Huijuan Zhang, Lili Zhou, Hua Wei, Xuejing Lu, Li Hu

Social observation is one of the main ways to gain experience. Similar to first-person experience, observational experience affects the effectiveness of subsequent treatments. Yet, it is still undetermined whether the influence of social observation on placebo and nocebo effects to subsequent treatments remains even if related experience occurred a few days ago. Eighty-two participants were recruited and each of them was randomly assigned to one of the four experimental groups acquiring first-person or observational experience, which was either effective or ineffective. For the first-person groups, participants were presented with pain cues paired with pain stimuli in person. In the effective condition, low pain cues were paired with low pain stimuli, and high pain cues were paired with high pain stimuli. In contrast, the associations between cues and pain stimuli were not established in the ineffective condition. Similarly, for the observational groups, participants received effective/ineffective treatment through observation. Five or six days later, all participants underwent a conditioning phase followed by a test phase composed of two tests, where participants were asked to report their perceived pain. Placebo and nocebo responses to subsequent treatments can be affected by prior experience gained several days ago regardless of acquisition ways, and both placebo and nocebo responses in the effective condition were significantly larger than those in the ineffective condition. Furthermore, once placebo and nocebo effects were elicited, the latter was more persistent, while the former was more likely to diminish. First-person and observational experience obtained a few days ago could affect the following treatments, which advance our understanding of the crucial and sustained influence of social observation on placebo analgesia and nocebo hyperalgesia, and provide insights into clinical applications.