DISCUSSION
chronic pain, pain, anxiety, hyperalgesia
CHRONIC PAIN
The current study investigated the predictors of nocebo hyperalgesia and nocebo change after interventions aimed at reducing nocebo hyperalgesia in a healthy female sample. This study entails additional exploratory analyses on a larger study,Investigation into the psychological differences indicated that higher trait anxiety and lower optimism predicted larger nocebo hyperalgesia. Only trait anxiety was a predictor of nocebo reduction across groups, which suggests that regardless of which nocebo-reduction strategy is selected, as trait anxiety increases not only the induction but also the reduction of nocebo hyperalgesia increases. This appears in contrast to a previous study, which found that higher levels of anxiety, measured by changes in autonomic arousal, perpetuate nocebo hyperalgesia and lead to resisting extinction.To the best of our knowledge, the current study is the first to suggest that susceptibility to nocebo hyperalgesia is an important predictor of nocebo reduction. A few studies have looked into the influence of prior experiences on subsequent nocebo and placebo effects.There are several clinical implications of our findings. In more than 95% of our healthy female sample, nocebo effects on pressure pain were successfully conditioned with an open-label suggestion. It is possible that in clinical populations, such as with chronic pain, the conditioning procedure results in more robust nocebo effects than in the healthy population. Potentially in chronic pain populations, increased exposure to negative treatment experiences and persistent pain could be associated with larger nocebo hyperalgesiaSeveral suggestions could be provided for future research directions. First, although the investigation of open-label treatment strategies is desirable due to ethical considerations,