were merely memorized without concurrent movement planning, this general increase of distance with cue size was not observed. The results of these experiments indicate that visual perception of near space is specifically affected by the costs of planned hand movements.
Previous research using neuroimaging methods proposed a link between mechanisms controlling motor response inhibition and suppression of unwanted memories.The present study investigated this hypothesis behaviorally by combining the think/no-think paradigm (TNT) with a go/no-go motor inhibition task. Participants first learned unpleasant cue-target pairs. Cue words were then presented as go or no-go items in the TNT. Participants’ task was to respond to the cues and think of the target word aloud or to inhibit their response to the cue and the target word from coming to mind. Cued recall assessed immediately after the TNT revealed reduced recall performance for no-go targets compared to go targets or baseline cues not presented in the TNT. The results demonstrate that doing the no-think and no-go task concurrently leads to memory suppression of unpleasant items during later recall. Results are discussed in line with recent empirical research and theoretical positions.
Flexible behavior is only possible if contingencies between own actions and following environmental effects are acquired as quickly as possible; and recent findings indeed point toward an immediate formation of action-effect bindings already after a single coupling of an action and its effect. The present study explored whether these short-term bindings occur for both, stimulus- and goal-driven actions (“forced-choice actions” vs. “free-choice actions”). Two experiments confirmed that immediate action-effect bindings are formed for both types of actions and affect upcoming behavior. These findings support the view that action-effect binding is a ubiquitous phenomenon which occurs for any type of action.
When a key press causes a stimulus, the key press is perceived later and the stimulus earlier than key presses and stimuli presented independently. This bias in time perception has been linked to the intention to produce the effect and thus been called intentional binding (IB). In recent studies it has been shown that the IB effect is stronger when participants believed that they caused the effect stimulus compared to when they believed that another person caused the effect (Desantis et al., 2011). In this experiment we ask whether causal beliefs influence the perceived time of an effect when the putative effect occurs temporally close to another stimulus that is also an effect. In our study two participants performed the same task on connected computers with separate screens. Each trial started synchro- nously on both computers. When a participant pressed a key, a red and a yellow stimulus appeared as action effects simultaneously or with a slight delay of up to 50 ms. The partic- ipants’ task was to judge the temporal order of these two effect stimuli. Participants were either told that one participant caused one of the two stimuli while the other participant seated at the other computer caused the other stimulus, or each participant was told that he/she caused both stimuli. The different causal beliefs changed the perceived time of the effects’ appearance relative to each other. When participants believed they each caused one effect, their “own” effect was perceived earlier than the other participant’s effect. When the participants believed each caused both effects, no difference in the perceived temporal order of the red and yellow effect was found. These results confirm that higher order causal beliefs change the perceived time of an action effect even in a setting in which the occurrence of the putative effect can be directly compared to a reference stimulus.
Background: A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children’s Sleep Comic is an adapted version of the unpublished German questionnaire “Freiburger Kinderschlafcomic” and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis. Methods: All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5–10 years to test the applicability of the Children’s Sleep Comic in young children and to run a preliminary analysis. Results: The Children’s Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations. Conclusion: The Children’s Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary.
Brain–computer interfaces (BCI) based on event-related potentials (ERP) allow for selection of characters from a visually presented character-matrix and thus provide a communica- tion channel for users with neurodegenerative disease. Although they have been topic of research for more than 20 years and were multiply proven to be a reliable communication method, BCIs are almost exclusively used in experimental settings, handled by qualified experts. This study investigates if ERP–BCIs can be handled independently by laymen without expert support, which is inevitable for establishing BCIs in end-user’s daily life situations. Furthermore we compared the classic character-by-character text entry against a predictive text entry (PTE) that directly incorporates predictive text into the character- matrix. N = 19 BCI novices handled a user-centered ERP–BCI application on their own without expert support. The software individually adjusted classifier weights and control parameters in the background, invisible to the user (auto-calibration). All participants were able to operate the software on their own and to twice correctly spell a sentence with the auto-calibrated classifier (once with PTE, once without). Our PTE increased spelling speed and, importantly, did not reduce accuracy. In sum, this study demonstrates feasi- bility of auto-calibrating ERP–BCI use, independently by laymen and the strong benefit of integrating predictive text directly into the character-matrix.
