title: Pain and placebo in pediatrics: a comprehensive review of laboratory and clinical findings.
abstract: Pain modulation by placebo mechanisms is one of the most robust and best-studied phenomena, yet almost all research investigating the mechanisms and implications of the placebo analgesia are based on adult research. After highlighting crucial aspects that need to be considered in studying pain modulation in children, this comprehensive review examines studies related to pain modulation with an emphasis on factors such as age, neural development and pain measures. We critically discuss psychological mechanisms underlying placebo effects, including (1) verbally induced expectations, (2) conditioning and learning mechanisms, and (3) child-parent-physician interactions. Taken together, research suggests that placebo mechanisms can affect therapeutic outcomes and potentially be exploited clinically to improve clinical outcomes in pediatric population. Recommendations for further investigating the mechanistic bases and harnessing placebo effects for supportive therapeutic applications are given.
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD, USA.
authors.forename: Kanesha
authors.initials: K
authors.lastname: Simmons
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Ortiz
authors.affiliation: Department of Anesthesiology Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA.|Department of Psychology, Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.
authors.forename: Joe
authors.initials: J
authors.lastname: Kossowsky
authors.affiliation: Department of Psychology, Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.|Collegium Helveticum, University of Zurich and ETH Zurich, Zurich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Krummenacher
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Grillon
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pine
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD, USA.|Clinical Center, Department of Bioethics, National Institutes of Health, Bethesda, MD, USA.|National Center for Complementary and Alternative Medicine (NCCAM), Bethesda, MD, USA.
authors.forename: Luana
authors.initials: L
authors.lastname: Colloca
mesh_terms: D000698:Analgesia / Q000379:methods* / Q000523:psychology; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000523:psychology*; D010372:Pediatrics; D010817:Physician-Patient Relations; D015990:Placebo Effect
keywords: Age; Analgesia; Children; Clinical applications; Conditioning; Development; Expectations