There are always news to report: the participating teams of the SFB/TRR 289 are looking for collaborators and study participants, deliver talks, and publish their results. You can take part in the scientific as well as public discourse. From open study calls and reports in the media to scientific publications - here you can discover what is currently happening at the Collaborative Research Center "Treatment Expectation".
Negative previous experiences and expectations are associated with greater pain-related disability
A new study from our Collaborative Research Center shows: Negative expectations have a stronger effect and last longer than positive ones. This result is of great importance for communication between doctors and their patients.
It's a kind of self-fulfilling prophecy: if we truly believe that a treatment will help, it is more likely to work. Conversely, if we fear that the treatment will be ineffective and cause unpleasant side effects, this is often exactly what happens.
This phenomenon is particularly common and well-studied in the case of pain: positive expectations can alleviate pain and increase the effect of a painkiller – this is the placebo effect. Negative expectations, on the other hand, often intensify the pain and can nullify the effect of even highly potent painkillers – this is known as the nocebo effect.
In experiments, nocebo effects are stronger than placebo effects
But which of these effects is stronger? Unfortunately, it is probably the nocebo effect, as a study from projekt A01 of our CRR 289 shows. In an experiment, a research team led by Prof. Ulrike Bingel at the University of Duisburg-Essen exposed 104 healthy volunteers to short-term heat pain. The researchers specifically influenced the participants' expectations and treatment experiences of a sham nerve stimulation and then investigated how strongly these affected subsequent test phases on the same day and after one week. In these test phases, all participants received equally strong pain stimuli - but associated with different expectations: positive, negative or neutral. The pain stimuli were rated on a scale of 0–100.
The exciting result: negative expectations had a stronger and more lasting influence on the sensation of pain than positive ones. On average, those with negative expectations rated subsequent pain around 11 points higher than those with no specific expectations. A positive expectation, on the other hand, only reduced the pain rating by around 4 points. (Here is the link to the original publication.)
The effect of negative expectations is greater - even in the long term
The effect of negative expectations was twice as strong as that of positive expectations - even though the pain induced was the same for all participants. Only the expectations were different. But how long does this effect last?
To test this, all participants received the same pain stimulus again in the second session one week later. The effect remained similar: the nocebo effect meant that the people with negative expectations rated the pain about 9 points higher than those in the control group without expectations. The placebo effect, on the other hand, resulted in the pain being perceived as 4.6 points lower.
"Better safe than sorry": Why do people expect the worst?
“People apparently tend to expect the worst - and this is also reflected in the way they process pain,” explains Prof. Dr. Ulrike Bingel, neurologist and head of the Interdisciplinary Center for Pain Medicine at Essen University Hospital. The reason for this could lie in human evolution, suspects Dr. Katharina Schmidt from Bingel's team, who was also involved in the study: “This behavior corresponds to a ‘better safe than sorry’ strategy.” It is possible that humans have evolved to be better prepared for potential threats - and therefore give more weight to negative expectations.
“This is very important for clinical practice,” explains neurologist Bingel. In everyday life, doctors often focus on promoting positive expectations. "However, our study shows that it is at least as important to avoid unintended negative expectations," says Bingel. Healthcare professionals should be aware that the way they provide information about treatments can strongly influence patients' reactions to them – in both a positive and negative sense.
“Nocebo effects can be prevented by simple and effective strategies to improve communication between patients and doctors,” adds Bingel: "Positive wording, avoiding unnecessary emphasis on side effects and building a trusting relationship can reduce the risk of nocebo reactions. At a time when cost efficiency in healthcare is critical, avoiding nocebo effects should be a key strategy to improve treatment outcomes."
Foto: SFB/TRR 289
"This study marks a significant milestone in the study of placebo effects in severe somatic diseases such as psoriasis. It reveals possibilities and limitations, as well as raising important questions for future research,” says Prof. Ulrike Bingel, spokesperson of SFB/TRR 289, in her assessment of the research. In this interview, Prof. Sondermann explains how patient and doctor expectations influence the success of psoriasis therapy.
