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Learning Effects on Pain Generalize to Perceptually and Conceptually Similar Cues and Modify Pain Perception

Abstract

Prior learning about pain can drive a placebo or nocebo effect in later settings and influence pain more broadly. This up- or down-modulation of pain is influenced by expectations and learning during conditioning. After conditioning, it has been shown that the association between the original conditioned stimulus (CS) and the unconditioned stimulus (UCS) can generalize to novel, but similar stimuli. This is known as generalization, which is seen across humans and non-human animals. The present studies tested the hypothesis that conditioning effects on pain will generalize to similar, but novel stimuli; meaning that pain will be modulated in new situations based on perceptual or conceptual similarity to previous conditioned stimuli. Two studies were conducted with healthy participants (study 1, n=40; study 2 n=36) to test the generalization of pain learning to novel, but perceptually and conceptually similar stimuli, respectively. The results of both studies show that learned conditioned pain modulation generalizes to perceptually and conceptually similar stimuli, and that explicit awareness of the cue-pain relationship was necessary for this effect. These findings provide evidence that pain perception can be modulated by generalization stimuli, which could also play a role in clinical placebo effects

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