Faces in context: A review and systematization of contextual influences on affective face processing
(2012)
Facial expressions are of eminent importance for social interaction as they convey information about other individuals’ emotions and social intentions. According to the predominant “basic emotion” approach, the perception of emotion in faces is based on the rapid, auto- matic categorization of prototypical, universal expressions. Consequently, the perception of facial expressions has typically been investigated using isolated, de-contextualized, static pictures of facial expressions that maximize the distinction between categories. However, in everyday life, an individual’s face is not perceived in isolation, but almost always appears within a situational context, which may arise from other people, the physical environment surrounding the face, as well as multichannel information from the sender. Furthermore, situational context may be provided by the perceiver, including already present social infor- mation gained from affective learning and implicit processing biases such as race bias.Thus, the perception of facial expressions is presumably always influenced by contextual vari- ables. In this comprehensive review, we aim at (1) systematizing the contextual variables that may influence the perception of facial expressions and (2) summarizing experimental paradigms and findings that have been used to investigate these influences. The studies reviewed here demonstrate that perception and neural processing of facial expressions are substantially modified by contextual information, including verbal, visual, and auditory information presented together with the face as well as knowledge or processing biases already present in the observer. These findings further challenge the assumption of auto- matic, hardwired categorical emotion extraction mechanisms predicted by basic emotion theories. Taking into account a recent model on face processing, we discuss where and when these different contextual influences may take place, thus outlining potential avenues in future research.
Numerous studies have shown that humans automatically react with congruent facial reactions, i.e., facial mimicry, when seeing a vis-á-vis’ facial expressions. The current experiment is the first investigating the neuronal structures responsible for differences in the occurrence of such facial mimicry reactions by simultaneously measuring BOLD and facial EMG in an MRI scanner. Therefore, 20 female students viewed emotional facial expressions (happy, sad, and angry) of male and female avatar characters. During picture presentation, the BOLD signal as well as M. zygomaticus major and M. corrugator supercilii activity were recorded simultaneously. Results show prototypical patterns of facial mimicry after correction for MR-related artifacts: enhanced M. zygomaticus major activity in response to happy and enhanced M. corrugator supercilii activity in response to sad and angry expressions. Regression analyses show that these congruent facial reactions correlate significantly with activations in the IFG, SMA, and cerebellum. Stronger zygomaticus reactions to happy faces were further associated to increased activities in the caudate, MTG, and PCC. Corrugator reactions to angry expressions were further correlated with the hippocampus, insula, and STS. Results are discussed in relation to core and extended models of the mirror neuron system (MNS).
In recent years, Ideomotor Theory has regained widespread attention and sparked the development of a number of theories on goal-directed behavior and learning. However, there are two issues with previous studies’ use of Ideomotor Theory. Although Ideomotor Theory is seen as very general, it is often studied in settings that are considerably more simplistic than most natural situations. Moreover, Ideomotor Theory’s claim that effect anticipations directly trigger actions and that action-effect learning is based on the formation of direct action-effect associations is hard to address empirically. We address these points from a computational perspective. A simple computational model of Ideomotor Theory was tested in tasks with different degrees of complexity.The model evaluation showed that Ideomotor Theory is a computationally feasible approach for understanding efficient action-effect learning for goal-directed behavior if the following preconditions are met: (1) The range of potential actions and effects has to be restricted. (2) Effects have to follow actions within a short time window. (3) Actions have to be simple and may not require sequencing. The first two preconditions also limit human performance and thus support Ideomotor Theory. The last precondition can be circumvented by extending the model with more complex, indirect action generation processes. In conclusion, we suggest that IdeomotorTheory offers a comprehensive framework to understand action-effect learning. However, we also suggest that additional processes may mediate the conversion of effect anticipations into actions in many situations.