Happy winners of the German Psoriasis Prize 2025: Prof. Wiebke Sondermann with members of her research team from project A12. From left to right: Dr. Frederik Krefting, Prof. Wiebke Sondermann, Senta Mühlhaus and Daniela Bese
Ms. Sondermann, for which aspect of your research have you receied the DDG prize?
The prize was awarded to me for the publication of the data from our main study from sub-project A12 from the first funding period of the SFB/TRR “Treatment Expectation”. Using the targeted modulation of positive expectations, we wanted to see whether the effect of secukinumab can be influenced. This is a human monoclonal antibody that acts specifically on the pro-inflammatory protein interleukin-17A. Our study showed that verbal expectation modulation alone only has a limited influence on the course of the disease. Therefore, in the second funding period, we want to examine the effect of unconscious learning mechanisms in the context of expectation modulation.
Having dealt with the psychological factors influencing psoriasis, why not move on to new medications?
We now have a wide range of medications that can effectively treat psoriasis. For most patients, we can now improve the skin condition by 90 percent. However, these very good results are achieved with using drugs called biologics, which include secukinumab, the drug used in our study. Biologics are expensive and can be associated with side effects, so we believe it makes sense to investigate whether part of the dose could be saved by using psychological factors, such as expectation effects, in our specific study.
An older study with psoriasis patients has already shown that the effect of corticosteroid-containing creams is maintained when the full dose is alternated with a placebo.
Is the pharmaceutical industry interested in this research?
Fortunately, yes. For example, Novartis provided us with logistical support to obtain a certain formulation of the biologic secukinumab, enabling us to work more easily with the lower dosage of the preparation. Above all, however, we would like to thank the German Research Foundation, which supports the 'Treatment Expectation' Collaborative Research Center and thus our research.
Is there a need to improve care for psoriasis patients?
Yes, definitely. That was the exact title of my habilitation thesis. Many patients are still undertreated, particularly worldwide, because not everyone has access to highly effective medication.
How do you assess new therapies with biologics?
Biologic therapies have been available for psoriasis for around 20 years. Our growing understanding of the inflammatory processes underlying psoriasis has continually driven the development and refinement of biologics. The modern biologics currently used for psoriasis specifically block two inflammatory messengers that play a central role in the condition: Interleukin 17 and Interleukin 23. By specifically blocking inflammatory messengers that are present in excessive amounts in psoriasis, we achieve very high response rates. As the immune system is no longer broadly suppressed as it was during past treatments, the side effect profile has also improved. Unfortunately, due to the high costs of biologics therapy, too few patients are still receiving this type of modern treatment.
Do biosimilars work just as well?
Biosimilars are copycat products of biologics whose patent protection has expired. They are already available for older biologics. One advantage of biosimilars is that they are significantly cheaper than the original preparations. Studies show that biosimilars are actually just as effective as the original preparations. However, discontinuation rates following a switch from the original preparation to a biosimilar are above average, which is attributed to the nocebo effect. Biosimilar quotas exist, particularly in the private practice sector, meaning that a certain percentage of patients must be prescribed biosimilars instead of biologics. Education and effective communication between doctors and patients are therefore crucial in order to prevent discontinuation.
This inflammatory chronic skin disease affects two to three percent of the population. Is your work of great clinical relevance?
Yes, psoriasis is actually one of the most common inflammatory skin diseases in the western world, affecting two to three percent of the population. Around 20 to 30 percent of all patients suffer from a moderate to severe form of the disease, which requires systemic therapy, i.e. treatment from the inside. Early treatment can probably have a positive effect on the overall course of the disease and may even prevent the onset of psoriatic arthritis to some extent. “Hit smart and early” is therefore the order of the day. This is precisely where our research comes in, making it of great clinical relevance for many patients.
What connections and interactions exist between the skin, the immune system and the psyche?
These three systems are connected via a complex network and influence each other. The skin is not only a physical barrier, but also an active immune organ.
What goes wrong in the brain-skin axis in psoriasis?
