CONCLUSIONS
pain, anxiety, hyperalgesia
To conclude, lower optimism and higher trait anxiety predict larger nocebo hyperalgesia. Open-label counterconditioning appears to be an especially promising method for reducing (open-label) nocebo hyperalgesia in individuals who are highly susceptible to acquiring nocebo hyperalgesia. Moreover, individuals with high trait anxiety are likely to benefit from either counterconditioning or extinction, whereas for individuals with low optimism, counterconditioning, compared to control, is more effective. Our findings suggest that susceptibility to nocebo hyperalgesia, dispositional optimism, and trait anxiety might be indicators of a flexible pain-regulatory system that may shape pain experiences in both a negative and positive direction. Research into nocebo-reduction interventions could help personalize interventions to minimize nocebo effects in clinical practice.