Background & Aims

Nocebo hyperalgesia is characterized by pain increase following an inactive intervention. Existing research on the mechanisms of nocebo effects has predominantly centered around the role of cognitive processes, leaving emotional processes relatively understudied [1, 2]. Consequently, our understanding of the potential mechanisms underlying the development of nocebo effects may be incomplete. The objective of the present study is to investigate the impact of experimentally induced pain-related anxiety on the magnitude of nocebo hyperalgesia induced through classical conditioning.

Methods

Healthy volunteers are being randomized to one of three groups: 1) classical conditioning of nocebo hyperalgesia; 2) classical conditioning preceded by anxiety induction; and 3) no-manipulation control. Anxiety is induced by the anticipation of electric shock in the anxiety-nocebo group. During the conditioning, the white circle (a placebo) is paired with higher thermal pain, while thermal pain at moderate intensity is provided without any visual cues. To test nocebo hyperalgesia occurrence, participants receive thermal stimuli at moderate intensity during posttest. Pain intensity and anxiety ratings are collected as primary outcomes. Pain expectancies are assessed as secondary outcomes.

Results

Pilot study results indicated a significant increase in anxiety levels after the anxiety induction as compared to the measurement before manipulation (p = .02). Significant differences were found in the mean pain ratings in the posttest (p = .01): participants rated pain higher in the nocebo than in the control condition. Significant correlations were observed between nocebo hyperalgesia and anxiety ratings after the anxiety induction (r = .47, p = .04).

Conclusions

Classical conditioning is effective in inducing nocebo hyperalgesia. Higher state anxiety is associated with a stronger nocebo effect.

Note: the pilot study included only an anxiety-nocebo group. Data collection for the main experiment is ongoing and the results will be presented on the poster.

References

[1] Faasse, K. (2019). Nocebo effects in health psychology. Australian Psychologist, 54(6), 453–465. https://doi.org/10.1111/ap.12392

[2] Geers, A. L., Faasse, K., Guevarra, D. A., Clemens, K. S., Helfer, S. G., & Colagiuri, B. (2021). Affect and emotions in placebo and nocebo effects: What do we know so far? Social and Personality Psychology Compass, 15(1). https://doi.org/10.1111/spc3.12575

Presenting Author

Daryna Rubanets

Poster Authors

Daryna Rubanets

MA

Doctoral School in the Social Sciences, Jagiellonian University, Kraków, Poland

Lead Author

Elzbieta A. Bajcar

PhD

Jagiellonian University

Lead Author

Przemys?aw B?bel

Prof.

Jagiellonian University, Institute of Psychology, Pain Research Group

Lead Author

Topics

  • Placebo