In chronic inflammatory diseases such as psoriasis, the immune system in the skin is overactive. This leads to redness, scaling and itching. Stress, anxiety and depression can in turn dysregulate the immune system, further exacerbating the skin disease. Among other things, the stress hormone cortisol and the autonomic nervous system are involved. Stress causes the body to release stress hormones such as cortisol and adrenaline. At the same time, the immune system is activated - but this can backfire, especially in the case of inflammatory diseases such as psoriasis: The immune response becomes overactive, the inflammatory processes increase and flare-ups can be triggered or intensified. Recent research also shows that the nervous system communicates directly with the immune system. Visible skin changes can lead to feelings of shame, stigmatisation, social withdrawal, anxiety and depression. These psychological burdens can increase the stress experienced by patients, exacerbating the disease. It's a classic vicious circle. I am glad that the subjective stress experienced by patients can now be accurately assessed using various questionnaires, and that individual suffering is increasingly being considered in therapy guidelines.
Imagine a scale from 0 to 10: 0 means you know very little about the correlations and 10 means you know everything. Where does psoriasis research stand on this scale?
I would estimate five. There is still a lot to do because the mutual influences are extremely complex, as is the research.
What do you consider to be the best evidence that placebo effects work?
In my opinion, one of the most convincing proofs of the effectiveness of placebo effects is the fact that they are measured in randomized, double-blind clinical trials. In a meta-analysis of 34 randomized clinical trials with patients suffering from psoriasis, atopic dermatitis, chronic spontaneous urticaria, it was shown in 2015, for example, that placebos could significantly, i.e. considerably and not by chance, reduce itching - by an average of 24 percent.
Does this also apply to nocebo effects?
Various studies have shown that patients who are informed prior to therapy that a drug could have certain side effects are significantly more likely to report these side effects, even if they have only received a placebo. Furthermore, studies in dermatology have shown that verbal suggestions or information about an allergen-containing solution, even when it is only water, can significantly increase perceived itching. If you tell a study participant, 'This is going to itch a lot', it is very likely that it will.
How can expectations be used specifically to improve the treatment of psoriasis?
Expectations can amplify the psychological effects of therapies in many clinical cases. However, in the first funding period of our project, we found that positive expectations induced verbally alone only have a limited influence on the objective course of the disease. In the second funding period, we are therefore expanding our approach by using reinforcement learning through pharmacological conditioning to optimise treatment. This principle is based on the observation that, in certain cases, the body remembers the effect of a drug and can partially replicate it itself. In our CRC project A12, we are investigating whether this is also possible with systemic biologic treatment: If successful, this approach could reduce side effects and make treatment more cost-effective.
What advice would you give to colleagues in practice?
If we utilise expectation effects effectively, we can enhance the efficacy of medication, mitigate inflammatory activity, and elevate the quality of life for individuals with psoriasis. Specifically, using appreciative and affectionate language in doctor-patient consultations builds trust and strengthens the placebo effect.
And what can patients do themselves?
Many patients suffering from psoriasis are depressed and skeptical about new therapeutic approaches after years of inadequate treatment attempts. Nevertheless, it makes sense for patients to be optimistic about new therapies. Study data also show that confidence in the therapy - and therefore also its effectiveness - increases if the patient is involved in shared decision-making together with the doctor. Maintain your optimism and don't let yourself be disheartened!
Original publikcation:
Hölsken S., Krefting F., Mühlhaus S., et al. and Sondermann W. Shaping Treatment Expectation to Optimize Efficacy of Interleukin 17A Antagonist Secukinumab in Psoriasis Patients. Psoriasis (Auckl). 2025 Jan 10;15:9-22.
https://doi.org/10.2147/PTT.S486338
New publication: How Placebo Effects in Emotion Processing Depend on Cognitive Resources
Also this year, we are continuing our popular webinar series on treatment expectations: until September, four renowned scientists will shed light on important facets of our field of research in exciting online lectures.
Prof. Christian Bellebaum from Heinrich Heine University Düsseldorf will kick things off on April 1, 2025 at 4 pm. His webinar will focus on “Effects of Expectancy in the Processing of Actions and their Outcomes". Later this year, we will also be welcoming Prof. Andreas Olsson from the Karolinska Institutet in Stockholm, Prof. Thomas Graven-Nielsen from Aalborg Universitet sowie Dr. Nathan Huneke from the University of Southampton.
The webinars in the “Treatment Expectation” series are aimed at a scientific audience and will be held in English. Participation is free of charge, but the number of participants is limited. We therefore ask you to register early.
