Is Fear of Pain Associated with  Experimentally Induced Nocebo  Hyperalgesia?

Chronic pain is one of the most prominent medical conditions associated with significant limitations in various life aspects. Nocebo hyperalgesia which refers to increased pain perception due to negative expectations about pain plays crucial role in pain chronification. Nocebo effects have also been linked to dispositional characteristics. Studies investigating the role of fear of pain and nocebo hyperalgesia found inconsistent results. This study used conditioning and verbal suggestions hypothesizing that nocebo hyperalgesia will occur. We further investigated the association between fear of pain and nocebo hyperalgesia, expecting a positive relationship. In this study, 27 healthy individuals were randomly assigned to either a control group or a nocebo group in which negative expectancies about pain were induced. This was done by means of conditioning, through pairing electrically painful stimuli with color cues, and by giving negative verbal suggestions about an increase in pain...Show moreChronic pain is one of the most prominent medical conditions associated with significant limitations in various life aspects. Nocebo hyperalgesia which refers to increased pain perception due to negative expectations about pain plays crucial role in pain chronification. Nocebo effects have also been linked to dispositional characteristics. Studies investigating the role of fear of pain and nocebo hyperalgesia found inconsistent results. This study used conditioning and verbal suggestions hypothesizing that nocebo hyperalgesia will occur. We further investigated the association between fear of pain and nocebo hyperalgesia, expecting a positive relationship. In this study, 27 healthy individuals were randomly assigned to either a control group or a nocebo group in which negative expectancies about pain were induced. This was done by means of conditioning, through pairing electrically painful stimuli with color cues, and by giving negative verbal suggestions about an increase in pain related to a color cue and a sham electrode. Pain levels were rated on Numerical Rating Scale (NRS) and compared between groups. Dispositional fear of pain levels was measured using the fear of minor pain subscale of the Fear of Pain Questionnaire-III (FPQ-III). Nocebo hyperalgesia was successfully induced, as reflected by a significant difference (p =.005) in nocebo responding between the two groups. No significant relationship was found between FPQ-III scores and nocebo hyperalgesia. Findings are in line with previous research suggesting that conditioning and verbal suggestions can induce nocebo hyperalgesia. Since no association has been found between fear of pain and nocebo hyperalgesia, future research should investigate this relationship using other subscales of the FPQ-III.Show less

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Is Fear of Pain Associated with Experimentally Induced Nocebo Hyperalgesia?