Conditioning Theory

The classic example of conditioning theory is the Pavlovian experiment on dogs, in which administration of food was paired with the ringing of a bell. Over time, the ringing of the bell alone would produce salivation in the dogs. In this experiment, a neutral stimulus (the bell) paired with an unconditional stimulus (food) elicited an unconditioned response (salivation). Over time, the neutral stimulus alone elicited a response similar to the unconditional response and became a conditioned stimulus capable of eliciting a conditioned response (salivation). With respect to the placebo effect, the placebo drug represents the conditioned stimulus, and the beneficial effect is the conditioned response.

The biological effects of conditioning can be profound and varied. For instance, in 1975, Ader and Cohen showed that a flavoring agent administered with an immunosuppressant produced profound immune suppression. After conditioning, the administration of the flavoring agent alone decreased the immune response (Ader and Cohen 1975). In 1973, Laska and Sunshine demonstrated a similar conditioning response to pain medication. In their study, patients were first given analgesics at different strengths, and subjects experienced pain reliefin proportion to the strength ofpain medication administered. Later, patients were instead given a placebo medication. Those patients who had experienced greater pain relief from the higher strength analgesic during the first arm of the study reported greater pain relief with the administration of the placebo. In effect, the patients' prior analgesic experience predicted the efficacy of the placebo (Laska and Sunshine 1973).

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