If you would like to attend individual webinars or the full program, please register at
We would be very pleased if you could write a few words about your scientific background and why you would like to attend the webinars.
10 steps to a successful publication: Dr. Helena Hartmann presents the ARIADNE Navigator
Felgenhauer Research Prize 2024 for Dr. Livia Asan
Dr. Helena Hartmann und Dr. Julian Packheiser receive the Pain Research Award 2024
Sintetica Research Fellowship 2024 for Dr. Jana Aulenkamp
"More effektive fake medicine": IG Nobel Prize for the research of Lieven A. Schenk, Tahmine Fadai and Christian Büchel
“Fake medicine that causes painful side effects can be more effective than fake medicine that does not cause painful side effects": The jury found this research result astonishing and amusing enough to award the “IG Nobel Prize” for Medicine 2024 to Dr. Lieven Schenk, Dr. Tahmine Fadai and Prof. Christian Büchel from Project A02 of the SFB/TRR 289. As is so often the case with this award, which only seems absurd at first glance, there is an important finding behind it - in this case with major implications for patients.
A bizarre ceremony, a worthless prize: the scientific community celebrates its freedom at the award ceremony for the “IG Nobel Prizes”. And it shows that research can often be hilarious at first glance - and thought-provoking at second glance.
“How side effects can improve treatment efficacy: a randomized trial” is the title of the publication in the journal Brain, which was ‘honored’ with the IG Nobel Prize (to the publication). In the article, Schenk, Fadai and Büchel describe their observation that the effect of a medical treatment can be enhanced if people experience mild side effects.
To demonstrate this, the researchers administered a nasal spray to volunteers that supposedly contained either a painkiller or a placebo. The test participants were then asked to assess how strong a heat stimulus was on their arm. The trick was that all the nasal sprays actually contained a placebo substance. In some cases, however, the heat stimulus was reduced in order to simulate an effect; and for some participants, capsaine was also mixed into the spray, which causes a slight burning sensation in the nose. The result: when there was a burning sensation in the nose, the heat stimulus on the arm felt less painful for the test subjects - even though no painkiller was administered at all. It was therefore the supposed side effect that had reduced the pain.
Prof. Katja Wiech, Dr. Helena Hartmann and Prof. Ulrike Bingel comment on the very serious and important implications of these results for medicine and clinical research in the same issue of the journal. They explain that this effect is a problem for clinical studies: if side effects increase the effect of a test substance, it can no longer be compared with a placebo without side effects - and can therefore no longer be measured correctly.
In therapy, on the other hand, noticeable side effects could possibly not only be a burden, but even a therapeutic opportunity. However, only under certain circumstances, the scientists write: For example, this presumably only applies to mild side effects that are not perceived as threatening by the individuals. And the individual expectations and previous experiences of those affected certainly also play a role.
In any case, the results give reason to re-evaluate side effects - and to investigate whether they can be useful for patients not only experimentally, but also as part of a therapy. In the spirit of the “IG Nobel Prizes”, which are awarded by the US journal “Annals of Improbable Research” for research that “first makes you laugh and then makes you think”. (Here is the link to this year's ceremony.)
Frontiers in Psychiatry
Deutsche Gesellschaft für Psychologische Schmerztherapie und -Forschung DGPSF e.V.
New publication: Transtheoretical Psychological Therapy – New Perspectives for Clinical Training and Practice
Accompanying the SFB/TRR 289, we again offer a webinar series with scientific lectures by internationally renowned researchers.
All lectures will be given online and participation is free. The talks are geared towards a scientific audience and will be held in English.
If you would like to attend individual webinars or the full program, please register at
We would be very pleased if you could write a few words about your scientific background and why you would like to attend the webinars.
At the Science Slam of the SIPS Conference 2023 in Duisburg, young researchers explained their science as creatively and entertainingly as possible for a broad audience, moderated by Dr. Helena Hartmann (picture below). High praise for two SFB researchers from the University Hospital Essen: Elif Buse Caliskan (picture left) from the Bingel Laboratory and Stefanie Hölsken (picture right) from the Institute of Medical Psychology and Behavioral Immunology won at the Science Slam! Rewatch this great event here.
