PAIN: PSYCHOBIOLOGICAL MECHANISMS AND THEIR RELEVANCE FOR TREATMENT

We apply for a grant from the DAAD and the Norwegian Research council (NRC) for travel and accommodation to discuss and develop common projects in the field of pain and treatment of pain between the Central Institute of Mental Health, Mannheim, Germany, a nd the University of Tromsø, Norway. Pain is the most common symptom in patients seeking treatment from health care personnel. Almost all treatment induces an expectation of relief, and expectations alone, in the absence of active treatment, have been sh own to reduce pain. This is termed placebo analgesia, and is an example of how the brain controls bodily function. At present, the group in Norway of Magne Flaten is developing models to test the effects of psychological processes (learning, expectations , emotions) in samples of patients with chronic pain, and this is the background for the present proposal. The group of Herta Flor at the CIMH in Germany is currently involved in a research group funded by the German Research Foundation which focuses mai nly on the placebo effect. The underlying mechanisms of the placebo effects are still unclear. Two explanatory psychological mechanisms have been discussed with respect to placebo and nocebo effects: expectancy theory and classical conditioning. The pro jects conducted at both locations (Mannheim & Tromsø) aim to describe the psychobiological mechanisms underlying the modulation of pain, and try to implement this knowledge in treatment programmes for chronic pain. The aim of the mutual visits is to deve lop experimental designs that examine the specific influence on learning on the placebo response and to test these effects in patient populations and thus combine the two research paths into one common project that aims to translate the basic research que stions about placebo analgesia with clinical applications.