Elif Buse Caliskan (picture below) explained in four minutes what placebo effects have to do with the perception of wine. Did you know that the label, the price, the shape of the glass, and even the ambience of the environment affect how we perceive wine quality?
Stefanie Hölsken (picture below) took us into the world of dermatology and reported how allergy symptoms can be alleviated there with the help of classical conditioning and green strawberry milk. Without any real anti-allergy medication, but through expectations!
Three CRC/TRR 289 teams (A04, A10 and A11) jointly investigated the interaction of inflammation or depressed mood and the expectations with and experiences of visceral pain in healthy subjects.
The results of the study were published recently in the journal Brain Behavior and Immunity under the title "Amplified gut feelings under inflammation and depressed mood: A randomized fMRI trial on interoceptive pain in healthy volunteers."
You can read the full publication ScienceDirect.
Positive influence on the perioperative well-being of patients through the preoperative administration of open-label placebos
In the approved clinical project, the perioperative well-being of patients will be positively influenced by open-label placebo administration before an upcoming surgery. Additionally, it will be investigated whether these effects can be enhanced by observational learning. As target parameters, effects on anxiety and well-being as well as the postoperative experience, especially postoperative pain and its effects, will be analyzed. This prospective, randomized, controlled study will be conducted in patients with planned laparoscopy at the University Hospitals of Essen and Hamburg.
Congratulations to Jana Aulenkamp and Johannes Wessels for this great project and good luck for its implementation!
As part of SFB/TRR 289, we offer a virtual webinar series with scientific talks by internationally recognized researchers.
Many of the past lectures can now be found on our YouTube channel!
All lectures are given online and participation is free. The talks are aimed at a scientific audience and are given in English. If you would like to attend individual webinars or the entire program, please register at
If you have any questions or requests, please send us an email at
Three early career researchers from the Department of Neurology at the University Medical Center Essen received awards for pain research. The three innovative projects focus on expectancy and learning mechanisms in the perception and processing of pain, both in healthy individuals and in patients. Congratulations to Frederik Schlitt* for the 2nd prize in the category Clinical Research on his work in pain-related learning mechanisms in patients with chronic back pain. Dr. Laura Ricarda Lanters** accepted the 2nd prize in the Basic Research category for her work on the specificity of conditioned nocebo effects in visceral interoceptive pain. The prizes were awarded by the German Pain Society and the donor Grünenthal GmbH. Livia Asan*** can be excited the 1st place of the Young Investigator Award for Pain. She wants to investigate how adverse effects after lumbar puncture can be avoided.
"We are very proud that this year scientists from the University Medical Center Essen were represented in every category of the highest award for pain research in Germany. Their work confirms the success of the interdisciplinary, cross-project collaboration in the Translational Pain Research Unit at the Center for Translational Neuro- and Behavioral Sciences," said Prof. Ulrike Bingel, head of the Center for University Pain Medicine and spokesperson of the SFB/TRR 289 Treatment Expectation.
*Frederik Schlitt, Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medical Center Essen, received the 2nd prize in the Clinical Research category for his research on pain-related learning mechanisms in chronic back pain. Pain-related learning mechanisms seem to play a key role in the development and maintenance of chronic pain. Initial studies have been able to show impairments in pain-related learning in patients with chronic pain. However, the results are not consistent. Frederik Schlitt investigated pain-related learning and unlearning of visual cues that announced a painful heat stimulus or predicted its absence - in patients with nonspecific chronic back pain and healthy subjects. In patients with chronic back pain, reduced pain-related learning was observed both from cue stimuli that announced a heat pain stimulus and from those cue stimuli that predicted its absence. The data provide preliminary evidence for more diminished learning of cue stimuli that announce a heat pain stimulus with increasing clinical pain duration. Given the high prevalence of chronic low back pain in the general population, as well as the challenges that arise in its treatment, this work highlights the high clinical relevance of altered pain-related learning in this patient population. If the ability to discriminate between cues that announce a pain stimulus and cues that predict its absence is impaired, this may lead to ambiguity in the emotional appraisal of these stimuli and, subsequently, to overprotective behavior, which could contribute to the development and maintenance of chronic pain. The project was funded by the Collaborative Research Center 1280 "Extinction Learning".
**Dr. Laura Ricarda Lanters, Department of Neurology, Associate of the Translational Pain Research Unit led by Prof. Dr. Ulrike Bingel, demonstrated the relevance and specificity of visceral pain across methods in her work. In two consecutive but independently conducted fMRI studies, the team was able to show that interoceptive visceral stimuli are rated as more aversive compared to different exteroceptive stimuli by healthy subjects, even if both stimuli were perceived intraindividually as initially comparably unpleasant or painful. In both studies, cue stimuli announcing interoceptive visceral stimuli were found to be prioritized for learning, storage, and recall in healthy subjects compared with exteroceptive cue stimuli, accompanied by greater involvement of the insula and cingulate cortex for the visceral modality. The prioritization of learning processes with respect to negative expectation of clinically-relevant interoceptive compared to exteroceptive stimuli represents an addition to the understanding of conditioned nocebo effects for the development and maintenance of chronic pain and thus has high relevance for further research and, prospectively, therapy of functional and inflammatory diseases along the brain-gut axis. "In our understanding, the studies presented in the submitted work have a particular clinical validity due to the pain models used - e.g., rectal distensions for the visceral stimuli versus thermal stimuli on the skin- and thus, from a translational perspective, probably represent an interface between basic research conducted in healthy subjects and clinically oriented research with the aim of deepening the understanding of the underlying mechanisms of visceral pain along the brain-gut axis," explains Dr. Lanters. The work originated as a collaboration between two projects in the SFB 1280 "Extinction Learning" under the project leadership of Prof. Sigrid Elsenbruch (A10) and Prof. Harald Engler (A12) at the Institute of Medical Psychology and Behavioral Immunology in close collaboration with the Department of Neurology, Translational Pain Research Unit and the Institute of Diagnostic and Interventional Radiology and Neuroradiology, which are united under the umbrella of the C-TNBS.
*** Livia Asan, assistant physician and researcher at the Department of Neurology and C-TNBS, Unversitätsmedizin Essen, received the German Pain Society's Young Investigator Award for Pain (1st place). The award-winning project aims to investigate how adverse effects following lumbar puncture can be avoided. During lumbar puncture, a few milliliters of nerve fluid are extracted from the spinal canal and then analyzed. Nerve water analysis has a high value in neurological diagnostics for a wide range of diseases and is therefore performed in many of our patients. Although lumbar puncture is a very safe and low-risk procedure, patients sometimes complain of mostly harmless but nonetheless limiting side effects such as headache. There has been evidence in previous studies that the rate of post-puncture headache is significantly dependent on prior education in this regard. Ms. Asan would now like to test whether some of these complaints can be reduced by optimizing the positive design of the physician's risk information.
Clinical Psychological Science
This month, we will be addressing the topic of back pain in the Patient Forum on Neurology. Prof. Dr. Ulrike Bingel, Head of University Pain Medicine, and her team of experts invite you to join them on July 21 from 5:30 pm.
This time, patients, relatives and interested parties can find out about topics such as "The cross with the cross - widespread disease chronic back pain", "Why movement is so important and there is no wrong movement in chronic back pain" and "The interaction of pain and psyche".
Of course, there will be plenty of time for questions this time as well.
You can find the link to the registration Azum Zoom-Meeting here or send an e-mail to:
Mr. Schmidt has been suffering from strong back pain for a long time and has almost given up hope of relief after several attempts at therapy. Then his neighbor tells him about a new doctor and a very good therapy offer. This had helped her husband wonderfully. Mr. Schmidt is hopeful.
And indeed, the treatment helps him, too. But the success is not only based on the professional individual treatment, but also on Mr. Schmidt's positive expectations. He simply believed that he could be helped after all.
But how can such a positive expectation promote the success of the therapy? What happens in the brain and body? Our new film from the Collaborative Research Center SFB/TRR289 explains this in an understandable and competent way. You can also watch this film on YouTube.
A research group associated with the SFB/TRR 289 investigated the effects of placebos in the area of sadness.
The result of the study was published in the Journal of Affective Disorders on May 1, 2022,under the title "Even when you know it is a placebo, you experience less sadness: First evidence from an experimental open-label placebo investigation".
You can read the full publication on ScienceDirect.
Members of the SFB/TRR 289 have published a research paper about the Impact of a 12-week open-label placebo treatment on headache days in episodic and chronic migraine. The first authors Dr. Katharina Schmidt and Dr. Julian Kleine-Borgmann belong to the project team of Prof. Ulrike Bingel in Essen.
The publication can be downloaded here or read directly on the BMJ Open site.
Effects of open-label placebo on pain and functional disability in patients with chronic back pain: A 3-year follow-up study
How Do Expectations Influence Treatment Outcome?
Patients’ expectations are important modulators of pain and analgesic treatment outcomes. As best illustrated in experimental and clinical placebo studies, an individual’s expectation can substantially shape the perception and neural processing of acute and chronic pain. Treatment expectation is not only the key determinant of placebo analgesia, but is also increasingly recognized to modulate the efficacy and tolerability of pharmacological and non-pharmacological treatments for pain and other acute and chronic conditions.
Recent insights into the psychological and neurobiological mechanisms underlying the clinically relevant effects of treatment expectations call for their systematic integration and utilization into standard treatment regiments. Such strategy promises to optimize analgesic treatment outcomes and to prevent or reduce the burden of unwanted side effects and misuse of analgesics, particularly of opioids. In this lecture Prof. Ulrike Bingel highlights current concepts, recent achievements but also challenges and key open research questions that need be addressed to improve (analgesic) treatment outcomes in a personalized manner and to use our knowledge to inform the designing and outcome interpretation of clinical trials.
Learning objective 1 :
be aware of the impact of expectation on (analgesic) treatment outcomes.
Learning objective 2 :
define key psychological and neurobiological mechanisms underlyind expectation effects.
Learning objective 3 :
outline implications for clinical routine and clinical trials as well as key-open questions and challenges.
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If you are interested in the above exciting topic, watch the full lecture of Prof. Ulrike Bingel on June 16th at 10:30 a.m. EST at IASP 2021 VIRTUAL WORLD CONGRESS ON PAIN.
The full program of the event can be viewed here.
To view the above lecture or the full program, you must register here.
Prof. Yvonne Nestoriuc, one Leader of the project A15, has published a new paper about the hypothesis, that understanding patients's informational needs and adapting drug-related information are the prerequisites for a contextualized informed consent. Current information practices might rather harm by inducing nocebo effects.
You can read the complete publication on frontiers in Psychiatry or download it here.
The formation and fulfillment of expectations play an important role in positive subjective treatment outcomes. Julia Stuhlreyer (Project Regine Klinger, A13) discovered that patients receiving a combination of a digital health app and patient-oriented physician visits postoperatively were more likely to rate their treatment as successful, based on their stated preoperative treatment expectations. This also leads to significant reduced postoperative pain and opioid consumption.
More information about DGAI is available here.
Prof. Winfried Rief has studied the fear towards Covid-19 vaccinations and the influence of our society.
The full result of his reflections on this topic can be downloaded here or read directly on the JAMA website.
Medicine also lives from stories. Medicine is also shaped by people’s stories. This is why we’re gathering patients’ diverse experiences regarding their own expectations for the Collaborative Research Centre “Treatment Expectation”. Almost everyone has experienced a positive placebo or negative nocebo effect.
This virtual lecture incorporates a discussion on improving research transparency and robustness by exploring the necessity of preregistrations and registered reports.
New study gives the most detailed look yet at the neuroscience of placebo effects, which was published by Prof. Ulrike Bingel and Dr. Tamas Spisak from our project Z03.
eLive has published a research paper about the temporal and spectral characteristics of expectations and prediction errors in pain and thermoception. The first author Andreas Strube works as a PhD Student closely with the project leaders Prof. Christian Büchel and Prof. Michael Rose from the SFB/TRR 289.
The publication can be downloaded here or read directly on the eLife site.
Scientific Reports has recently published our research about the impact of Open-Label Placebos on test performance and well-being in acutely stressed students. Dr. Julian Kleine-Borgmann is corresponding author and happy to answer comments!
The CRC/TRR 289 receives one of the highly competitive grants from the German Research Foundation (DFG).
